Written reflection in NHS appraisal: time for an alternative

Curtis et al provide reflections on National Health Service (NHS) as key part of their continuous learning and considered essential for professional competence. The General Medical Council (GMC) states that doctors 'should regularly reflect on their own performance'. Reflection may be verbal (for example, through discussion with colleagues), internal (thinking about what they have done), or written (unstructured, for example, in a diary, or structured by use of a pro-forma). Most GPs do find reflection valuable, reporting that it is embedded into their daily routines -at work, on the way to and from work, and at home. Some feel that reflection can help with processing thoughts and feelings, describing it as 'therapeutic' and 'cathartic' in helping to process emotionally difficult situations.