Reflective practice

For today's General Dental Council (GDC) registrants there is unarguably a requirement for us to demonstrate our commitment to lifelong learning. Without a doubt this is excellent for us, not just as a profession, but ultimately in the best interest of our patients.

I work with a diverse range of dental professionals who, without exception, are dedicated to learning and developing themselves in order to become the best they can be. I am grateful to call these people my colleagues and I am in complete awe of their dedication to continually reviewing and reflecting on their progress. I have no doubt that on reading this you also share a working environment with similar groups of professional colleagues. The downside of all of their continued professional development planning is the fact that they have become almost fatally flawed. Not because they aren't doing all that they should and can do to develop themselves, and not because they don't take the time to reflect on their personal practice. The flaw is that whilst they are compassionate and kind to others it is beginning to become apparent that, somewhere along the way, they have forgotten to be kind to themselves.

Insight and compassion

On an almost daily basis I hear discussions that demonstrate genuine concern and worries about whether colleagues have ‘done the right thing’. It is human nature to see the world from the inside out1 and it is this egocentric cognitive bias that lends us, in its most raw form, to see the world from our own perspective. Nonetheless over the past ten years I have seen the steady development of insight and compassion that is driven by the need to see the world from another perspective. This can only be a positive thing, following the findings of the Mid-Staffordshire Enquiry led by Robert Francis.2 The move towards the use of reflective practice as a requirement to demonstrate reflection throughout a professional's practising career has been integrated into the undergraduate dental curriculum and identified by the GDC for all registrants, as included in the document Continuing professional development for dental professionals.3 The GDC recommends that time is made ‘to reflect individually or with others on what you have learned following each CPD activity’,3 a process which will no doubt become more formalised in the future, with the advent of ‘enhanced CPD’ on the horizon in 2017.

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Barriers to effective practice

Whilst the many perceived virtues of using reflective practice are extolled by our statutory regulatory authority, I have become increasingly aware of the barriers to effective reflective practice. As a DCP I have just completed my doctoral research on the use of reflective practice in educational activities and whilst I am a complete convert to incorporating reflective practices into my professional life, I have also gained insight and understanding of the factors that can potentially hinder reflective processes. What stands out for me most is the way that we criticise ourselves when things are not what we consider to be perfect. Life, by its very nature and form, is messy and complicated. Yet we seem to take great delight in berating ourselves when things don't turn out the way we expect them too.

Take a step back

It is at this point that I feel that practitioners should take the time to show themselves some self-compassion. Self-compassion4 has been described as acting towards yourself in the way that you do towards others when they have got something wrong. For example, how often do you internally berate yourself for not doing something right, in a way that you would never dream of speaking to someone you know and care for? Sometimes we need to take a step back and remember to be warm and understanding to ourselves when things have gone wrong. Take the time to speak to ourselves with the same way we would choose to speak with others. By managing life's little upsets in this way, we are not letting ourselves off, just recognising that everyone makes mistakes; we just need to deal with ourselves in a kinder way. This doesn't mean that we won't reflect or improve; it is just a more mindful and less stressful way of improving ourselves and the habits that we have established.

Habits, by nature, are reflexive and accessible;5 we call upon our skills in a dental environment utilising them routinely in a seamless way. This however, does not mean that our habits are not adaptable, should we so choose. What we need to establish is a culture of deliberating and reviewing our own role in what has gone wrong, then take the time to reflect and consider if changing the way we do something would be of greater benefit to ourselves and our patients, giving consideration to what skills we need to develop (would a course help us to learn and cement this new skill or activity?) and then ... congratulate ourselves on taking the time to identify the ‘problem’ and finding a way to solve it.

Removing the stress

Using our professional colleagues to develop our reflective practices can be an extremely useful way of taking the stress of isolation out of the situation. By sharing our worries and concerns with our professional support network, we allow ourselves to develop, not just professionally but also emotionally. As the old saying goes: a problem shared is a problem halved.

Face to face discussion is no longer a prerequisite for sharing our reflections. Providing we respect anonymity and confidentiality there is a whole raft of ways to develop professional support networks in which we can support one another. Ultimately, we should make time to remember that the underpinning benefit of reflective practice is the opportunity to recapture experiences in order to become more self-aware of one's own personal practice - not to berate ourselves, becoming embroiled in a cycle of self-pity and loathing - but to enter into a process which is the pivotal element at the heart of a life-long learning journey. We should use reflective practice to provide affirmation, improvement and development for future professional practice.

Joanne Brindley also wrote The benefits of mentorship for the dental team. This was published in BDJ Team in May 2016. Visit http://www.nature.com/articles/bdjteam201685