Types and Examples of Reflective Practice

Modern theories about reflective practice were established in part by the work of Donald Schon (Bassot, 2023) who described two key types of reflective practice:

Reflection-in-action takes place during a situation, or 'on-the-spot' and is typically considered a more advanced form of reflective practice. It occurs during clinical practice, while a health professional is actively practicing their profession.

Sometimes described as ‘thinking while doing’ or ‘thinking on your feet’, the practitioner is internally analysing the situation or interaction, and consciously or subconsciously using their own experience, knowledge and skills to develop theories and guide their actions. It may sound like clinical reasoning, and it is related. However, it also involves self-awareness of your own thinking and emotional reactions. It can help you to determine in the moment whether you are making the best judgement, acting professionally, and engaging with the actual situation or relying on unconscious routine.

Reflection-on-action happens after an event or situation and involves stepping back to recall and analyse your experience.

There are a number of reflective practice models that can be used to structure reflection-on-action, but it typically involves a process of:

Recalling and describing what happened, including what went well or what went wrong.
Critically evaluating why or how the situation occurred, to identify underlying issues, knowledge gaps, new insights and opportunities, and to generate knowledge from the experience.
Recognising emotional reactions and the influence of personal feelings, bias or assumptions, so they can be processed with a goal to improved self-awareness.
Establishing a plan of action, acknowledging growth, and determining how to integrate learnings from this experience into clinical practice.

This type of reflective practice does demand a time commitment, which can be a challenge. However, it has an important place in professional development and allows the practitioner to actively and mindfully engage in improving their practice.

References and further reading

Superficial, Medium and Deep reflective practice

Reflection at this level is very basic – some would say it is not reflection at all, as it is largely descriptive. However, the description should not just be of what happened but should include a description of why those things happened.

Reflection at a superficial level makes reference to an existing knowledge base and includes theories, but does not make any comment or critique of them.

Example

Today I spent time with James (client) and his family on the ward. The family had a lot of questions about the rehabilitation process and wanted to know what was going to happen for James. I wanted to reassure them that things were OK because I knew this was what they needed to know. I said that while it was difficult for anyone to know the rate of James’ improvement I could be sure that he would improve and that it was important for the family to keep hopeful about his future.

James’ father became angry and after raising his voice at me, telling me I was a “patronising little fool”, he stormed out of the room. James mother sat weeping beside his bed and I felt I had really stuffed things up for this family. I need to get some advice about how to handle angry families.

At this level of reflection, the person takes a step back from what has happened and starts to explore thoughts, feelings, assumptions and gaps in knowledge as part of the problem-solving process.

The reflector makes sense of what has been learnt from the experience and what future action might need to take place.

Example

Today I spent time with James (client) and his family on the ward. The family had a lot of questions about the rehabilitation process and wanted to know what was going to happen for James. I wanted to reassure them that things were OK because I remembered from a uni lecture by a carer that carers needed reassurance, information and hope for the future of the person they cared for. I said that while it was difficult for anyone to know the rate of James’ improvement I could be sure that he would improve and that it was important for the family to keep hopeful about his future.

James’ father became angry and after raising his voice at me, telling me I was a “patronising little fool”, he stormed out of the room. James mother sat weeping beside his bed. I felt confused and like I had done the wrong thing. I remembered from the same lecture about the emotional rollercoaster of caring for someone after a brain injury and how families could experience a range of emotional responses as they adjusted to their new reality.

I decided to ask James’ mother how things were going for the family and she started to open up about how she felt. She revealed that James’ accident had opened up longstanding conflict between her and her husband, and that she didn’t feel hopeful about anything. It seemed like a useful conversation.

This level of reflection is the most detailed and analytical. It shows that the experience has created a change in the person – his/her views of self, relationships, community of practice, society and so on. To do so, the writer needs to be aware of the relevance of multiple perspectives from contexts beyond the chosen incident – and how the learning from the chosen incident will impact on other situations.

Example

Today I spent time with James (client) and his family on the ward. The family had a lot of questions about the rehabilitation process and wanted to know what was going to happen for James. I wanted to reassure them that things were OK because I remembered from a uni lecture by a carer that carers needed reassurance, information and hope for the future of the person they cared for. I said that while it was difficult for anyone to know the rate of James’ improvement I could be sure that he would improve and that it was important for the family to keep hopeful about his future.

I started thinking about what was happening in this family and how James’ parents were both clearly distressed and may have been having difficulty supporting each other due to their own distress. James’ father’s abuse of me was possibly not a fair reflection on me but said a lot about how he was feeling. I wondered about his parent’s differing emotional responses and tried to put myself “in their shoes” to consider what it must be like for them. I could see that their questions and behaviours were driven by their extreme emotional states. They both needed an outlet for their emotions.

I also thought about what James needed from his parents to optimise his participation in the rehabilitation program and how I could support them to provide that. I knew I didn’t have the skills or confidence to provide the grief counselling they probably needed but I thought I could provide them with some space to share and acknowledge their grief and to suggest options for them to get further assistance in this area. I sat by his mother and said “This is really hard for you all isn’t it”. She responded with “so hard” and cried some more. We sat without talking for a while and when she was calmer I said “a lot of families find it helpful to talk with our social workers about how they are feeling when things like this have happened”. She agreed it would be good to talk and I helped her organise an appointment for the next day.

From the experience today I have learned that families don’t need superficial reassurance and that this can be perceived as patronising. It will be more helpful if I can acknowledge their emotional distress and fears and reassure them that their response – whatever it is – is normal and expected. If I show that I can cope with their distress I can assist them to get the support they need and this will be critical in getting the best outcome for clients like James.