Welcome to the WellMedic GP trainee portfolio guide. If you’re looking to reflect at ease, this is the guide for you! This guide will focus on several actionable points that you will implement into your portfolio entries and is helpful for GP trainees at all levels.
Welcome to the WellMedic GP trainee portfolio guide. If you’re looking to reflect at ease, this is the guide for you!
In my personal opinion, GP trainees often struggle with reflecting. This isn’t because reflecting is difficult; it generally comes down to inefficient use of the GP trainee portfolio.
This guide will focus on several actionable points that you will implement into your portfolio entries and is helpful for GP trainees at all levels.
If you find this to be helpful, please share it with your colleagues!
What will we cover?
The reflective learner
Are you a reflective learner? A critical questions to consider before reading this blog post. If you don’t consider yourself a reflective learner, rest assured, three years of GP training will help showcase your inner reflector.
At some point in your training, your educational supervisor may ask you to complete a learning quiz. A standard recommendation is Honey and Mumford, which identifies four distinct learning styles or preferences: Activist, Theorist, Pragmatist and Reflector.
In theory, knowing your particular style helps you maximise your learning opportunities by making learning more effective and, most of all, more enjoyable! I’m no expert in the Honey and Mumford quiz, but I’d like to share some characteristics from the “reflector” learning style and how this ties in nicely with the GP trainee portfolio.
Reflectors learn by observing and thinking about what has happened. They prefer to stand on the sidelines and view experiences from several perspectives. By doing this, reflectors can collect data, analyse it, and then work towards their appropriate conclusion.
Although reflection comes naturally to some doctors, reflection is a professional habit that we all possess, which often goes unrecognised.
“Reflecting is very similar to driving a car.”
Think about the last journey you made. How many of your driving decision can you recall?
Do you remember why you chose to change lanes? Or maybe why you decided to slow down? Generally speaking, it’s a subconscious experience, and it’s hard to pinpoint every decision and write it down. Similarly, in our clinical practice, we are continually making decisions.
After my most recent clinic experience, I’ve counted making at least 50 decisions across two clinical sessions. If I were to write those decisions down, it would be pretty tricky to do so.
Key take-home – Don’t go looking for the reflection. There will be a case that comes to you!
Try this: We often use the drive-home as a time to switch off, but if you’re like me, there’s always a patient that sticks in my mind. It may be an unreasonable patient, you may have had some positive feedback, or you may have implemented some new learning. These are the cases that can form great reflections if you can figure out why they’re on your mind.
What is a reflective cycle?
You will repeatedly create a personal development plan directly based on reflective learning theory during your GP training. Ultimately, your personal experiences will drive your learning needs. In 2020, the RCGP co-launched the new GP trainee portfolio with FourteenFish; having used their older portfolio, this is an astronomic improvement!
We will be covering the critical components of the GP trainee portfolio entries later in this guide. Before we do this, I’d like you to become familiar with some of the key reflection steps and how you can draw inspiration from each stage. To demonstrate this, I’m going to focus on the Gibbs Reflective Cycle.
Description – each of your portfolio entries will require a brief description, just enough to provide context to the reflective entry.
Feelings – as we progress through our careers, we are probably less aware of how we feel about a situation as our mind makes rapid judgments to help us proceed. Breaking down exactly why you’ve made a decision is beneficial.
e.g. what was it about this UTI that made you worry?
Evaluation – now every reflection may not require you to over-analyse every aspect, but if you’re able to pin down the positives and negatives from within an experience – it quickly moves onto our next point.
Conclusion – is there something else that you could have done? Is there something that you would do again?
Action plan – what’s going to happen when you re-encounter this scenario? Alternatively, can you identify a learning knowledge gap commonly referred to as the Doctors’ Educational Needs (DENs)?
Key take-home – create your own learning needs by analysing your performance.
Try this: Close your learning loop. Use your clinical case reviews to identify your DENs. Then complete your DENs by uploading supporting evidence under CPD and supporting documentation within the GP trainee portfolio.
Does reflective learning have to be glamorous?
Far too often, trainees seek out complex cases to use as reflections in the GP trainee portfolio. Which often happens in the first six months of GP training. Unfortunately, for some trainees, this cycle continues until their ARCP.
How can I make easy GP trainee portfolio reflections?
- Keep your GP training reflection short!
There will always be a natural tendency to write and write! This isn’t particularly efficient for you, nor is it efficient for your trainer, who will have to sieve out the critical pieces of information. When describing the case, tell me exactly what I need to know.
