REFLECTIVE PRACTICE GUIDANCE SHEET

REFLECTIVE PRACTICE

GUIDANCE SHEET

Who should read this guidance sheet?

This guidance sheet is for everyone involved in the reflective elements of revalidation. That

includes nurses, midwives and nursing associates who are revalidating, and nurses, midwives and

nursing associates who have been asked to take part in a reflective discussion as a reflective

discussion partner.

This sheet provides some general principles for everyone on our register to consider when

undertaking reflective practice. It also gives you information about how to meet the reflective

requirements for revalidation, including what you need to tell us as part of your application.

We have specified when there are particular activities for the reflective discussion partner.

Principles of reflection

Everyone on our register

Reflection allows you to make sense of a situation and understand how it has affected you.

It allows you to identify areas for learning and development to include in your professional

development objectives and supports sharing and learning from other professionals. Reflective

practice is a way for you to consider how you can put changes or improvements into action in

your everyday practice.

To help guide your thinking when you are undertaking a reflective activity, whether as part of

revalidation or as part of your everyday practice, you could consider the following questions:

• What key things did you take away or learn from this experience/feedback?

• How did you address any issues or problems that arose?

• What would you do differently, if anything, next time around?

• How has it impacted on your practice?

• Are there any changes you can quickly apply to your practice?

• Are you able to support yourself and other colleagues better?

• What can you do to meet any gaps in your knowledge, skills and understanding?

Reflection and revalidation

Everyone on our register

We believe reflection is an important part of the practice of everyone on our register. We have

included two reflective requirements as part of revalidation: five written reflective accounts and

a reflective discussion with another nurse, midwife or nursing associate on our register. Below

we provide you with more information about how to meet these requirements.

For more details of the reflective accounts and reflective discussion, and the other revalidation

requirements and how to meet them, please see How to revalidate with the NMC. We also

provide a range of supporting information about the requirements, including a video of people

revalidating discussing their experiences of the reflective discussion on our website.

Five written reflective accounts

Nurses, midwives and nursing associates who are revalidating

These accounts should be based on either instances of (or a combination of) your CPD, feedback,

or an event or experience in your practice. They should be from the three year period since

you last renewed or joined the register. You should reflect on both positive and constructive

experiences. You should explain what you learnt, how you changed or improved your practice as

a result, and how these real-life experiences link to the four key themes of the Code (prioritise

people, practise effectively, preserve safety, promote professionalism and trust). You might find

the questions in the Principles of reflection section above helpful to guide your thinking.

The written reflective accounts must not include any information that might identify an

individual, whether that individual is alive or deceased. This means that all information must

be recorded in a way that no patient, colleague or other individual can be identified from the

information.

The section on non-identifiable information in How to revalidate with the NMC provides examples

of how to anonymise the written reflective accounts.

Before you have your reflective discussion you should have written your five reflective accounts

on the NMC form we’ve provided. You may find it beneficial to share your reflective accounts with

your discussion partner in advance of the discussion.

Reflective discussion

The benefits of the reflective discussion

Nurses, midwives and nursing associates who are revalidating and their reflective discussion

partner

The reflective discussion centres on talking over your five written reflective accounts with

another person on our register.

This discussion is designed to encourage a culture of sharing, reflection and improvement by:

• requiring you to discuss your professional development and improvement

• considering the role the standards in the Code have in your practice and professional

development

• ensuring you don’t work in professional isolation

• giving you the opportunity to respond constructively to feedback, experiences and learning.

The reflective discussion will be most valuable if you consider how you can benefit from it.

The reflective discussion should be a positive experience that offers both participants the

opportunity to help each other to think about their practice and learn from others.

Choosing a reflective discussion partner

Nurses, midwives and nursing associates who are revalidating

Before the discussion you need to choose who to have your reflective discussion with. This must

be another nurse, midwife or nursing associate on our register because in the discussion you

and your reflective discussion partner will be linking your reflective accounts to the Code. It’s

important that both of you are familiar with, and working to, the same professional standards

presented in the Code.

