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How should doctors use e-portfolios in the wake of the Bawa-Garba case?

BMJ 2018; 360 doi: (Published 08 February 2018) Cite this as: BMJ 2018;360:k572
  1. Clare Dyer, freelance journalist, London, UK,
  2. Deborah Cohen, associate editor, The BMJ, London, UK
  1. Correspondence to: C Dyer claredyer4{at}

Clare Dyer and Deborah Cohen look at the professional advice on personal reflections

The case of trainee paediatrician Hadiza Bawa-Garba has rocked the medical profession from top to bottom. Doctors fear that their written reflections about mistakes made, intended as an important tool for personal learning, could be used against them in court. There are widespread worries that doctors will be less than frank in their reflections, threatening the learning culture that patient safety demands.

Did Bawa-Garba’s reflections feature in the crown court trial that led to her conviction for gross negligence manslaughter?

The Medical Protection Society (MPS), which defended Bawa-Garba against the prosecution, said the documents from her e-portfolio “did not actually go on to form part of the evidence before the court and jury. Indeed, the court was clear that reflections were irrelevant to the facts to be determined and that no weight should be given to remarks documented after the event.” The MPS acknowledged, however, that it “may well have been the case” that the reflections, as The BMJ has stated, “fed into the trial.”1

How so?

Stephen O’Riordan, a …

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