An 18-year-old patient attended the A+E department with an 11-day history of fever, with lower abdominal pain and diarrhoea. She had no other medical problems and took no regular medications. Her last period was six weeks ago, and this was unusual for her. I reviewed the patient, and I noticed that she was very tender in the right iliac fossa during my examination, which made me consider appendicitis as a diagnosis.
However, the nurse conducted a pregnancy test, which came back as positive. I was now in a position where I had to discuss the case with the gynaecology and surgical team to see who would first accept the patient for review.
As part of my management plan, I prescribed this patient IV fluids, gave her IV analgesia and took blood tests, including a group and save.
The patient was accepted under shared care with both specialities and subsequently underwent an abdominal ultrasound scan, confirming an ectopic pregnancy.
I reviewed a generally fit and well 18-year-old patient during my A+E shift, who presented with an 11-day history of fever and lower abdominal pain. My initial concern was that this patient had appendicitis. However, following a positive pregnancy test, the patient had an ultrasound scan, confirming an ectopic pregnancy.
- Use your GP trainee portfolio strategically!
To demonstrate the best use of the GP trainee portfolio, I need to introduce you to the RCGP Capabilities and the Clinical experience groups.
RCGP WPBA Capabilities
In my “What is the GP trainee portfolio?” guide, I mention that the portfolio and workplace-based assessment (WPBA) work in tandem to evaluate our progress in areas of professional practice which are best tested in the workplace.
The WPBA Capabilities are the thirteen areas of professional practice that must be deemed competent or excellent by your final ST3 review. The capabilities are tested across all of your portfolio assessments.
Some of your assessments are better suited to specific capabilities, whereas other capabilities are best suited to your clinical case reviews (previously considered log entries). This will become more apparent as you work through the GP trainee portfolio.
There is little benefit in repeating all thirteen capabilities, as the RCGP has done an excellent job of summarising them. I will help you to demonstrate the capabilities whilst avoiding unnecessary duplications of the same capability. Trust me when I tell you that this is a recurring trend amongst GP trainees. If you’d like to see a complete list of your expected capabilities – please click here.
RCGP Clinical experience groups
The RCGP curriculum has recently been updated, and there is a new approach to linking with clinical experience groups. Previously, GP trainees were expected to link their entries to twenty-five clinical experience areas, and the aim was to demonstrate a broad exposure over your three-year curriculum.
You’d be pleased to know that the GMC has now approved nine clinical experience groups.
Why does this matter?
Clinical experience groups and capabilities are essential in completing your educational supervisor report bi-yearly.
For August starters your first review will occur around January and the second is often shorter, occurring in May or June.
Each review is mandated to demonstrate three pieces of evidence for each capability from within your GP trainee portfolio. In an ideal scenario, three pieces of evidence for each clinical experience group should also be linked. However, this may not be possible in certain hospital specialities.
How to be strategic when linking evidence to your GP trainee portfolio?
In every assessment and reflective entry, you will choose the relevant clinical experience groups and capabilities demonstrated.
You can link a maximum of three capabilities and two clinical experience groups per entry. You will justify why you’ve met the capability, and your supervisor will share their thoughts if they agree with the selected capability.
The common mistake that occurs is often within the capability section. GP trainees will continually link to the easy capabilities, such as “Communication and consultation skills”, whereas we struggle demonstrating evidence in “Organisation, management and leadership.” If we take our earlier example of the ectopic pregnancy case, I will demonstrate how you evidence specific capabilities.
Working with colleagues and in teams:
I have demonstrated this capability as I have communicated proactively with team members to enhance patient care using an appropriate mode of communication for the circumstances.
During this case, I specifically coordinated patient care by speaking with the surgical and gynaecology doctors. During my verbal handover, we were able to synchronise the patients care under a shared-care agreement.
Now how would you link this towards “Organisation, management and leadership”?
Organisation, management and leadership:
I have demonstrated this capability as I am well organised with due consideration for colleagues and patients. I have shown effective: time-management, hand-over skills, prioritisation and delegation in this case.
This case occurred during a busy A&E shift, and I concurrently saw three patients waiting for outstanding investigations. The cases were not urgent, and I knew that I had to balance my time across them. I prioritised the most acute, handed one issue to my colleague and apologised to the other for the delay.
If you’ve found this guide to be helpful, please share it with your colleagues!
In the meantime, you may want to know how to complete a clinical case review with example reflections. Click here to read “Example clinical case reviews for GP trainees. GP trainee portfolio reflection guide.”