However, your reflective discussion partner doesn’t need to be on the same part of the register

as you. For example, a nurse can have a reflective discussion with a midwife and vice versa.

Any person on our register can be a reflective discussion partner as long as they meet the

following:

a) They must have an effective registration with the NMC. This means they can’t be subject

to any kind of suspension, removal or striking-off order at the time of having the

discussion.

b) They can’t charge a fee for acting as a reflective discussion partner as this might

affect their ability to remain objective. It’s the responsibility of both the person who

is revalidating and their chosen reflective discussion partner to ensure that the

revalidation process retains credibility, and to be mindful of any personal or commercial

relationships that may create a conflict of interest.

It’s important that both people are comfortable having an open and honest discussion. Some

other factors to consider when choosing your discussion partner include:

• How well you know them: you might prefer to have the discussion with a colleague you work

with regularly, or with someone you are less familiar with.

• Whether they undertake the same type of practice as you: you might find it more helpful to

discuss your reflective accounts with someone who has had similar experiences to you, or

someone with different experiences.

• Whether they are senior or junior to you, or at the same level: would you find it valuable to

have insight from someone who has been working at a different level to you?

If you practise in a setting with few other people on our register, you may wish to reach out to

your wider NMC professional network.

Reflective discussion and confirmation

Part of the revalidation process involves demonstrating to a confirmer that you have met the

revalidation requirements. If your confirmer is on our register and you choose to have your

reflective discussion with them, your reflective discussion can form part of the confirmation

discussion. If your confirmer is on our register, or you choose to have your reflective discussion

with a different person on our register, you will need to have your reflective discussion before

your confirmation discussion.

If your line manager is on our register, you might like to have both your reflective discussion

and your confirmation discussion as part of an annual appraisal, if you have one, but this is not

necessary.

How to prepare as a reflective discussion partner

Before taking part in a reflective discussion with another person on our register, you should

familiarise yourself with this guidance and the other revalidation requirements in the How to

revalidate with the NMC guidance. You might also find it helpful to refresh your understanding of

the professional standards presented in the Code.

You may want to ask the person revalidating to share their five written reflective accounts with

you beforehand. They should be used as a starting point for the reflective discussion, and you’re

not being asked to assess these reflective accounts as academic pieces of writing. Reflective

accounts are individual to the nurse, midwife or nursing associate and will vary in length, detail

and writing style.

You might like to think about what lessons can be learned from these accounts. You might find

the questions above in the in the Principles of reflection section helpful to guide your thinking

and structure your discussion.

During the discussion

Nurses, midwives and nursing associates who are revalidating and their reflective discussion

partner

The discussion itself is based on the five written reflective accounts. You can have discussions

with more than one person on our register if you want to, but the discussion you record for

revalidation must cover your five written reflective accounts because we may need to contact

your reflective discussion partner for the purpose of verification.

This is an opportunity for participants to re-familiarise themselves with the Code and gain a

greater understanding of how it applies to your everyday nursing and/or midwifery practice. It

may be helpful for both of you to bring your copies of the Code with you to the discussion.

It should be a face-to-face conversation in an appropriate environment. If for some reason you

can’t have a face-to-face discussion, then you could arrange a video conference. We advise that

the reflective discussion takes place well in advance of the revalidation application date of the

person revalidating to allow plenty of time to fully complete all of the requirements.

You can use the reflective discussion in lots of different ways, for example:

• to share ideas, information and experiences

• to debrief after an incident

• to get another person’s perspective on a situation

• to think about professional development objectives.

The discussion partner can offer a different perspective on an event or piece of feedback. You

could help the person revalidating to reach a conclusion, or develop an action plan for the future.

During your discussion you shouldn’t discuss patients, service users or colleagues in a way that

could identify them unless they expressly agree.

