English and Reflective Writing Skills in Medicine: A Guide for Medical Students and Doctors PDF
Preview English and Reflective Writing Skills in Medicine: A Guide for Medical Students and Doctors
English and Refl ective Writing Skills in Medicine English and Refl ective Writing Skills in Medicine A GUIDE FOR MEDICAL STUDENTS AND DOCTORS CLIVE HANDLER BSc (Hons), MB BS, MD, MRCP, FACC, FESC Consultant Cardiologist, Consultant in Pulmonary Hypertension, Royal Free Hospital Honorary Senior Lecturer, Division of Medicine, UCL Medical School Honorary Consultant Cardiologist, Guy’s and St Thomas’ Hospitals CHARLOTTE HANDLER BA (Hons) Teacher of English, JFS School, London and DEBORAH GILL MB BS, MRCGP, MMEd, FHEA Senior Lecturer in Medical Education, Division of Medical Education, UCL Medical School Foreword by PROFESSOR SIR JOHN TOOKE FRCP, FMedSci Head, UCL School of Life and Medical Sciences and UCL Medical School Radcliffe Publishing London • New York Radcliffe Publishing Ltd 33–41 Dallington Street London EC1V 0BB United Kingdom www.radcliffepublishing.com Electronic catalogue and worldwide online ordering facility. © 2011 Clive Handler, Charlotte Handler and Deborah Gill Clive Handler, Charlotte Handler and Deborah Gill have asserted their right under the Copyright, Designs and Patents Act 1998 to be identifi ed as the authors of this work. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the copyright owner. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library. ISBN-1 3: 978 184619 462 7 Typeset by Pindar NZ, Auckland, New Zealand Contents Foreword vi Preface vi About the authors x List of contributors xi 1 Refl ective practice and written refl ection in medicine 1 2 How to write good English 11 3 The essays 21 4 Self-a ssessment exercises 135 Index 161 Foreword The UK consensus statement on the contemporary role of the doctor states: “All doctors must be demonstrably committed to refl ective practice, monitoring their contribution and working continually to improve their own and their team’s perfor- mance”. Enhancing one’s own contribution requires the capacity to refl ect on one’s performance as the foundation for improvement. Committing that process to the written word encourages rigour and provides a record of self-d evelopment, the lat- ter an increasingly important requirement. Against this background, this book is a timely source of clarity and stimulus for the development of effective refl ective writ- ing that will aid medical students, doctors in training and established practitioners wishing to hone their skills. Rather than “model answers” the book uses the device of revealing the uncorrected (anonymous) refl ective essays from third- y ear medical students to highlight the good and the not so good and where change is necessary. In health there is much emphasis on good communication skills, which usually focus on oral and non-v erbal elements. The written record (the illegibility of which is stereotypical of doctors) is equally important, with good- q uality English being the critical component. If we heed the lessons herein, this book will make an important contribution to the quality of care. Professor Sir John Tooke, FRCP, FMedSci Head, UCL School of Life and Medical Sciences and UCL Medical School February 2011 vi Preface Most medical students do not study English or other essay-b ased subjects at A Level and, by nature and education, are scientists rather than craftsmen in English Literature and creative writing. Generally, their skills in science tend to be more devel- oped than their creative writing skills. Writing good, concise, well- structured and correctly spelled and punctuated English has always been an essential part of effec- tive communication among doctors, other healthcare professionals and patients, and is becoming increasingly important. Good communication underpins good clinical practice. In many respects, the care a doctor takes in their written communication refl ects the care taken in clinical and organisational matters. The ability to write good English is essential for applicants to medical school when they write their personal statement, a key component of the application. It pro- vides a valuable insight into the abilities of the applicant. A poorly written statement is not a good start. The essay section of the BioMedical Admissions Test (BMAT), required by some universities, constitutes a signifi cant element in the overall score. At UCL (University College London), the essay is part of the interview; applicants are given the essay they wrote in the examination to discuss during the interview. A well-w ritten essay is a major advantage for the applicant. A less than satisfactory essay is a stumbling block. Once accepted into medical school, good written English remains essential. Refl ective writing is an established and increasingly important educational discipline in many of the UK medical schools. Students are required to submit essays or reports during their clinical course and, not surprisingly perhaps, many fi nd this challenging. Refl ecting on various educational experiences (clinical