Learning Log

The Learning Log is your personal learning record. It’s used to collect evidence about your progress and share it with your supervisors and ARCP panel, as part of the Workplace Based Assessment component of the MRCGP exam.

How the Learning Log works

Maintaining your log is just as important as completing your other workplace based assessments.

Entries you choose to ‘share’ can be read and commented on by your Clinical or Educational Supervisor. These log entries will contribute to the evidence available to your supervisors and ARCP panels when they come to take a view on your capability progression.

All trainees are expected to document their learning through their learning log. The learning log is your personal learning record. It’s used to collect evidence about your progress and share it with your supervisors and ARCP panel, as part of the Workplace Based Assessment component of the MRCGP exam.

List of log types

  • Clinical Case Reviews
  • CEPS
  • Placement Planning Meeting
  • Quality Improvement Activity
  • Prescribing
  • Learning Event Analysis (LEA) and Significant Events
  • Leadership, Management and Professionalism
  • Reflection on Feedback
  • Supporting Documentation (CPD)

The learning logs are grouped in a manner that mirrors your post-CCT GMC requirements:

  1. Reflection on reviewing what you do, and learning from cases, data and events.
  2. Seeking and reflecting on feedback about what you do.
  3. Evidence of keeping up-to-date (for trainees, becoming up-to-date across the curriculum) – Continuous Professional Development (CPD).

For most log entries you will suggest linkage to the relevant Clinical Experience Groups and Capabilities, providing justification of the Capabilities chosen in certain logs. The GMC requires you to demonstrate reflective practice, which is core to your professionalism and learning and this will be done through your learning logs.

How many log entries are required?

You are required to write three Clinical Case Reviews per month on average (pro rata for those who are Less Than Full Time (LTFT)).

You are also required to arrange and document a Placement-Planning Meeting at the start of each new post.

You are expected to have more than one log entry which addresses each Capability in each 6-month review period. You will therefore need to complete a breadth of learning log entries in addition to Clinical Case Reviews, which reflect on your experiences in such a way that they are appropriately linked to Capabilities such as Organisation, management and leadership, Ethics, and Fitness to Practice. Learning logs looking at leadership, quality improvement and prescribing activities, for example, will be very important in achieving these links.

Outline of log types

I. Reflection on reviewing what you do, and learning from cases, data and events

Clinical Case Reviews

These should account for the majority of your learning logs and provide the best opportunities for linkage to the Capabilities and Clinical Experience Groups. The clinical learning from acute, chronic, emergency or unscheduled care experiences is recorded here. There is now the option within the Clinical Case Review to document learning in a variety of settings (both in and out of standard GP hours) in addition to the type of consultation. You are expected, after a brief description of the case, to reflect on what you need to maintain, improve, or stop doing. Before considering this, it is recommended that you reflect on what went well and why, so that you can maintain these behaviours. This reflection should include actions required in response to your emotional needs as well as clinical and educational actions i.e., ‘how did it make you feel?’

The option for the supervisor to comment on the entry is retained. The supervisor is encouraged to comment on each capability linked. Whenever the supervisor disagrees with a suggested Capability or Clinical Experience Group link their explanation should appear in the comments section.

When new learning or experiences present themselves, these should be documented in your log. It is particularly important to document learning in Unscheduled Urgent Care/ OOH care within your Clinical Case Reviews, as this will provide evidence of your understanding of working in this setting. It is not mandatory that you complete a Clinical Case Review for each Unscheduled / OOH care session undertaken but documentation of any attendance in this setting should be entered in the ‘supporting documentation’ section of the log.

Log example

Title:

Date: xx yy zz

Setting: [GP Surgery, Telephone triage, Electronic (video consult etc), Home visit, Out of hours GP setting, Hospital, Other ___________________]

Brief description:

Clinical experience groups (max 2):

Capabilities that this entry provides evidence for

Capability:

Justification [describe how your actions and approach link to the capability]:

Supervisor: add/change capabilities chosen

Reflection and learning needs

Reflection: what will I maintain, improve or stop?

