Reflective practice in health

Reflective practice happens when you explore an experience you have had to identify what happened, and what your role in this experience was – including your behaviour and thinking, and related emotions. This allows you to identify changes to your approach for similar future events. If reflective practice is performed comprehensively and honestly, it will lead to improved performance.

Other authors have described it as follows:

• "Process of internally examining and exploring an issue of concern, triggered by an experience, which creates and clarifies meaning in terms of self and which results in a changed conceptual perspective" (Boyd and Fales, 1983, p.100).
• "...requires you to stand back, to consciously analyse your decision making processes, drawing on theory and applying it again in practice" (CSP, Information paper 31, 2005).
• "Professional activity in which the practitioner thinks critically about their practice and as a result may modify their action or behaviour and/or modify their learning needs" (CSP, Information paper 31, 2005).
• "The way in which an individual develops a repertoire of knowledge and ability, which can be drawn upon in future situations" (Schon, 1983).

Reflective practice is increasingly being considered as a critical dimension of professional development for health professionals. Professional standards and credentialing processes to demonstrate continuing competence for most health professionals now require demonstrations of reflection or reflective practice.

Description Describe in detail the event you are reflecting on. Include e.g. where were you; who else was there; why were you there; what were you doing; what were other people doing; what was the context of the event; what happened; what was your part in this; what parts did the other people play; what was the result.

Feelings At this stage try to recall and explore the things that were going on inside your head, i.e. why does this event stick in your mind? Include e.g. how you were feeling when the event started; what you were thinking about at the time; how did it make you feel; how did other people make you feel; how did you feel about the outcome of the event; what do you think about it now.

Evaluation Try to evaluate or make a judgement about what has happened. Consider what was good about the experience and what was bad about the experience or didn’t go so well

Analysis Break the event down into its component parts so they can be explored separately. You may need to ask more detailed questions about the answers to the last stage. Include e.g. what went well; what did you do well; what did others do well; what went wrong or did not turn out how it should have done; in what way did you or others contribute to this.

Conclusion This differs from the evaluation stage in that now you have explored the issue from different angles and have a lot of information on which to base your judgment. It is here that you are likely to develop insight into you own and other people’s behaviour in terms of how they contributed to the outcome of the event. Remember the purpose of reflection is to learn from an experience. Without detailed analysis and honest exploration that occurs during all the previous stages, it is unlikely that all aspects of the event will be taken into account and therefore valuable opportunities for learning can be missed. During this stage you should ask yourself what you could have done differently.

Action Plan During this stage you should think yourself forward into encountering the event again and to plan what you would do – would you act differently or would you be likely to do the same? What can you do in the interim to improve your practice/ ability to respond effectively in like situations? Here the cycle is tentatively completed and suggests that should the event occur again it will be the focus of another reflective cycle.

Cycle originally appears in Gibbs, G. (1988). Learning by doing: a guide to teaching and learning methods. London: Further Education Unit.

Text from Jasper, M. (2003). Beginning Reflective Practice – Foundations in Nursing and Health Care. Cheltenham: Nelson Thornes.

To find other books on this topic, try searching in Library Search for the keywords "reflective practice" AND health or try a search for "reflective practice" AND your discipline eg. nursing, physiotherapy.

Boyd, E. M. & Fales, A. W. (1983). Reflective learning: key to learning from experience. Journal of Humanistic Psychology, 23(2), 99-117. doi: 10.1177/0022167883232011

Chartered Society of Physiotherapists (2005). Workplace learning: evidencing through reflection and evaluation, Information Paper 31. London: CSP.

Gibbs, G. (1988). Learning by doing: a guide to teaching and learning methods. London: Further Education Unit.

Schön, D. A (1983). The reflective practitioner: how professionals think in action. New York: Basic Books.

Sarah Barradell, Physiotherapy

Priscilla Ennals - Lecturer in Occupational Therapy P.Ennals@latrobe.edu.au

Melissah Burnett -Neonatal Intensive Nursing & Midwifery

Sharon Karasmanis -  Library S.Karasmanis@latrobe.edu.au

Amanda Connors - Lecturer in Nursing.

Katie Wiese - Library