Reflective Practice (RP) is mandated in the professional role of a Urologist and this is evidenced in their annual appraisal and quintenial revalidation returns. Urology trainees are also required to show competence in RP at their ARCP’s through various work based-assessments .Reflective practice is ‘the process whereby an individual thinks analytically about anything relating to their professional practice with the intention of gaining insight and using the lessons learned to maintain good practice or make improvements where possible. RP may occur ‘in practice’ as in thinking on your feet or more often ‘on practice’ as in thinking after the event . It should be performed regularly as a self-assessment tool to avoid complacency and to promote personal and professional development and most importantly to maintain or enhance best patient care. A good framework of RP is the Driscol model which has 3 stages . Firstly , ‘What happened “, secondly ‘So what ‘ and thirdly ‘Now what ‘.It is important to recognise that the proper endpoint of RP is to crystallise the outcome(s) in writing in a journal, diary, blog, tweet or e-portfolio as this allows subsequent validation at a later time by a third party, for example at annual appraisal. This ensures that any newly acquired learning is not lost which might be the case if only conversation with a colleague is used. Clearly thoughts alone may not endure. Learning happens when thoughts are put into language, written or spoken. Furthermore, insights alone are not enough, it’s the action you take with newly acquired insights that matters.
Formal RP, using Driscoll’s model, should be prompted by significant experiences or situations which are readily characterised by the need for remedial end-point translational or transformative management and system change. These situations do generate important new learning and should be recorded using a standardised template uploaded into an e-portfolio. Most daily RP however is actually done informally, naturally and instinctively, using considered thought and intuition .. We might call this “small RP” (informal) as opposed to “big RP” (formal). Small RP regularly monitors clinical practice through checking that accepted standards in all domains are being maintained and if they are not, then minor process change(s) maybe required and subsequently audited. Small RP may need to become big RP if the situation is not resolved .
The benefits of formal RP for the Urologist are those of improved self-awareness, self-development, and the validation of their professional performance in all domains which can drive CPD and life-long learning. Regular informal and formal RP attends to emotional intelligence and promotes the ability to inspire, influence and motivate colleagues. Its consistent use also enhances innovation, good judgement and heightens awareness of risk. Through better emotional management of oneself, we may become more compassionate to others. Regular review of one’s emotions offers an opportunity for a Urologist to be aware of their resilience and be proactive in its management when necessary The current literature suggests that burn-out is a condition endemic in its own right amongst clinicians and urologists in particular and which has now been exacerbated by the Covid-19 pandemic ..When self-awareness suggests loss of resilience it is time for the individual to seek help through developmental mentoring which is available at www.mentoringmedics.co.uk

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