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Understanding Reflective Practice CONTINUING PROFESSIONAL CPD DEVELOPMENT Understanding reflective practice NS842 Nicol JS, Dosser I (2016) Understanding reflective practice. Nursing Standard. 30, 36, 34-40. Date of submission: September 28 2015; date of acceptance: January 9 2016. Abstract Aims and intended learning outcomes This article aims to increase the nurse’s The Nursing and Midwifery Council (NMC) requires that nurses and knowledge and understanding of reflective midwives use feedback as an opportunity for reflection and learning, practice and assist them to develop a portfolio to improve practice. The NMC revalidation process stipulates that of evidence for revalidation (Nursing and practitioners provide examples of how they have achieved this. To reflect Midwifery Council (NMC) 2015a). After in a meaningful way, it is important to understand what is meant by reading this article and completing the time out reflection, the skills required, and how reflection can be undertaken activities you should be able to: successfully. Traditionally, reflection occurs after an event encountered in Define reflection and explain its role in practice. The authors challenge this perception, suggesting that reflection professional practice. should be undertaken before, during and after an event. This article Describe two different models of provides practical guidance to help practitioners use reflective models to reflection. write reflective accounts. It also outlines how the reflective process can Discuss how self-awareness is integral be used as a valuable learning tool in preparation for revalidation. to reflection. Discuss how reflection can be used as a Authors learning tool. Jacqueline Sian Nicol Lecturer, Edinburgh Napier University, Edinburgh, Prepare several examples of reflection Scotland. to support the NMC revalidation process. Isabel Dosser Lecturer, Edinburgh Napier University, Edinburgh, Scotland. Correspondence to: [email protected] Introduction Keywords An integral part of continual, evolving nursing practice is the need to evaluate and improve critical thinking, portfolio, professional development, reflection, care in a constantly changing healthcare reflection models, reflective account, reflective practice, revalidation, environment (Bulman and Schutz 2004). self-awareness Such evaluation of practice, however, requires the ability to reflect in a critical and Review focused way. For reflection to be valuable in All articles are subject to external double-blind peer review and checked professional practice, a questioning approach for plagiarism using automated software. is required. Reflection is a method of using experiential Revalidation knowledge to enable professional and personal development while reinforcing Prepare for revalidation: read this CPD article, answer the questionnaire continuous learning (Gustafsson and and write a reflective account. www.rcni.com/revalidation Fagerberg 2004). The Code. Professional Standards of Practice and Behaviour for Online Nurses and Midwives (NMC 2015b) states For related articles visit the archive and search using the keywords above. that to fulfil all registration requirements, To write a CPD article: please email [email protected] nurses and midwives must ensure their Guidelines on writing for publication are available at: knowledge and skills are up to date. This journals.rcni.com/r/author-guidelines. may be achieved by participating in continuing professional development (CPD) activities to maintain competencies and improve practice. Complete time out activity 1 34 mDownloadeday 4 :: vol 30from no RCNi.com 36 :: 2016 by ${individualUser.displayName} on Aug 17, 2017. For personal use only. NoNURSING other uses without STANDARD permission. Copyright © 2017 RCN Publishing Company Ltd Defining reflection If reflection is to be practised to best effect, the Reflection, in a professional sense, should be supporting model should have personal appeal purposeful, focused and questioning. Many as well as being clear and coherent. Reflection nurses believe that they reflect regularly; is a personal matter as well as a statutory however, for this to be purposeful they are requirement. Professional reflection requires a required to ask what happened or what might focused and strategic approach in contrast to happen, what they are doing or did, and how reflection on personal and social circumstances. that relates to their objectives. In reality, nurses Two commonly used models of reflection that rarely scrutinise when situations have gone have been advocated by educationalists are well, or investigate why or how something went shown in Figure 1 (Borton 1970, Gibbs 1988). well or went wrong. By adopting a structured Driscoll (2007) developed Borton’s (1970) and strategic approach, practitioners can link model by including prompt questions for experience to intentions of what was, or is, each stem question to complete the process of being attempted. reflection (Figure 1). Borton’s (1970) model has Several authors have attempted to also been adapted by Rolfe et al (2010). Other define reflection, the consensus being that reflective models used in academic study can be reflection has three components (Schön 1983, applied to nursing practice, for example Johns’ Rolfe et al 2010): (2013) model. Although Johns’ (2013) model is Reflection before action – involves thinking complex, with more than ten steps, it can be a 1 Consider what about what you aim to achieve and useful aid when learning how to reflect. you think reflection understanding the means by which this will Different reflective models may be appropriate on your professional be accomplished by drawing on previous for different practitioners and situations. Some practice entails. Does it experience. favour a structured model, such as that developed involve your emotions, Reflection in action – relates to your conduct by Gibbs (1988) (Figure 1), to prompt the questioning what you while undertaking the task and allows you process of reflection. Gibbs’ (1988) model is a did, or what you thought to modify what you are doing while you step-by-step process that encourages the user to suitable or right? Does it are doing it. This is commonly described as consider how an event made them feel. This is involve reviewing choices ‘thinking on your feet’. important when considering self-awareness and as part of an episode of Reflection on action – involves looking emotional intelligence, and can often be missed care or reviewing your retrospectively at how practice was executed in the absence of prompts. Thinking about how knowledge? and analysing the information gathered an event makes you feel can be challenging and in terms of knowledge, new learning and can easily be overlooked in favour of focusing 2 Look at your professional development. on evaluation and analysis of the situation. In answers to time out The majority of nurses are very familiar with the evaluation stage of Gibbs’ (1988) model, activity 1 and decide reflection on action. However, many nurses the reflector explores the main issues associated how your ideas about also reflect before action and in action without with the situation and determines which aspect reflection are modified being consciously aware of this. Nurses may requires additional analysis. The analysis depending on whether believe that they reflect on practice on a stage prompts the reflector to search and you reflect before, regular basis. However, for reflection to be read the literature to increase their knowledge during or after an event. meaningful conclusions must be reached and and understanding to make sense of the Does reflection at a an action plan agreed to inform future practice. situation, arrive at a conclusion and, ultimately, specific point require Reflection may result in a positive outcome; reach the action plan stage to formulate more effort or offer conversely, reflection can identify areas that new learning. greater possibilities? require improvement or a change in approach Gibbs’ (1988) model is most often used or attitude. retrospectively (reflection on action); however, 3 Select a reflective Although reflection is often associated it can be used when reflecting on an anticipated model to evaluate a with situations that did not go well, it is also event (reflection before action) and considering situation you have a valuable learning tool to understand why how to approach a particular situation. encountered in practice things did go well. Some may feel that Gibbs’ (1988) model is with a mentor or Complete time out activity 2 unnecessarily complex. Borton’s (1970) model colleague. Begin with has three steps (Figure 1), is simple to use and reflection on action. easy to remember. However, in contrast to Gibbs’ What seemed easy or Models of reflection (1988) model, the questions do not automatically difficult when using Different models of reflection are recommended remind us to consider our emotions. The second your selected model to assist thinking; having a range of models question: ‘So what?’ requires attention to the to prepare notes on to choose from enables their use by a broad individual, their perceptions and feelings, but what happened? community who might learn in different ways. might result in overlooking important insights. NURSINGDownloaded STANDARD from RCNi.com by ${individualUser.displayName} on Aug 17, 2017. For personal use only.may No 4 other:: vol uses30 nowithout 36 :: permission.2016 35 Copyright © 2017 RCN Publishing Company Ltd CPD reflection Borton’s (1970) three questions
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