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4. Written reflective accounts

You will need to record five written reflective accounts that explain how you have developed and improved your care of patients and how it is relevant to The Code.

The NMC has developed a template that you can use to record your reflective accounts. Click here to access.

Reflection has a number of purposes:

  • to develop or to consolidate practice
  • to improve performance or understanding
  • to enhance the quality of patient care.

There are a variety of encounters and events that you can reflect upon.  You can focus on an episode of CPD, an encounter you have had in your practice, on a particular topic that has may have arisen from feedback you have received, or a complaint that the practice may have received. The key purpose of reflection is to demonstrate what you have learnt from focusing on this aspect of practice.

You may find it useful to undertake a module on reflective writing:

Below is an example of a reflective account by a Practice Nurse following a letter of complaint from a patient.


Case Study: Richard’s Reflective Account: Letter of complaint

What happened?

Richard received a letter from a patient. The patient was angry about having had an appointment with Richard which was 40 minutes late; in addition, the patient felt that Richard rushed the appointment and did not apologise for the lateness.


On reflecting, Richard  learnt that he needed to:

  • Work out why appointments were running late – lack of equipment / skills/ knowledge?
  • Manage his appointment times better
  • Manage his stress better
  • Delegate more to other colleagues
  • Ask the reception staff to apologise and explain to  patients when there were delays
  • Remember to always be polite and to treat patients with respect
  • Write an apology to the patient advising of the new changes to practice (see below)
  • Discuss this incident with a trusted colleague.

Changes to practice

Richard decided to try a pilot to experiment with ‘catch up’ appointments

He also planned short appointments early in the morning, double appointments later in the day when possible

In addition, he booked a ‘time management’ study day.

Connect with the Code

Richard believed this reflective account could be related to:

  • Prioritising people
  • Promoting professionalism and trust. 


The process of reflection is based on considering:

  • What happened?
  • What did you learn from it?
  • What impact has it had on your practice?
  • How does it relate to The Code?

Here is an example of a reflective account on a CPD module.


Case Study: Jini’s Reflective Account:  CPD module

What happened?

Jini undertook a module on Family Planning at her local university.  She attended the University for five days of participatory learning and then spent five days in a family planning clinic.


Jini learnt skills and knowledge about a wide variety of patient contraception methods, making informed choices, the menopause, sexual health, unintended pregnancy and the specific family planning needs of young people.

Changes to practice

As a result, and in consultation with colleagues, Jini decided to set up a specific clinic for young people wanting family planning advice. By applying her new knowledge and skills, she believed she was confident and competent to set up the new clinic.

Connect with the Code

Jini believed this reflective account related to:

  • Prioritising people
  • Practising effectively
  • Promoting professionalism and trust.

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Further information

More information about this module, further reading and a complete list of glossary terms.

Learning activities

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