The IACC reflective written narrative — Scientist Training Programme

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Your written narrative will demonstrate your readiness to practise against the five Good Scientific Practice domains by directly referencing completed evidence in your portfolio. You will need to demonstrate that you recognise your current stage of ability as well as your continuing development needs.

In summary, the written reflective narrative of the IACC assessment requires you to:

Analyse your completed evidence in your portfolio.
Synthesise what you have learnt against the five Good Scientific Practice (GSP) domains:
- Professional practice
- Scientific practice
- Clinical practice
- Research, development and innovation
- Clinical leadership
Reflect on gaps in knowledge and practice.
Demonstrate a plan of action to inform future practice and development.

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Writing your reflective narrative

Critical reflection involves a process of thinking which demonstrates your ability to:

explore, question, and analyse your experiences
apply your knowledge
use your knowledge to enhance your understanding of these experiences
use your knowledge to shape your future experiences
learn from past experiences and implement changes to ensure ongoing professional development

You are required to use the “what? so what? and now what?” model of reflection (Driscoll, 2007) to write your narrative. This model is summarised below:

Driscoll Model of Reflection

Driscoll, J. (ed.) (2007) Practicing Clinical Supervision: A Reflective Approach for Healthcare Professionals. Edinburgh: Elsevier.

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Content of the graphic 'Driscoll Model of Reflection'

What?

Describe an event or action or experience

So what?

Reviewing the experience and explaining why that action or event was significant

Now what?

Demonstrate learning from the experience by explaining how you will use that information to inform practice in the future

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Using the Driscoll model for the IACC reflective narrative

What?

You will briefly describe the evidence from your portfolio which demonstrates your readiness to practice for each of the five Good Scientific Practice domains.

So what?

Reflective pieces will build on descriptions to analyse and unfold the account further. You will analyse the evidence you have referenced.

What does it prove?
How do you feel about the evidence and the experiences?
What are the gaps in your knowledge?

Now what?

Critical reflective pieces will assess your own capabilities (knowledge and skills) and further learning needs or support. This is where you will demonstrate that you are a lifelong learner and that you can critically evaluate your practice.

What are you going to do about the gaps in your knowledge or practice?
How are you planning to develop further?

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Examples of "what? so what? and now what?"

The examples listed below are from IACCs which passed. You can identify good practice for example, they are clearly referenced to evidence in the portfolio, but they also use the “what? so what? now what?” model of reflection.

After each example an illustration is given on how it reflects Driscoll’s approach to reflection but remember when writing your IACC it must be presented in a continuous narrative following the template and guidance.

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Domain 1: Professional practice extract

“Despite ample exposure to various EEG types [SP S222c7:3, SP SC222c8:3, SP SC222c8:4], I have identified some gaps in my learning. For example, currently I am assisting with ambulatory recordings. Although I have developed my clinical and technical skills, such that I am able to successfully apply and remove the ambulatory device, I ensure that I seek supervision for this [SPS222c8:8]. This is because I recognise that a seemingly small technical error can result in a malfunction, meaning that data has not been captured. This would ultimately delay the diagnostic process and cause undue stress and inconvenience to the patient. By seeking supervision in such instances, I ensure that I work within the limits of my personal competence and therefore minimise any undue harm to the patient. Moving forward, I am also aiming to develop my confidence in reporting full ambulatory recordings. I have worked closely with my training supervisor to devise a plan which will make this achievable over the coming weeks [SPS222c8:10].”

What?

Despite ample exposure to various EEG types [SP S222c7:3, SP SC222c8:3, SP SC222c8:4], I have identified some gaps in my learning. For example, currently I am assisting with ambulatory recordings. Although I have developed my clinical and technical skills, such that I am able to successfully apply and remove the ambulatory device, I ensure that I seek supervision for this [SPS222c8:8].

So What?

This is because I recognise that a seemingly small technical error can result in a malfunction, meaning that data has not been captured. This would ultimately delay the diagnostic process and cause undue stress and inconvenience to the patient. By seeking supervision in such instances, I ensure that I work within the limits of my personal competence and therefore minimise any undue harm to the patient.

