Reflection is hard. Guidance is required in the design of reflective questions (by course teams), the writing of reflective accounts (by students) and the marking of assessments (by tutors). Reflective skills need to be built up gradually. It takes time to get used to the new ways of thinking required. It is necessary to situate reflection in the course and relate it to the students’ practice. Reasons for introducing reflection to students must be made clear up front.