Learning needs identified from this event

Supervisor comment


Clinical Examination and Procedural Skills - CEPS

Evidence of your ability to perform a variety of examination and procedural skills to demonstrate this Capability (including the mandatory skills) remains essential.

Log example

Title:

Date: xx yy zz

CEPS performed: [Please be specific, for example prostate examination not just rectal examination or cranial nerve examination not just neurological examination]:

Reason: [State reason for examination or procedural skill performed. Describe physical signs elicited (to include if this was the expected finding]:

Communication: [reflect on any communication and cultural factors]:

Ethics: [reflect on any ethical factors (to include consent)]:

Self assessment: [Self-assessment of performance (to include overall ability and confidence in this type of examination or procedure)]:

Learning needs identified: [How and when will these learning needs be addressed?]


Placement Planning Meetings

This allows for a record of placement planning meetings which are now mandatory. It links to Working with colleagues and in teams, Fitness to practice, and Organisation, management, and learning.

Log example

Title:

Date: xx yy zz

What were the main areas discussed?

What learning opportunities were highlighted in this placement?

What objectives did you agree on?

What plans have you agreed to achieve these objectives?

Supervisor comment:


Quality Improvement Activity - QIA

This reflective learning log entry enables QIA to be captured across the full training programme. At present, the GMC and RCGP are promoting quality improvement activities, which are different to simple audits. (Previous Audit/Project entries will be mapped to this area). The quality improvement activity should be robust, systematic, and relevant to your work. The QIA reflection should include an element of evaluation and action, and where possible, demonstrate an outcome or change.

The GMC recommend that all doctors demonstrate involvement in Quality Improvement in each training year (ST1/2/3). This mirrors the broad definition for post-CCT doctors and ensures that you are equipped with appropriate quality improvement methods for lifelong competence. Please see the WPBA website pages for further guidance on QIA suggestions.

The QIA should be completed electronically in the portfolio.

For detailed information, please see the QIA section.

Please note Quality Improvement Project (QIP) is a separate assessment. You can read more about this form.

Log example

Title:

Date: xx yy zz

Clinical experience groups (max 2):

Capabilities that this entry provides evidence for (you can only add 3 capabilities)

Capability:

Brief description of QIA [Be explicit about your role and the extent of your contribution]

What were you trying to accomplish? [This could include a statement of the problem, a brief summary of relevant literature or guidelines, relevant context, and the priority areas for improvement]

How will we know that a change is an improvement? [What information/data did you gather – baseline and subsequent data?]

How have you engaged the team, patients and other stakeholders?

What changes have taken place as a result of your work? How will these be maintained? [If improvement was not achieved, explain why]

Reflection: what will I maintain, improve or stop in QIA?

Supervisor comments:


Prescribing

This assessment has been created because of the importance attached to prescribing by the GMC. You must complete this assessment and reflective entry in ST3. It follows a formal process where you will reflect on your prescribing of 50 consecutive prescriptions in relation to safety and appropriateness. See the section on prescribing assessment for more information.

Log example

Title:

Date: xx yy zz

Clinical experience groups (max 2):

Capabilities that this entry provides evidence for (you can only add 3 capabilities)

Capability:

Justification [describe how your actions and approach link to the capability]:

Supervisor:

I confirm that I have completed a review of 50 of my prescriptions in line with the RCGP WPBA prescribing assessment guidelines and have attached my spreadsheet of results to this log: Yes / No

Reflect with reference to the GP Prescribing Proficiencies:

All prescribing GPs are expected to demonstrate the following, across people of all ages which includes extremes of age, for example babies, children and older people with frailty (based on the GMC GPCs 2017):

  1. Assesses the risks and benefits including those posed by other medications and medical conditions, reducing polypharmacy where possible.
  2. Identifies when prescribing unlicensed medicines and informs patients appropriately.
  3. Adheres to national or local guidelines (including recommendations for over-the-counter prescribing (OTC) and evidence-based medicine.
  4. Uses antimicrobials appropriately.
  5. Counsels’ patients appropriately including giving instructions for taking medicines safety in line with up-to-date literature.
  6. Reviews and monitors effects including blood testing at appropriate intervals.