encounters, practical pro- cedures, conferences and self-d irected learning) are an integral part of continuing professional development for doctors, nurses and other healthcare professionals. They are also an important component of job applications and appraisals and a central aspect of plans for revalidation. Refl ective writing is diffi cult because by its very nature it is highly personal, sub- jective and often emotive. It demands several characteristics: sensitivity, sensibility, emotional intelligence, insight and the ability to be self-c ritical and to provide a bal- anced analysis of an important clinical encounter or event. People feel differently about the same event; we all learn different things from the same experience. The author has to be honest enough to disclose to the reader what they felt at the time vii viii PREFACE and later, and how, on refl ection, they could have performed better and what they have learned from the event. Refl ection aims to help doctors perform better the next time they are faced with a similar situation. Each stage of the refl ective process is chal- lenging, particularly when describing what has been learned, because this implies that the author was unaware or ignorant of this aspect before the event. This should not be a cause of embarrassment. The purpose of refl ective practice is self-e ducation. Most young people, and, indeed, many older people, feel uncomfortable disclos- ing their personal frailties. This often becomes less uncomfortable as we develop and gain more experience of human nature, and learn about similar or even worse frailties in others! The skills to express yourself clearly and keep your reader interested are fun- damentally important in reflective writing. This demands a good grasp of the fundamentals of English grammar and writing: these are the tools of expression. When you write you must have a clear idea of what you want to tell your readers. The fi rst few lines should transport them to the scene so they appreciate the situation you were in at the time of writing and, if relevant, the people who were with you. You have to explain how you felt at the time and later, what you think you did well and what did not go well and how you think others might have viewed your perfor- mance. Importantly, what were your conclusions, what did you learn and how will this affect what you do next time? Your reader might disagree with your analysis of the situation and this is because we all see events differently; an event you fi nd dis- turbing or impressive may not have a similar effect on someone else. We have written this book to help medical students, doctors and other healthcare professionals understand what refl ection is, to point out the attributes of a satisfac- tory or good refl ective essay, and what makes a refl ective essay unsatisfactory. We also focus on the quality of the English writing, which we feel is at least as important as the quality of the refl ection, and we provide guidelines on how to write satisfactory English. This has been a diffi cult task for us because there is no “correct” or approved way to write a good refl ective essay, although there are certain fundamentals. Whilst spotting “good” and “bad” written English is relatively easy, marking essays with a summative comment is more challenging. Each essay can contain a multitude of dif- ferent types of problems. Marking is rarely a clear-c ut, categorical process. We have not attempted to comment on every error in each essay. For the purposes of this book, we have focused and commented on the most prominent problem areas in each essay. We have selected a range of essays that we hope illustrate both good and unsatisfactory standards of English writing. Writing is like other disciplines; inter- est in producing a good piece, practice, revision and refi nement will improve your skills. There is a general consensus on what constitutes a good refl ective essay and we hope that this short book will go some way to showing what would be considered by most tutors to fi t the bill. We invited our third-y ear clinical students to submit their essays for publica- tion, informing them that we wanted to publish their uncorrected essays, which we thought highlighted both satisfactory and unsatisfactory examples of refl ection and English. The essays are published anonymously and in a random order. We publish PREFACE ix the names of the contributing authors who wished their names to be published and we are very grateful to them. They have exposed their own successes and failures to help you to grasp what might be required of you as a professional or developing professional when asked to write a refl ective piece. We, along with our students, have learned and continue to learn about refl ection and strive to improve the quality of our written English. We hope that our readers will be similarly inspired by these essays and our comments and will fi nd refl ective practice an enjoyable and useful part of their professional work. Clive Handler, Charlotte Handler, Deborah Gill February 2011
The list of books you might like
