English and Reflective Writing Skills in Medicine

By Clive Handler, Charlotte Handler and Deborah Gill

Radcliffe Publishing (2011)

Review by Carol Parker

For medical students, as well as postgraduate clinicians, reflective writing is challenging as it is emotive, personal and subjective. Engaging with subjectivity is often (but, I acknowledge, not always) a new experience for those from a medical background. Writers frequently wrestle with a fundamental shift in approach/perspective, from seeing the world 'objectively' (that is, in terms of hard facts or as entirely evidence-based), to acknowledging the need to trust their own thoughts and feelings through grappling with the notion of subjectivity.

Reflecting on learning experiences through clinical encounters, peer-to-peer or supervisory discussions, practical procedures, self-directed learning or conferences remains an essential part of continuing professional development for healthcare professionals. Reflection also feeds into appraisals and job applications, and is a central characteristic of meeting the requirements of revalidation. Enhancing the contribution an individual might make in medicine requires the capacity to reflect on performance.

This book will be valuable for anyone engaged in developing their own, or supporting others', reflective writing. Adopting self-criticism and self-analysis of a clinical event or encounter requires insight and independent thinking, and the ability to work through possible changes. The book attempts to support the reader to engage in reflective writing through a range of constructive approaches.

Chapter One offers a useful overview of the utility of reflective writing in medical contexts, grounding the practice by drawing on a range of definitions, ranging from Dewey's in 1933 up to Moon's in 1999. It offers a clear introduction to and rationale for reflective writing in general, situating the process in a medical context. This first chapter comprises a simple overview to reflective writing in any specialism, the writing style itself is clear and jargon free.

Chapter Two considers common pitfalls of writing 'good English', which is useful for those for whom English is not a first language, and refreshing for those for whom English at school seems a long time ago!

Chapter Three onwards consists of 'The Essays'. Perhaps these excellent resources would benefit from brief introductions to their utility. Reading the book in a non-linear fashion might be confusing if this and subsequent chapters were the first to be encountered by the reader. I wondered if a short signposting paragraph at the start of each chapter, describing how it might be used, would remedy this situation.

The framework provided draws on a range of third year University College London Medical Students' writing. Students were informed that their essays would be published as originally submitted, to highlight to the reader both satisfactory and unsatisfactory examples of reflection, and that their English writing ability would be commented on. In reviewing examples of more and less successful reflective writing, the reader has a unique opportunity to examine what is involved in developing a piece of reflective writing. These examples and comments from the marker enable the individual reader to develop professionally, regardless of what stage they are at in their clinical career.

The rest of the book provides further examples of student's attempts at reflective writing, with feedback on specific problems with suggestions as to how the writer might amend their writing to move towards a more reflective genre. These examples provide a powerful and authentic insight into the challenges of reflective writing, with useful feedback for those new to the process of responding to students' reflective writing. Overall, this is a useful resource that clearly explains the nature of reflective writing, considering common pitfalls when writing English and providing the opportunity to engage with and evaluate a wide range of real examples.

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