If the reflective discussion partner believes that the person revalidating hasn’t met the

requirement to have a reflective discussion based on five written reflective accounts, you

should explain to them how they have failed to meet the requirement. Factors to consider when

reviewing the reflective accounts and considering the discussion include:

• Can you identify any areas in the reflective accounts or reflective discussion that the person

revalidating hasn’t considered?

• Have they focused exclusively on the positive feedback, events or experiences in practice with

no evidence of constructive criticism or learning?

Is the evidence or feedback used to inform the account and discussion robust? You can find

guidance and examples of practice-related feedback in the How to revalidate with the NMC

guidance.

• Have they reflected on all relevant areas of the Code in their accounts and throughout the

discussion?

If in doubt, don’t sign the reflective discussion form. The person revalidating can then be given

the opportunity to fully complete the requirements and come back to the reflective discussion

partner before their revalidation application is due.

Unless the reflective discussion is part of the confirmation discussion, you don’t need to

consider evidence relating to other revalidation requirements.

Completing the reflective discussion form

Nurses, midwives and nursing associates who are revalidating and their reflective discussion

partner

You must record details of your reflective discussion on the NMC form we have provided. You

need to record your name and NMC Pin. You should keep the completed and signed form. You will

need to show it to your confirmer as evidence that you have had a reflective discussion (unless

your confirmer was your reflective discussion partner).

The reflective discussion partner will need to sign the NMC form and record their name, NMC Pin,

email, professional address including postcode, contact number, discussion date and a summary

of the discussion. You will also need to agree with the reflective discussion partner that the

NMC can contact them if necessary to verify the information that you have provided in your

application.

The discussion summary section of the reflective discussion form mustn’t include any

information that might identify an individual, whether that individual is alive or deceased. This

means that all information must be recorded in a way that no patient, colleague or other

individual can be identified from the information. The section on non-identifiable information

in How to revalidate with the NMC provides examples of how to anonymise the reflective

discussion form.

After the discussion – the online application

Nurses, midwives and nursing associates who are revalidating

As part of your online application you will need to declare that you have had a reflective

discussion with another NMC-registered nurse, midwife or nursing associate. Please enter the

name, NMC Pin, email, professional address including postcode and contact number of your

reflective discussion partner, as well as the date you had the reflective discussion.

You will also need to agree that the NMC can contact your reflective discussion partner if

necessary to verify the information that you provided in your application.

Other ways to reflect

Our reflective requirements provide a strong basis for you to develop a more reflective

approach to your practice and we encourage you to reflect on your practice in other ways. A

systematic and structured approach will have a greater impact by helping you to continually

improve the quality of care you give to people.

For revalidation you need to reflect as an individual and with one other person on our register.

In addition, having reflective discussions at regular intervals throughout your renewal period,

and with a number of different people (including as part of a group), makes reflection more

meaningful.

Reflecting in groups, teams and multi-professional settings is an excellent way to help develop

ideas or actions that can improve practice. You may be involved in regular activities that drive a

team to reflect on their practice, such as debriefs or case reviews. Learning with others builds

a collective wisdom and increases the likelihood that meaningful and positive change will happen.

Care for individuals and service delivery improves when teams and groups are given opportunities

to explore and reflect on their work together. Outputs from team reflective activities may

include suggestions or plans to improve care or the service provided.

Another requirement for revalidation is to collect feedback, which can come from patients and

service users. Involving the people in your care, their families and carers in the reflective process

may help you focus on what matters to them, which in turn will improve the care you provide.

You can record notes of these discussions in your portfolio if you would find that helpful. The

reflective discussion that you have in order to revalidate can be used as a summary discussion of

the reflective accounts you have written and the discussions you have had over the three years.

You can bring reflections and actions from previous discussions to the reflective discussion

meeting and look back at what you have learnt, as well as reflect on anything more recent.