The NMC Form 6 Reflective Account: Field by Field

The NMC Form 6 has four fields. This chapter walks through each one with worked phrasing: what to write, what to avoid, and the length each field should run to.

Chapter 18 of this guide gave the overview. This chapter is the detail.

Field 1: What happened

The descriptive field. Sets the scene for the auditor. Length: 100–200 words.

Structure that works:

1. One-sentence setup. When, where, what role you were in.
2. The event itself. Concrete description with enough detail to make the learning understandable.
3. The immediate context. Why this event was noteworthy and what made it different from routine.

Worked opening lines:

“During a late shift in December 2024, I was administering medications to a 78-year-old patient recovering from hip replacement surgery.”

“In May 2025, I attended a one-day study event on recognising deterioration in adults with learning disabilities.”

“Following a peer review meeting in March 2025, I received feedback from a colleague about how I had handled an SBAR handover earlier that day.”

Avoid:

• Vague generalisation (“I have been working in palliative care and have encountered many difficult situations”).
• Identifiable patient detail (full name, exact age, named ward).
• Long-form clinical case description that pushes other fields out.
• Drama or emotional framing. The field is for fact, not narrative.

Field 2: What you learned

The most important field. Length: 150–300 words.

Structure that works:

1. The insight in one sentence. Specific, concrete, not generic.
2. Why the event produced the insight. What was unusual or revealing.
3. How the insight generalises to other situations.

Worked phrasing:

“What I learned was that the SBAR format I had been using compressed the contextual detail too aggressively when handing over a patient with multiple comorbidities. The ‘Background’ section in my standard usage was three or four words on the main diagnosis; in this patient, the background needed to include three concurrent conditions and two medications with significant interactions. The receiving nurse correctly identified that my handover had under-supplied her, and we adjusted the handover on the spot.”

“The study day reinforced that my baseline observation skills for patients with profound learning disabilities had been pattern-matched to verbal patients. I learned that subtle behavioural change (a person becoming quieter, sitting differently, eating less) was often the only early indicator of deterioration in non-verbal patients.”

Avoid:

• “I learned the importance of [X].” Description of importance is not learning.
• “I learned to be more careful.” Care intensity is not insight.
• Repeating the description from Field 1.
• Generic platitudes about communication, safety or compassion.

Field 3: How you changed practice

The behavioural change field. Length: 100–250 words.

Structure that works:

1. The specific behaviour change. What you now do differently.
2. When the change started and how it stuck.
3. An example of the new behaviour in action.

Worked phrasing:

“I now write the medication name, dose, route and time as a single line immediately after each drug round, rather than batching the documentation at the end. The change started in the week after the near-miss and has held since. In a busy shift this week I noticed I was tempted to defer documentation; I caught myself and went back to single-event recording.”

“Since the study day I have changed my baseline observation routine for patients with profound learning disabilities. I now check positioning, food intake and behavioural baseline at the start of every shift, rather than waiting for an obvious clinical change. Two months in, I picked up the early signs of an aspiration pneumonia using this baseline; change in food refusal was the first indicator.”

Avoid:

• “I will [X] in future.” Future tense is not change.
• “I am now more aware of [X].” Awareness without behaviour change.
• Same change described in another reflection.

Field 4: Code link

The shortest field. Length: 30–80 words.

Structure:

1. The section number selected.
2. One sentence on why it fits, naming the specific wording of that section that connects to your reflection.

Worked phrasing:

“Section 10 (keep clear and accurate records). The change to single-event documentation aligns with sub-clause 10.1’s requirement to complete records at the time of an event.”

“Section 3 (assess physical, social and psychological needs). The change to baseline observation for non-verbal patients addresses 3.1’s expectation that needs are recognised across all life stages and communication abilities.”

The next chapter goes deeper on the “what you learned” field, the field that most often fails audit when written weakly.