Now What?

Moving forward, I am also aiming to develop my confidence in reporting full ambulatory recordings. I have worked closely with my training supervisor to devise a plan which will make this achievable over the coming weeks [SPS222c8:10].

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Domain 2: Scientific practice extract

“I have gained knowledge and practical skills in many qualitative and quantitative methods used in laboratory medicine (SLS100:4, SLS103:4). This has established a good breadth of knowledge and shows my abilities in standard 2.1.3. However, when I first started shadowing the duty biochemist role and reflected on these sessions (SC110:13), I realised gaps in my knowledge in some of the analytical methods specific to clinical biochemistry. Therefore prior to starting on the duty biochemist rota, I further enhanced my knowledge of automated and manual analytical methods. One way in which I did this was through completing multiple assay verifications for the biochemistry service, demonstrating 2.2.4 and 2.2.5. These verifications necessitated an understanding of the underlying principles of methods in order to design assay verification experiments and interpret the verification data (SC110:22, SC110:23)”.

What?

I have gained knowledge and practical skills in many qualitative and quantitative methods used in laboratory medicine (SLS100:4, SLS103:4). This has established a good breadth of knowledge and shows my abilities in standard 2.1.3.

So What?

However, when I first started shadowing the duty biochemist role and reflected on these sessions (SC110:13), I realised gaps in my knowledge in some of the analytical methods specific to clinical biochemistry.

Now What?

Therefore prior to starting on the duty biochemist rota, I further enhanced my knowledge of automated and manual analytical methods. One way in which I did this was through completing multiple assay verifications for the biochemistry service, demonstrating 2.2.4 and 2.2.5. These verifications necessitated an understanding of the underlying principles of methods in order to design assay verification experiments and interpret the verification data (SC110:22, SC110:23).

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Global statement extract

“I believe I have been an extremely hard-working trainee throughout my time on the STP, with one comment on MSF 2 describing an ‘almost impeccable work ethic’ alongside multiple positive comments on my professionalism (MSF: 2). I believe this has been reflected across all 5 domains of the GSP that is required to be a clinical scientist. This work ethic has been reflected in both my academic work and clinical practice. Successfully passing the BSE written exam alongside multiple ultrasound competencies (SPS121: 11-13) allowed me to demonstrate the knowledge and ability required to perform, analyse, and report echocardiograms. One of my goals over the next year is to gain my full BSE accreditation. The COVID-19 pandemic has undoubtedly impacted my training to some extent. It was however an opportunity to gain skills and assist in different areas such as learning more about correct PPE usage. This was reflected in becoming a fit tester for the trust and advising on the correct FFP-3 masks required. As the pandemic appears to be easing, I believe there will be more opportunity to gain exposure to the areas I missed out on during the pandemic. These mainly relate to more ward-based scanning, such as suspected endocarditis scans and post-surgical referrals, as trainees we weren’t allowed on ward rounds to minimise the number of people”.

What?

I believe I have been an extremely hard-working trainee throughout my time on the STP, with one comment on MSF 2 describing an ‘almost impeccable work ethic’ alongside multiple positive comments on my professionalism (MSF: 2). I believe this has been reflected across all 5 domains of the GSP that is required to be a clinical scientist. This work ethic has been reflected in both my academic work and clinical practice.

So What?

The COVID-19 pandemic has undoubtedly impacted my training to some extent. It was however an opportunity to gain skills and assist in different areas such as learning more about correct PPE usage. This was reflected in becoming a fit tester for the trust and advising on the correct FFP-3 masks required.

Now What?

As the pandemic appears to be easing, I believe there will be more opportunity to gain exposure to the areas I missed out on during the pandemic. These mainly relate to more ward-based scanning, such as suspected endocarditis scans and post-surgical referrals, as trainees we weren’t allowed on ward rounds to minimise the number of people.

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