Ohsun Kwon graduated in 2013 from King's College London. After completing Dental Foundation Training last year, Ohsun is now working as a Dental Core Trainee in Oral and Maxillofacial Surgery Department at Salisbury District Hospital.
Here I will share my own experiences of how reflective exercise has benefited my professional development. I also hope that the article gives a clearer guidance of how and when reflections can be done.
Background
I was first introduced to the concept of reflection during fourth year of dental school, by one of my clinical tutors. To be frank, reflection was something that I have overlooked at until graduation; the BDS itself had a busy schedule that we all were struggling, with case presentations, written exams, quotas and so on...
After graduation, came the dental foundation training (DFT). Reflection now became a mandatory exercise; it was not an option anymore. Here we go, I said to myself. I still remember how I found it hard to write the first few reflective logs on the e-Portfolio (ePDP), as I was not used to doing it on a regular basis.
As our DFT progressed, we all started to face various challenges that we didn't come across at dental school. Sometimes it was the pressure of running late with clinics, other times we were having difficult interactions with patients. One big difference that everyone realises after leaving dental school, is working with more independence. Although the trainer was always there to provide support, we now have more responsibilities in solving problems ourselves, both clinical and non-clinical. For example, one clinical area that I struggled in the early months of DFT was with large MOD amalgam restorations, which would crumble every time I removed the matrix band from tooth!
How did reflections help me?
Initially, I thought that making progress in DFT was a matter of practice after practice, and that over time everything would come by second nature. I was wrong. I realised how same mistakes would repeat if I didn't put thoughts into why it went wrong, and actually made changes to correct them.
This was where reflections came helpful. I believe most of improvements that I have made are result of reflecting upon situations and incidents that had happened to me throughout the DFT year. Sometimes it was straightforward, other occasions it was more of trial and error; overall the exercise allowed me to take a logical approach in finding solutions. And now, I will explain specifically how I reflect on every kind of situation.
The Steps of Reflection Exercise:
In the ePDP reflection log, there are four main questions to answer:
1. Nature and details of the case or incident:
It can be anything, clinical or non-clinical. Usually we tend to think of negative situations - from extraction techniques, pressure of running behind in clinics, or the unpleasant experience of dealing with an adverse incident. Anything positive should be reflected upon as well, because if you can figure out why you are doing well, you can reproduce the performance and apply the same principles into other areas.
I find it very helpful to write about the event in good detail, so when I look at it later I can remember exactly what had happened at the time. It is important to recognise the significance of the event - for example, if you were under time pressure, think how your standards of clinical care or record keeping may have suffered.
2. Where the situation went well, bad, or was difficult:
Here, you are self-assessing whether you have made a good progress, or if you are at the beginning of a steep learning curve. It is perfectly fine to be honest here; we all have different strengths and weaknesses, and by no means are we expected to be capable of doing everything from the first day of dentistry. The DFT year is there to learn and demonstrate that you can identify and work on the areas of weakness.
3. Feelings that went through the situation:
Try to recall how it felt at the time, and how it feels retrospectively. What may have been a stressful situation, in hindsight you may think differently and realise that it was a much more comfortable situation than how you felt at the time. It is a good idea to question how others could have felt, as it shows that you are not only dealing the situation itself, but also that you have made an insight into looking after the patient and colleagues at the same time.
4. Analysis
Time to bring all ideas together. List every possible reason that could have led to the event, and things that you could do differently if the same situation came again. Try to be realistic in setting SMART (specific, measurable, achievable, relevant, timescale) targets, as changes can take time and over several stages. For example, if you are working on your posterior composite restorations, it is unrealistic to expect improvements to be made overnight. A more realistic approach would involve reviewing your current technique that you are using at the moment, and possibly discuss with your colleagues and trainers. Take a step further, you can attend extra hands-on courses, take photographs of your own work, and possibly carry out a prospective audit.
Summary
Consider reflections to be an on-going and continual process of refining your own practice, and not simply as a one-off exercise. If used effectively, it can be a powerful tool in identifying and making progress for your own learning.
- Ohsun Kwon
- [email protected]