Reflective practice for occupational therapists: turning everyday judgement into CPD

Occupational therapy is full of judgement, but short on drama. Much of the learning that matters happens in ordinary moments: a discharge decision, a home visit that changes your plan, a goal renegotiated with someone whose priorities differ from the referral. Because those moments do not announce themselves, occupational therapists often struggle to find something they feel is "worth" reflecting on. This piece is about finding that learning where it actually lives, and writing it up in a way that satisfies the HCPC.

What the HCPC actually asks of you

You renew your HCPC registration every two years. When your profession's renewal window comes round, the HCPC selects a random sample of 2.5 per cent of registrants and asks them to submit a written CPD profile. Selection is random, so being organised across the whole cycle matters far more than any single burst of activity near the deadline.

The HCPC standards of continuing professional development ask you to:

1. Maintain a continuous, up-to-date and accurate record of your CPD activities.
2. Demonstrate that your CPD activities are a mixture of learning relevant to current or future practice.
3. Seek to ensure that your CPD has contributed to the quality of your practice and service delivery.
4. Seek to ensure that your CPD benefits the person using your services.
5. On request, present a written profile, which must be your own work and supported by evidence, explaining how you have met the standards.

You can read the full wording on the HCPC standards of CPD page.

One point is worth clearing up. The HCPC does not require a set number of reflective accounts. That is the NMC model, where nurses and midwives write five. What the HCPC wants is a mixture of activities and, on audit, a profile that shows the line from your learning to your practice. Reflection is simply one of the most effective ways to show that line, which is why it is worth doing well.

Where the reflection actually lives in OT work

If you are staring at a blank page, the problem is usually topic choice, not writing. Occupational therapy learning tends to hide inside everyday clinical judgement. Useful candidates include:

• A discharge decision where independence and safety pulled in opposite directions.
• A home or workplace assessment that changed the plan you arrived with.
• A goal you renegotiated when the person wanted something different from the referral.
• An equipment or adaptation recommendation that was declined, abandoned or never used.
• A capacity or risk judgement you had to make with incomplete information.
• A multidisciplinary disagreement about whether someone was ready.

None of these are dramatic. All of them involve a decision you can defend, question and learn from, which is exactly what an assessor is looking for.

A worked example

I work in a community rehabilitation team. I completed a home assessment for an older adult returning home after a hospital stay. The referral asked me to put equipment in place to keep them safe. On the visit it became clear that the person did not want rails and declined most of what had been ordered. I felt caught between the referral, an anxious family and the person's clear wish to keep doing things their own way. I recorded my assessment of their capacity, weighed the risk against their right to take it, and agreed a smaller set of changes they would actually use, with a review date. Afterwards I reread our risk and capacity guidance and realised I had been treating "safe" as the goal, rather than "safe enough to live the way they choose". I now record the person's own priorities before the equipment list, and I open a home visit with a different first question.

That short paragraph is a complete reflection in miniature. It names the event, is honest about the feelings, shows the judgement, points to what was learned, and ends with a concrete change to practice. It maps neatly onto the standards: learning relevant to practice, a contribution to quality, and a benefit to the person using the service.

Turning it into a profile-ready piece

Describe briefly and reflect at length. The most common weakness in a CPD profile is a long case description followed by two lines of insight. The assessor already trusts that you can describe. What they want is the "so what": what you now understand, and what you do differently.

Anonymise as you write, not afterwards. Use the person's role rather than a name, leave out dates and locations that could identify anyone, and never include record numbers. If removing those details makes the account unclear, that is a sign to reshape the sentence, not to put the detail back in.

Keep the record continuous. A profile assembled the week before renewal reads like one, and it is far more stressful to produce. A few short entries across the two years, each showing learning and a change, are both easier to write and stronger to submit.

Occupational therapists have a further advantage here. The RCOT Career Development Framework gives you a ready structure for mapping your learning across the four pillars of practice, which can help you spread your CPD beyond direct clinical work into leadership, education and evidence.

Difficult cases, and your wellbeing

Some of the most valuable reflections come from cases that unsettled you: a person who deteriorated, a safeguarding concern, a decision you would make differently now. Reflection means learning from the event, not replaying it. If a case is still weighing on you, that is a reason to talk to someone rather than to sit with it alone. Your occupational health service and your union are there for exactly this, and the Samaritans are free at any time on 116 123. Write the reflection once the event has settled, not while it is still raw.

Getting it written

If you can name the moment that taught you something but freeze at the blank page, that is a writing problem, not a knowledge problem. Reflectory interviews you about the case one question at a time and turns your answers into a reflective account in your own words, with identifiable details screened out and an AI-assistance disclosure built in. Nothing is invented that you did not say. Your first reflection is free.