What do you plan to maintain with regard to your prescribing? [Reflect on what you are doing well]

What do you plan to improve with regard to your prescribing? [Consider how to improve your suboptimal prescribing]

What do you plan to stop with regard to your prescribing? [Comment on any significant errors]

Which of the GP prescribing skills listed above have you not covered (if any) in this assessment? How will you address these?

Supervisor comment:

Using your reflections above complete the following PDP(s): [creates a mandatory draft PDP entry which trainer will review]

  • Learning Objectives:
  • Target Date: xx yy zz
  • Action plan:
  • How will I know when it is achieved?
  • [Request generation of second PDP as required]

Learning Event Analysis (LEA) and Significant Events

The analysis of events which do not reach the GMC threshold for harm but present an opportunity for learning are referred to as Learning Events Analysis and need to be documented in each training year (ST1/2/3) on this form. This might include events which may not have a serious outcome but highlight issues which could have been handled with greater clinical effectiveness and from which lessons can be learnt.

An entry under Learning Event Analysis would normally involve sharing information within the team and demonstrating learning. Areas for further learning and development should be reflected in your Personal Development Plan (PDP).

Significant Events must be reflected on, and the format allows clarification of which type of event this refers to through having a drop-down box.

Log example

Title:

Date: xx yy zz

Setting: GP Surgery, Telephone triage, Electronic (video consult etc), Home visit, Out of hours GP setting, Hospital, Other ___________________]

Clinical experience groups (max 2):

Capabilities that this entry provides evidence for (you can only add 3 capabilities)

Capability:

Justification [describe how your actions and approach link to the capability]:

Supervisor: add/change capabilities chosen

What happened, including your role?

Why did it happen?

What was done well? [describe your personal involvement]

What could be done differently?

Who was involved in the discussion of the event?

What have you and the team learnt?

What changes have you or the organisation made in response to this review?

Does this significant event meet the threshold for reporting as a Significant Untoward Incident (SUI) for revalidation purposes on Form R in England (and SOAR in Scotland): Yes / No

If yes, additional boxes appear:

  1. Have you discussed this event with your ES/CS?
  2. How was the SUI identified?
  3. How did identification and progress of this SUI make you feel?

Supervisor comments:


Leadership, Management and Professionalism

Learning about leadership skills is an important area of GP training. The non-clinical work a GP is required to do is complex within an increasingly diverse clinical workforce. This log entry enables appropriate documentation of experiences and reflection. You are encouraged to record activities such as chairing a meeting, giving a presentation, or a ‘Fresh Pair of Eyes’ exercise. The NHS Leadership Academy suggests leadership in the health and care services is about delivering high quality services to patients by: demonstrating personal qualities, working with others, managing services, improving services, setting direction, creating the vision, and delivering the strategy. ‘Delivering the Service’ is at the core of this leadership model.

Log example

Title of event:

Date: xx yy zz

Clinical experience groups (max 2):

Capabilities that this entry provides evidence for (you can only add 3 capabilities)

Capability:

State your role in relation to the activity:

How did you approach this activity? [What planning you undertook for the activity]

How did you demonstrate your ability to work with colleagues, patients, learners and/or users (individually or in teams)?

How effective were you within this role? [Reflect on your achievements and feedback received]

Reflection: what will I maintain, improve, or stop?

What have you learnt about yourself? [Consider what motivates you, your core beliefs and areas to develop]

Supervisor comments:


Academic Activities

The Academic Activity log remains unchanged and is designed to be used by trainees in an academic post.

