WHAT DOES INSIGHT MEAN?
Before reading the definitions below, note down some of your own words related to "insight"
Some people have challenged the concept of ‘insight’ and ‘lack of insight’, arguing that these are simply ways of affirming or denying someone else's view of matters. In addition, social constructs such as insight, do not translate easily across cultures. While these criticisms have their merits, for the purposes of this module ‘insight’ will be treated as a genuine psychological capacity that can vary from person to person, or from one set of circumstances to another.
A general definition of insight is that of gaining a greater and more accurate understanding of someone or something. As such, insight is a form of self-awareness. Brown et al (2014) suggest that insight, as a mixture of emotional intelligence, self-awareness and motivation is capable of development. They offer a working definition of insight as:
‘A readiness to explore intellectually and emotionally how and why I, and those I interact with, behave, think and feel as we do, and for me to adapt my behaviour accordingly.’
Insight can be developed by reflecting on learning and from honest feedback. It is also about understanding and acknowledging, selecting, and organising what to communicate.
The GMC talk about insight in relation to concerns about doctors referred to the Medical Practitioner Tribunal Service, where they state (GMC & MPTS sanctions guidance 2017):
- 45 - Expressing insight involves demonstrating refection and remediation.
- 46 - A doctor is likely to have insight if they:
- a) accept they should have behaved differently (showing empathy and understanding)
b) take timely steps to remediate (see paragraphs 31–33) and apologise at an early stage11 before the hearing
c) demonstrate the timely development of insight during the investigation and hearing.
- a) accept they should have behaved differently (showing empathy and understanding)
The Nursing and Midwifery Council’s ‘Guidance for decision makers on Fitness to Practise panels’ (NMC 2017) covers the demonstration of insight in relation to remediation of concerns about conduct stating: When considering how likely it is that conduct will be repeated, decision makers will assess the extent of the nurse or midwife’s insight into the concerns, and will also consider whether the steps taken to remedy concerns are sufficient. Therefore, insight on the part of the nurse or midwife is crucially important.
Insight can include:
- the ability to step back from the situation and consider it objectively
- recognising what went wrong
- accepting one's role and responsibilities at the material time
- appreciating what could and should have been done differently
- understanding how to act differently in the future to avoid reoccurrence of similar problems.
Insight failure consists of a rejection of constructive criticism, defensiveness and counter-challenge (Cox and Holden 2009). Further consideration will be given later as to how and why people may fail to show insight.