FD Handbook


The Benefits of Reflection

From the start to the end of your foundation training year, you will be exposed a variety of learning and professional development experiences. With each experience, comes an opportunity for you to take a step forward on your year long journey to become a competent dentist.
It is when you take a moment to think seriously, during or often after your experience or an event that starts the process for you in reflecting. As you reflect, it will be your thoughts and feelings about your new experience that will come to you, and by linking these with the old experiences, you will have a revelation or a new meaning about what you reflected upon.
The benefits for you when you regularly and continually reflect is that you become a better dentist because you will

  • come up with theories, improve your critical thinking, and enhance your learning
  • become self-aware understanding your abilities and your limitations
  • know about future learning needs
  • develop safe and sound practice with improved outcomes for patients


Reflective writing in DFT

The E-Portfolio requires you as a FD to write about your experiences, with a view to demonstrating your learning and development. Some elements of the E-Portfolio logs take the form of reflective writing.
Reflective writing follows on from your reflective thinking. So how do you go about this? It can be viewed simply as a three stage process.


First, identify and look back at something (such as an event i.e. something that has happened. However, it could be an idea or object)


Then, analyse the event or idea (you should think deeply and from different perspectives or viewpoint. Then try to explain, often with reference to the subject matter concerned)


Finally, think carefully about what the event or idea means for you now and for your ongoing progress as a professional dentist.

Reflective writing therefore has a purpose but importantly has to be personal to you. Your piece of writing will be: relevant to you and so it will have originality and be written in your own style. It needs to be coherent and easy to follow. It is your own story!

You should complete the reflective elements of the E-Portfolio such that the person reviewing it is clearly informed about every stage of your reflection. The reflective writing if written well enough, will provide justification of new learning. Only then will the reviewer of your training records clearly understand and accept that you are progressing at the required pace in this foundation training year.

It is always a good idea to reference particularly if referring to sources of material.  It is helpful for the reader to see a reference to the competency concerned. The DFT curriculum serves as a useful document for this purpose.

Description v Reflection

There are different types of e-portfolio logs where you are required to reflect, these being: reflection on the learning from tutorials; the learning from study days; and there  are also general reflection logs on learning derived from anything that falls outside tutorials and study days.      Logs    

As you explore the layout of the e-portfolio logs, you will quickly notice a pattern. That is, the initial part of each log requires you to write a description to introduce what it is that you will then reflect upon. It is important to separate out this description from the reflection that will later flows from it.
So what do you write in the description section of logs? Anything relevant is acceptable, for instance you may write about the description of topics, events, incidents, achievements, concerns, challenges, difficulties, problems, or any other experience that is relevant to the log or pertinent to the stage of your learning. Description must also state and refer to the curriculum competencies or domains covered in that log.  
Once you have completed the description part of the log, your next task will be to write reflectively as instructed above. For this section, unleash your thinking power to gain the maximum benefit. If you get stuck at any point, then consider questioning yourself as a prompt to kick start your thinking once more.
Here are some useful list of questions as prompts for writing:

  • Why did you choose to reflect on this? Is there a significance in any way?
  • What went well for my patients? For me? How have I applied this for all my patients in practice?
  • What did not go well for my patient? For me? And how do I feel about this?
  • What could the patient be thinking? Did the patient respond in anyway? What does that tell me? Were there any body language signals that helped me? Was there any patient reaction? What did they say?
  • What do I think happened? Why do I think this happened? How do I feel about this?
  • Was there anything that came in the way or did not help my patient? Or me?
  • What issues have I identified as being personal to me? How does this affect my values and beliefs?
  • What were the difficulties and why? What can I do next time to avoid these?
  • Were there unexpected outcomes? If there is something I can change for the future what will that be?
  • Was there any feedback from my nurse that I should consider? From my Educational Supervisor? Are my thoughts similar or different in any way to my Educational Supervisor? How did the revelation make me feel? How can I use this feedback from improvements?
  • What exactly were the learning points? What impact has this had on your learning? Why has this reflection been useful for my own learning and development as a dentist?
  • What do I still need to do? What are my new learning and development needs? What do I need to do to progress? How can my patients benefit?
  • Do I see any patterns in my day to day experience? Do I see a pattern across time?
  • What can I now do differently as a direct result from this experience? How has this experience helped/hindered me to meet the standards/competencies?
  • Who can help me further my knowledge or skills? What resources do I need and how can I find these?
  • Following the event, my action plan is….  And the timescale is….
  • Some of the things that have happened since the event are…


Examples of reflective writing

Below are three examples of how a poor piece of writing could be transformed into a good reflective piece of writing

Instead of:

This week I had to cancel one patient at the time of his appointment because her laboratory work had not arrived on time. There were unexpected delays. The technician should have told me that the work will not arrive. Systems need to be changed so that next time I can ensure this does not happen to anyone else to avoid patient complaints.

this is much better:

There were several lessons I learned from the incident where I had to cancel my patient who had just arrived for their denture fitting appointment because of laboratory work that had not returned from the laboratory. It was embarrassing for me to have to explain the situation to the patient, being honest with her about the reason why I could not fit the denture at this time. I found myself in a little difficulty here, lost for words except I remembered to provide my sincere apologies for lack of organisation on my part and will investigate the reason why we did not have her work. I saw the disappointment on her face. I understood her time was precious, her trip to see me had been wasted, and also my surgery time was unused. I later found out that the laboratory work that should have arrived the day before was delayed because the technician had a family emergency. It would be a reasonable expectation for my patient to have known this in advance of their appointment, about the reasons behind delays. That way alternative arrangements that are mutually agreeable could have been made. I believe that to prevent such incidents that could lead to patient dissatisfaction, it would be good practice to check laboratory work is logged as in practice being available the day before the patient’s appointments. Whilst I was sensitive towards the technician who found himself called to the emergency, I also think that there can be improvements in communication between the technician and practice. My nurse also said to me that this was not an isolated incident as she recalled that two weeks ago there was another laboratory item needed for an associate colleague that was also delayed   I want to bring these points to the attention of my team, so I have included an item on next week’s practice meeting agenda to discuss with my team a revision of system avoiding a similar situation for anyone else.

Further important advice

At all stages of your reflections, please be aware that your E-Portfolio is a document that may in some circumstances be seen by others, some outside the profession, almost certainly in serious cases where a significant event involving a patient had occurred. For this reason it is essential that in all your reflections you do not refer to patients by name and that you do not describe events as mistakes or accidents. A useful course of action  to remember is:Keep reflections anonymous and target the learning from the event rather than the details and the angst of the actual event.