Log example

Title:

Date: xx yy zz

Capabilities that this entry provides evidence for (you can only add 3 capabilities)

Capability:

Justification [describe how your actions and approach link to the capability]:

Supervisor:

How did you approach this task?

How did you gather, appraise, and interpret available information?

What problems did you encounter, and how did you solve them?

Describe any other strengths highlighted by this work?

What developmental needs are highlighted by this work?

Supervisor comment:


II. Seeking and reflecting on feedback about what you do

Reflection on Feedback

This reflective log entry enables you to reflect on the following feedback: colleagues (MSF), patients (PSQ) and leadership (leadership MSF), in addition to reflections on the ESR, CSR, Educator notes, examination results for example.

Log example

Title: [e.g. feedback was received]

Date: xx yy zz

Clinical experience groups (max 2):

Capabilities that this entry provides evidence for (you can only add 3 capabilities)

Capability:

Justification [describe how your actions and approach link to the capability]:

Supervisor: add/change capabilities chosen

Brief description

How does this feedback make you feel?

What are your key learning points?

Reflection: what will I maintain, improve, or stop?

What support have you had or require?

Have you taken your plans to your PDP? Yes/No

How will you re-assess/monitor improvements?

Supervisor comments:


III. Evidence of keeping up-to-date – Continuous Professional Development (CPD)

Supporting Documentation (Continuous Professional Development (CPD) evidence)

This area allows you to record and reflect on relevant pieces of evidence that you may have highlighted from your clinical reviews or PDP. It also allows you to provide evidence and share brief summative reflections of your CPD evidence of reading / reflections on learning events. By separating this from the reflections on clinical work we are supporting a degree of separation between WPBA and the appraisal functions of the GP trainee Portfolio. Basic life support, safeguarding certification, Unscheduled / Out of
Hours attendance should be appropriately recorded here. Other learning such as eLearning, tutorials, courses/certificates, lectures and reading can appropriately be recorded in the CPD area. Trainees may want to note that entries which are purely documentation of reading or of doing an online course are not Workplace Based Learning Activities.

Log example

Title:

Date: xx yy zz

Clinical experience groups (max 2):

Capabilities that this entry provides evidence for (you can only add 3 capabilities)

Capability:

Justification [describe how your actions and approach link to the capability]:

Supervisor: add/change capabilities chosen

Briefly describe your key learning from this event [this could include helping you to maintain existing knowledge and skills]

Reflection: what will I maintain, improve or stop?

What learning needs have you identified from this event?

Supervisor comments:


Unscheduled urgent care (UUC) / Out of Hours (OOH)

All trainees need to get experience in UUC/ OOH and evidence of your attendance at these sessions needs to be included in your supporting documentation section.

Some areas of the UK expect the number of hours/sessions undertaken in the UUC / OOH setting to be documented as part of your GP trainee contract. In this case a summary table should be completed and uploaded as a separate ‘supporting documentation’ entry before your final ARCP.


Worked examples of logs

Worked examples for new log entries/evidence tools (PDF file, 656 KB)

Page last updated: 18 December 2022

Clinical experience groups

Clinical Experience Groups map to the RCGP curriculum. Instead of linking individual learning logs to individual sub headings of the curriculum, these curriculum headings have been grouped into Clinical Experience Groups. Up to two Clinical Experience Groups can be linked to each learning log.
Your supervisor is encouraged to review the links and amend/remove any inappropriate links.

Do not be put off from adding evidence into your learning log if none of the clinical experience groups apply as your entries can still be linked to the RCGP capabilities providing you have reflected on these within your entry.

The clinical experience groups are below:

  1. Infants, children, and young people (under the age of 19 years)
  2. Gender, reproductive and sexual health (including women’s, men’s, LGBTQ, gynae and breast)
  3. People with long-term conditions including cancer, multi-morbidity, and disability
  4. Older adults including frailty and/or people at end of life
  5. Mental health (including addiction, alcohol, and substance misuse)
  6. Urgent and unscheduled care
  7. People with health disadvantage and vulnerabilities (including veterans, mental capacity difficulties, safeguarding and those with communication difficulties/disability)
  8. Population Health and health promotion (including people with non-acute and/or non-chronic health problems)
  9. Clinical problems not linked to a specific clinical experience group

GP trainees are reminded to regularly review the topic guides in the curriculum for further understanding of these areas.

Capability linkage

The majority of the reflective learning log entries require you to suggest links to the 13 GP Capabilities (the basis of ‘Being a General Practitioner’). Most of which also require justification, describing how your actions and approach link to the capability suggested. This should help focus your thinking when writing entries and helps alignment with the Educational Supervisors Review, where you are required to demonstrate how you are meeting the Capabilities.

The format of the learning logs is intended to enable you to summarise the case. Comment on what you have done or learnt and possibly identifying some learning needs. Without necessarily linking it to a capability. Your supervisor will confirm each of your suggested links. They will add further comments about the capabilities chosen. The text inputted when justifying the capabilities chosen, will be autopopulated and available to you as part of your Educational Supervisors Review. You and your supervisor should be aware that the links made to Clinical Experience Groups is to enable you to demonstrate evidence. In each of the Capabilities across the range of Clinical Experience Groups with whom GPs work.

It is expected that by the end of training there should be sufficient coverage of the Clinical Experience Groups to demonstrate your ability to work as a General Practitioner in the UK in a range of settings. The coverage of the Clinical Experience Groups in each Capability should be reviewed at your Placement Planning Meeting and periodic Educational Supervisor meetings. You therefore need to be aware at each stage of training whether you are accumulating sufficient evidence. Minimum expected numbers per individual Clinical Experience Group or Capability have deliberately not been set and should not be set. Locally as the demonstration of Capability depends on your educational needs. The quality of evidence, and the reflections on learning rather than on numbers alone.

Evidence in the 13 capability areas

Your Clinical or Educational Supervisor can only validate log entries against the Capabilities if they are of sufficient quality.

Log entries should be reflective, demonstrating personal insight into how you are performing and learning from your everyday experiences. A good, reflective log entry will show:

  • evidence of critical thinking and analysis, describing your own thought processes
  • self-awareness, demonstrating openness and honesty about performance along with some consideration of your own feelings
  • evidence of learning, appropriately describing what needs to be learned, why and how.

You won’t be expected to produce perfect log entries from day one, but your Educational Supervisor will expect to see improvement in the quality of your Learning Log entries and insight as you progress.

Reflection

Two documents have been produced jointly by the:

  • Academy of Medical Royal Colleges (AoMRC),
  • Conference of Postgraduate Medical Deans (COPMeD),
  • General Medical Council (GMC)
  • Medical Schools Council (MSC).
  1. The reflective practitioner guidance (PDF file, 433 KB)
  2. Summary version of the reflective practitioner guidance (PDF file, 288 KB)

Reflection is an important part of professional practice. By reflecting, doctors assess how well they are performing, as well as identifying their learning needs and enabling improvements to be made to their practice.

The guidance was developed following requests for clearer information on what is meant by reflection, and how those in training and engaging in revalidation should reflect as part of their practice. It has been developed with input across the UK and is intended for use across the UK.

The guidance outlines the importance of reflection for personal development and learning. It highlights how reflection can help doctors and medical students to maintain and improve their professional practice and drive improvements in patient safety.

It emphasises ten key elements of being a reflective practitioner, including:

  • how reflection is personal; that there is no one way to reflect;
  • reflective notes don’t need to capture the full details of an experience, but should focus on learning outcomes and future plans.

This work, which is a joint effort by all four organisations to provide clearer advice in this area, is part of a wider commitment to drive an open and honest learning culture. We will explore what other guidance or information could be developed to provide more practical support.

The documents are available on the COPMeD website, along with the Academy and COPMeD Reflective Practice Toolkit.

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