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Review: REFLECTIVE PRACTICE WRITING AND REFLECTIVE DEVELOPMENT

Gillie Bolton
Sage

256 pp £19.99

By Lesley Morrison
Contact the author via Chris Johnstone by e-mail at christopher.johnstone@ntlworld.com

I've just been indulging in some deep reflection. Actually, I've been preparing for my appraisal but deep reflection sounds much more appealing. And reflective practice is, indeed, at the heart of personal and professional development.

Gillie Bolton is well qualified to write about it. A writer and poet, she is a senior research fellow in the English department at Kings College, London, and she has worked for many years facilitating seminars and groups and encouraging people to use reflective writing as a way of processing, and learning from, difficult or challenging experiences. Her previous books have addressed the therapeutic potential of writing and this book promotes writing as a valuable part of reflective practice. Anyone fortunate enough to have participated in one of her reflective writing workshops will have an insight into its potential power. She quotes a colleague as saying that, “We do not “store” experience as data, we “story” it”. Through stories, and narrative, and writing we reach an understanding of the human, and our and our patients' conditions. Especially at a time when our work involves recording and storing data, it is important to keep our imagination and curiosity alive through listening to and appreciating the stories.

The Einstein quote which prefaces the book sets the tone, “Knowledge is limited. Imagination encircles the world. The author suggests three foundations for reflective practice; certain uncertainty, serious playfulness and unquestioning questioning. She distinguishes between reflection as examination of practice (as opposed to confession), re-view and reflexivity, asking, “what are the mental, emotional and value structures which allowed me to lose attention and make that error?”. She addresses issues of trust and professionalism. The jury is currently out on the value of professionalism and the extent to which trust is the foundation of the relationship between doctor and patient. The pendulum is still hovering between the art and science of medicine and, for each of is, it rests most comfortably in a slightly different place but, for all of us, especially those of us in general practice, finding ways of accepting and dealing with uncertainty and risk is fundamental. As doctors our training and assessment has tended to be in facts, we are encouraged to be cerebral. Often, in practice, we need to listen to our instincts. Enter Pooh, quoted by Bolton,

“Rabbit's clever,” said Pooh thoughtfully.

“Yes”, said Piglet, “Rabbit's clever”.

“And he has brain”.

“Yes”, said Piglet, “Rabbit has brain”.

There was a long silence.

“I suppose”, said Pooh, “that's why he never understands anything”.

One of my colleagues is in the process doing an extraordinary job of creating a comprehensive contract reference document for the practice. As far as I am concerned, one of his greatest achievements has been helping me to see that the GMS contract can be an aid, not a deterrent, to holistic, reflective health care. Further evidence that the art and science of medicine are symbiotic.

Reading this book is valuable but it is very much a second best to attending a workshop, to beginning to engage with reflective writing, to doing. It serves to whet the appetite. At times, it risks causing mild indigestion. Some sections are rather dense with quotes, references and allusions to authors' work. The book is at its best when it touches on our daily experiences and encourages us to document and process them, when it offers techniques and ways of getting started. Saul Bellow, in a recent Radio 4 interview, talked about how people are happiest when at deep play, when they are focused and creative.

Roll on appraisal...

Other hoolet online articles by Lesley Morrison can be found at:
hoolet edition 49 - Review: Reflective Practice Writing and
Reflective Development
hoolet edition 49 - Enjoyable Journeys
hoolet edition 45 - Read All About It
hoolet edition 43 - Whistle-Blowing
hoolet edition 38 - Hope For Palestine?
hoolet edition 36 - Letter To The Editor
hoolet edition 32 - Letters To The Editor
hoolet edition 27 - The Bag Lady
hoolet webextra - Edinburgh Restival Review

Other hoolet reviews by Lesley Morrison:
Reflective Practice Writing and Reflective Development

hoolet is the magazine of RCGP Scotland. It is supported intellectually, financially and emotionally by RCGP Scotland.

This issue maintained by Robert Hallam.