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Logo of brjgenpracRCGP homepageJ R Coll Gen Pract at PubMed CentralBJGP at RCGPBJGP at RCGP
Br J Gen Pract. 2009 July 1; 59(564): 551.
PMCID: PMC2702031

Reflections in a cracked mirror

How I hate the modern obsession with reflection.

After every talk and lecture, at almost every trainers and appraisers meeting for the last few years and in everything associated with the medical learning industry, I am encouraged to reflect. To reflect on what I have learned and to shine that secondhand light on how my new knowledge will change the way I practise.

There are now Structured Reflective Templates as part of our annual appraisals. A contradiction in terms if ever there was one.

I have been a doctor for a third of a century. Seeing, thinking, absorbing, accommodating, and altering the way I work. Daily, hourly, constantly. I see what makes sense, what works better and I automatically adapt. Without thinking.

After all, isn't that what professionals do?

Usually this is a natural and subliminal process without recourse to protected time, a formal thought pattern or that self-conscious, unnecessary, and artificial self-analysis of reflection. We don't need to be told to do the obvious.

It works like this: someone with more experience tells you what works for them and you try it out yourself next time an appropriate situation arises. Thus, it has always been.

Or you do something that doesn't work and you don't do it that way again. In life as in medicine.

But for the last 5 to 10 years we have been encouraged to reflect on new information and how it will change us. This is like a photographer delaying the taking of a picture long enough to analyse why he is taking that particular picture. Or wondering how that picture will influence the viewer once he has taken it, rather than being spontaneous, instinctive, natural.

But it is worse than that. It isn't just that the whole process of being asked to reflect is artificial pointless and patronising; reflection isn't even a correct use of the word.

I mean, if they can get the concept so wrong, how can we trust anything they ask us to do?

You see the problem is this: reflecting is what mirrors and burnished surfaces do. They bounce incoming energy, that is, light, off their surfaces. The light doesn't penetrate their smooth skins and in the process the light is turned upside down. They are blissfully unaffected by it. Lateral inversion, left to right, back to front.

So reflection is a process whereby the reflector is uninfluenced by the reflecting, the incoming energy is turned upside down and reality is distorted.

So next time you are asked to reflect on a piece of information or an experience just bear in mind the fact that doing so won't change you. The moment you start you will instantly get it all back to front and, anyway, isn't it faintly narcissistic to keep reflecting like that?

Surely if we are talking about the physics of processing energy, what we should be doing is diffracting or refracting.

You see, these are processes whereby a prism or other penetrable transparent surface separates and defines the important constituents of incoming light, changes it, interprets it in a new way and helps clarify its secrets.

It is an even more appropriate term when you find out that the refractive index is related to the denseness of the medium.

Also the process is often startlingly pretty and always a pleasant surprise.

Now diffusion: that is something completely different.

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners