How inclusive is reflective writing for assessment within UK General Practice Training? A qualitative study of GP educators.
DOI:
https://doi.org/10.22024/UniKent/03/ajpp.1481Abstract
Background: Reflective practice is a central element of general practice training in the UK. This includes compulsory reflective writing in electronic portfolios, which are assessed by their educational supervisors - General Practitioners (GPs) who have additional training in education and supervision. However, concerns exist about whether reflective writing is equally inclusive for all learners.
Aim: To explore GP educators’ experiences of the use of reflective writing for assessment in postgraduate training, and inclusion.
Design and Setting: A qualitative study using thematic analysis.
Methods: Fourteen GP educators participated in focus groups and semi-structured interviews. Transcripts were analysed thematically to identify key perspectives on reflective writing.
Results: GP educators expressed mixed views about mandated reflective writing for assessment. They recognised its potential for supporting learning and professional growth but were concerned it reinforced bias against for international medical graduates (IMGs) who were disadvantaged by the linguistic demands of reflective writing. They feared reflective writing could be disruptive, unsafe and inauthentic and were cynical about its effectiveness as a developmental tool and suggested that more inclusive approaches to assessing reflection may be preferable.
Conclusions and Recommendations: GP educators are ambivalent about the use of reflective writing as an assessment tool. Our data indicates that when fostering reflective practice, we need to consider more inclusive assessment tools in addition to reflective writing. Upskilling and supporting educators to recognise and mitigate risks and biases in their assessments while recognising the emotional load of teaching is also recommended.
Keywords: inclusive assessment; reflective practice; international medical graduates; general practice; family practice; primary care
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Copyright (c) 2026 Dr Frances Wedgwood, Dr Simon Bailey, Dr Nagina Khan
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