Severn and Peninsula Schools of Primary Care

Learning Log recommendations (Naturally Occurring Evidence)                        

The General Medical Council make it clear in Good Medical Practice that reflection is the key to effective continuing professional development, and is a skill that must be developed and practised by all doctors.

All doctors have to provide written reflections for their ARCP and appraisal, and so doctors in training must continue to write reflections, especially when there are things that do not go well. This is an essential part of training and is needed to progress through a postgraduate training programme.

It is important that doctors in training should be mindful that their reflections are carefully written and focus on the learning gained from such events. In order to comply with Information Governance, there must be no patient identifiable information contained within written reflections and no third party should be identified either. The ES should provide support to develop reflective writing skills

Printable Version


Learning Log category

Minimum numbers


Competencies Demonstrated

Clinical Encounter

The school consider that trainees who are progressing satisfactorily will usually show evidence of reflection on at least three clinical encounters per month

Trainees are required to: “Show a commitment to professional development through reflection on performance and the identification of and attention to learning needs” – supervisors should therefore support trainees to produce entries that demonstrate learning and reflection

2 Practicing Holistically
3 Data gathering
4   Making a Diagnosis
5   Clinical Management
6   Managing Medical Complexity
8   Working with Colleagues
9   Community Orientation
10 Learning and Teaching
11 Ethical Approach

Professional Conversation

No minimum, but should record all formal meetings with supervisors.

Any complaints or feedback must be recorded

Supervision meetings should reflect on recent learning and progress to date, and key objectives for next stage

10 Learning and Teaching
11 Ethical Approach
12 Fitness to Practice


No minimum, but learning from tutorials should be documented

Entries should itemise areas of learning, and reflect on future learning needs 

10 Learning and Teaching


No minimum

Enter details of key learning points that are likely to affect your practice

10 Learning and Teaching


All learning from Day release sessions should be documented

Trainees are expected to have attended at least 70% of Day Release sessions 

10 Learning and Teaching

Out of Hours

All OOH sessions should be documented with the OOH spreadsheet completed prior to the ARCP panel

Learning from cases should be recorded with the clinical supervisor form added as an attachment

10 Learning and Teaching
12 Fitness to Practice


An audit or quality improvement project should be done within primary care.

This needs to have significant personal involvement and show evidence of: Data analysis; working with colleagues; change in practice; evaluation of the impact on patient care; reflection on your learning from the experience

7   Organisation, Management and Leadership
8   Working with Colleagues
9   Community Orientation
10 Learning and Teaching

Significant Event Analysis

Trainees should complete at least one reflective SEA every 6 months with evidence of reflection, learning and intended actions


SEAs may involve any significant clinical or administrative event (usually when something went wrong). There should be personal involvement and evidence of having discussed with colleagues – ideally a “team-based discussion”

All unintended or unexpected incidents where the trainee had direct involvement, that could have or did lead to harm to one or more patients, must be discussed and documented as Significant Events. These “GMC-standard SEAs” should also be recorded on the Form R

All complaints from patients or colleagues which have involved the trainee directly must be documented as SEAs and recorded on your Form R

8   Working with Colleagues
10 Learning and Teaching
11 Ethical Approach
12 Fitness to Practice


1) Less than full time trainees will be expected to complete WPBA and learning log entries on a pro-rata basis

2) Should Naturally Occurring Evidence recommendations not be met, and the trainee has not responded to developmental feedback, then the ARCP panel may award an unsatisfactory outcome


Updated August 2016