Re: How should doctors use e-portfolios in the wake of the Bawa-Garba case?
I do not think this article has provided any doctor with any reassurance at all about the portfolio. In fact, a consultant’s reflections were used in the Bawa-Garba case which appear to have caused considerable harm. The reality is that, as a lot of doctors have told me (particularly trainees) they are frequently put in an impossible situation with regards to ‘reflection.’
On the one hand one is asked to reflect honestly and on the other hand supervisors specifically order them to document about what they have done wrong. Discussion of systemic errors is described as being non- reflective. There is a fixation about stating what YOU have done wrong and in some cases colleagues have complained to me that they felt coercion to document matters in a fashion that could be self incriminating by their supervisors.
Failure to do so is met with threats to career progression through reporting to ARCP for being non reflective, referral to GMC for failure to adhere to duty of candour and so forth. Furthermore, they have spoken of how supervisors have documented ‘reflectively’ matters in a fashion to apparently apportion blame onto their trainees to cover themselves.
The reflective portfolio has become a tool by which to apportion NHS failings onto doctors. Unless this material is privileged and protected from disclosure for litigation it will be a persistent legal threat to doctors.
Trainees are extremely vulnerable. I could not recommend a career in medicine unless this situation is resolved. Doctors are effectively being told to self-incriminate themselves for systemic failings and to divest blame from senior doctors in a supervising capacity as well as non medical managers. Enter a career into this profession in the UK at your peril.....
Rapid Response:
Re: How should doctors use e-portfolios in the wake of the Bawa-Garba case?
I do not think this article has provided any doctor with any reassurance at all about the portfolio. In fact, a consultant’s reflections were used in the Bawa-Garba case which appear to have caused considerable harm. The reality is that, as a lot of doctors have told me (particularly trainees) they are frequently put in an impossible situation with regards to ‘reflection.’
On the one hand one is asked to reflect honestly and on the other hand supervisors specifically order them to document about what they have done wrong. Discussion of systemic errors is described as being non- reflective. There is a fixation about stating what YOU have done wrong and in some cases colleagues have complained to me that they felt coercion to document matters in a fashion that could be self incriminating by their supervisors.
Failure to do so is met with threats to career progression through reporting to ARCP for being non reflective, referral to GMC for failure to adhere to duty of candour and so forth. Furthermore, they have spoken of how supervisors have documented ‘reflectively’ matters in a fashion to apparently apportion blame onto their trainees to cover themselves.
The reflective portfolio has become a tool by which to apportion NHS failings onto doctors. Unless this material is privileged and protected from disclosure for litigation it will be a persistent legal threat to doctors.
Trainees are extremely vulnerable. I could not recommend a career in medicine unless this situation is resolved. Doctors are effectively being told to self-incriminate themselves for systemic failings and to divest blame from senior doctors in a supervising capacity as well as non medical managers. Enter a career into this profession in the UK at your peril.....
Competing interests: No competing interests