Nursing

Examples of reflective practice

In many industries it is important to reflect back on what has happened/ is happening to aid professional learning and growth.  

As an individual, professional growth comes with experience and the ability to reflect upon the good, the bad and the ugly.

Regardless of the organisation or discipline of study, reflective practice is also valued by managers and employment personnel as an indicator of an employee's ability to continually improve.

Here are some examples:

A sportsperson, keeping a journal of workouts and competitions:

• Will be able to identify factors that affect performance (injuries, mental states, training schedules)
• Can see growth achieved
• Can plan for the future based on experience

A scientist, logging their work on an experiment:

• Can record specifics of a current technique to report in their findings
• Can make personal notes about research related to their field and how it affects their own hypotheses
• Can consider alternative techniques that may answer questions
• Can redefine questions or pose new questions that have arisen

A teacher

• Can consider the effectiveness of a particular teaching technique
• Make notes on behaviour management techniques noting successful and unsuccessful actions.
• Modify lesson plans for future reference/ create action notes for conducting a lesson in the future.
• Map new ideas either generated through experience or posited by others

A nurse

• Can consider the effectiveness of a particular communication technique
• Make notes on behaviour management techniques with patients and relatives, noting successful and unsuccessful actions.
• Modify time management and priority planning for future reference/ create action notes for conducting comprehensive care plans in the future.
• Explore personal perceptions on health choices and treatment plans to identify any judgments or behaviours that impact on care given

A student

• Can consider new theories proposed in class
• Can identify gaps in knowledge
• Can map ways to improve performance
• Can explore experiences whilst applying learning in a workplace

There are many types of reflection and models that can be followed. They can roughly be broken up into two categories:

Reflecting IN action

Reflection ON action

Reflecting IN action

Reflection in action occurs during an experience or activity. Here are some examples:

1. A team brainstorms a new idea. Each member then returns to their own station to reflect on what has been raised. The team then meets again to discuss the idea with the benefits of the time reflecting. 
2. A student doing an online course completes a quiz at the end of the module to reflect on their understanding of the material.
3. A teacher determining if students are engaged in the activity set and reflecting whether it is evolving as planned or not.
4. A nurse communicating with the relatives of a terminally ill patient, and reflecting if the approach they are taking is being well received.

Reflection in action often leads to immediate research to discover answers or to provide additional information on a current area of growth or investigation.

Reflecting ON action

Reflection on action occurs at the end of an experience or activity, and can help us to incorporate new understanding into our broader knowledge base. Reflections of this type often lead us to question our own thoughts and behaviours and to make decisions regarding our future course of action.

Reflection involves asking very personal questions of ourselves to explore the reasons behind our choices and rationale for our actions. Ask yourself:

•  How did I feel about that experience?
•  What was I thinking at the time?
•  What were my actions?
• What is the reasoning behind why I felt/thought/acted the way I did?
• What in my previous experiences or knowledge led me to choose that course of action, choice of words or feelings at the time?
• What does this mean for my past, current and future practices?

One method for making useful reflections is to maintain a reflective journal.

Reflective journaling as an assessment

Each course that uses a journal for reflection assessments may have a different format for you to consider. The submission method may also be very different.

Many journals will create an on-going dialogue between the student and their tutor. Comments from the tutor on the first week's entry are considered in the second week, etc.

A critical incident journal may ask a student to focus on the analysis of one particular event from that week. Integration of learned theories and discussion of implications and alternative solutions is expected.

A journal submission could be a hard-copy of notes taken in the field with commentary, an online web page journal through ePortfolios, or an entry within the Moodle shell itself.

Some other ways or capturing reflection activities include:

• Oral reflection within a group.
• Reflective essay
• Written response to a question based on your experience
• Written analysis of an experience
• Video reflection
• Audio reflection

If you would like to learn more about reflective writing, visit the following site:

• Reflective Writing - UNSW
• Reflective Writing - Otago Polytechnic

Reflective tools

There are a number of reflective tools used in various professions.  One of the more common tools is Gibbs's Reflective Cycle and is a common framework for reflecting on critical incidences.

Rolfe, Freshwater and Jasper (2001) created a simple model based on three question: What? So what? Now what?

Image is based on Rolfe, G., Freshwater, D., Jasper, M. (2001) Critical reflection in nursing and the helping professions: a user’s guide. Basingstoke: Palgrave Macmillan.