What is a reflective discussion?

One of the requirements of revalidation is that all nurses and midwives must have a reflective discussion with another NMC-registered nurse or midwife. This discussion is designed to encourage a culture of sharing, reflection, and improvement amongst nurses and midwives by:

  • Requiring nurses and midwives to discuss their professional development and improvement; and
  • Ensuring that nurses and midwives do not work in professional isolation.

This discussion should be based on your five written reflective accounts, which are another requirement of revalidation. For more details on the revalidation requirements and how to meet them, please see Medical 24's Revalidation Guidance Sheet.

The NMC also provides examples of written reflective accounts on their website.

The purpose of reflective discussion

The reflective discussion will be most valuable to all nurses and midwives if you consider how you can benefit from it. Reflection enables you to make sense of a situation and understand how it has affected you. 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.

For nurses or midwives who are revalidating, it gives you the opportunity to respond constructively to feedback, experiences, and learning. It also allows you to identify areas for learning and development, and to consider how you can put changes or improvements into action in your everyday practice as a result.

Before the discussion

Nurses and midwives who are revalidating

The reflective discussion centres on your five written reflective accounts. These accounts should be based on instances of your CPD and/or feedback you have received about your practice and/or an event or experience in your practice, and how these relate to the Code. Before you have your reflective discussion, you need to have written your five reflective accounts on the NMC form we have provided. You may want to share your reflective accounts with your discussion partner in advance.

You also need to choose who to have your reflective discussion with. Some 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; and
  • 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?

It is up to you to choose who the most appropriate person is, and you can have discussions with more than one nurse or midwife if you want to. However, please note that although you only need to record the details of one discussion, this discussion must cover your five written reflective accounts.

Part of the revalidation process involves demonstrating to a confirmer that you have met the revalidation requirements. If your confirmer is a nurse or midwife and you choose to have your reflective discussion with them, your reflective discussion can form part of the confirmation discussion. If your confirmer is not a nurse or midwife, or you choose to have your reflective discussion with a different nurse or midwife, you will need to have your reflective discussion before your confirmation discussion.

If your line manager is a nurse or midwife, 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.

If you work with Medical 24 on a full-time or regular basis, you will be given access to a Medical 24 Reflective Discussion Partner and Confirmer. To make your Reflective Discussion or Confirmation Appointment please contact info@carefeedback.co.uk.

During the discussion

The discussion itself is based on the five written reflective accounts. These accounts link real-life experiences to the four key themes of the Code (prioritise people, practise effectively, preserve safety, promote professionalism and trust). This is an opportunity to re-familiarise yourselves 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 you to bring a copy of the Code with you to the discussion. 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; and
  • To think about professional development objectives.

Your discussion partner can offer a different perspective on an event or piece of feedback, help you to reach a conclusion, or develop an action plan for the future.

During your discussion, you should not discuss patients, service users, or colleagues in a way that could identify them unless they expressly agree.

Unless the reflective discussion is part of the confirmation discussion, you do not need to consider evidence relating to other revalidation requirements.

After the discussion – the reflective discussion form

Nurses and midwives who are revalidating

You must record details of your reflective discussion on the NMC form. 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).

Please remember:

The written reflective accounts, and the discussion summary section of the reflective discussion form, 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 reflective discussion form should be completed, stored, and shared in manual paper form only, as opposed to electronically. This is important because creating, storing, or sharing these data electronically may trigger an obligation to register with the Information Commissioner because they contain identifying information about another NMC-registered nurse or midwife.

After the discussion – the online application

Nurses and midwives 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 or midwife, and you will need to enter the name, NMC Pin, and email of the nurse or midwife with whom you had the discussion, 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.

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