Thursday, August 28, 2008

Helpful questions to ask when reflecting

Helpful questions to ask when reflecting:

· What was your role in the situation ?
· Did you feel comfortable or uncomfortable and why ?
· How did the other people involved in the situation act ?
· How did you interact with them ?
· Did you feel that you and the others involved acted in appropriately in that situation ?
· How could you have improved the situation for yourself, the patient or others involved ?
· Is there anything that you would have done differently next time in a similar situation and why?
· Do you feel, you have learnt anything about yourself from this situation ?
· What can you learn from this situation for the future ?
· Has this situation changed the way you think in any way ?
· Has this situation changed the way you will act in similar situations in the future ?
· What knowledge from theory and research can you apply to this situation ?
· What broader issues e.g ethical ,political or social arise from this situation?
· What do you think about these broader issues ?
(Johns 2000)

Definitions of reflection

Reflection has been defined as:

“ The higher order intellectual and affective activities in which physiotherapists engage to critically analyse and evaluate their experiences in order to lead to new understandings and appreciation of the way they think and operate in the clinical setting”. (Donaghy and Morss 2000).

“Reflective learning is the 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).

“ a window through which the practitioner can view and focus self within the context of his/her own lived experience in ways that enable him/her to confront, understand and work towards resolving the contradictions within his/her practice between what is desirable and actual practice”
(Johns 2000 p.34).

“Reflection – in- action which he states as critical practice on the spot thinking serves to reshape what we are doing while we are doing it”
(Schon 1987).

And reflection – on – action ‘post hoc’ “ making sense of the action after the event “.

“Reflection is a process of reviewing an experience of practice in order to describe, analyse, evaluate and so inform learning about practice”
(Reid, 1993 p.305).

“Reflective practice is something more than thoughtful practice. It is that form of practice that seeks to problematise many situations of professional performance so that they can become potential learning situations and so the practitioners can continue to learn, grow and develop in and through practice”
(Jarvis, 1992 p.180).

Why and when to reflect

Why we reflect

We reflect in order to engage in personal and self development and in order to make decisions or resolve uncertainty. Simply having and experiencing is not sufficient. Reflection upon this experience is needed in order to learn from it, with out reflection, experiences are often quickly forgotten and therefore the opportunity for development is lost. The feelings and thoughts developed through reflection are what generate concepts and it is through these concepts that we learn and accordingly adapt our attitudes, beliefs and actions. (Gibbs, 1988)


When to reflect

-Something that went really well
-A crisis
-An uncomfortable situation
-A situation where what usually works was not working
-An occasion when a usual explanation did not suffice prompting the need for a new explanation.

Framework 5: Atkins and Murphy's model of reflection


Atkins and Murphy's model of reflection (1994)

Framework 3:Johns model for structured reflection

Johns model for structured reflection (2000)
This model not only provides a framework but also encourages guided reflection; this involves sharing reflections with a supervisor or peer in order to obtain greater understanding of an experience.
Johns model for structured reflection is a very in depth framework in that it explores empirics, this is looking at what knowledge did or could have informed the writer in the given situation, this is the main differentiating point of Johns Model, and helps the writer understand their actions and others reactions.

Looking in
· Find a space to focus on self
· Pay attention to your thoughts and emotions
· Write down those thoughts and emotions that seem significant in realising desirable work.
Looking out
· Write a description of the situation surrounding your thoughts and feelings.
· What issues seem significant?
Aesthetics
· What was I trying to achieve?
· Why did I respond as I did?
· What were the consequences of that for the patient/others/myself?
· How were others feeling?
· How did I know this?
Personal
· Why did I feel the way I did within this situation?
Ethics
· Did I act for the best? (ethical mapping)
· What factors (either embodied within me or embedded within the environment) were influencing me?
Empirics
· What knowledge did or could have informed me?
Reflexivity
· Does this situation connect with previous experiences?
· How could I handle this situation better?
· What would be the consequences of alternative actions for the patient/others/myself?
· How do I now feel about this experience?
· Can I support myself and others better as a consequence?
· How available am I to work with patients/families and staff to help them meet their needs?http://staffcentral.brighton.ac.uk

framework 4: Kolb's Learning Cycle (1984)


Kolb's Learning Cycle (1984)


Kolb’s Experiential Learning Theory is a four-stage cycle which is applied to the way people learn through experience. The four stages are:
Concrete Experience - Situation taking place.
Reflective Observation - A description of what happened and what were you feeling at the time.
Abstract Conceptualization - Why did this happen and what do you plan to do to either change this or prevent reoccurrence.
Active Experimentation – plan/practice the concepts developed in stage 3 so when the concrete experience occurs again you take a different action.

Image: Kolb's Learning Cycle (1984)


Framework 2: Gibbs Reflective Cycle


Gibbs Reflective Cycle: 1988

This is a fairly popular and simple method of reflection which involves the writer describing a situation, identifying how they felt or what they were thinking at the time, evaluating the situation including stating what was good and bad about the situation, analysing, concluding and finally creating an action plan as to what they would do differently or the same next time.

This framework is simple to follow while at the same time encourages the writer to think critically about the situation.


Framework 1: Rolfe et al (2001) Framework for reflective practice

Rolfe et al (2001) Framework for reflective practice
This is a simple model which poses the questions ‘What? So what? And Now what?’

What – describe the situation; achievements, consequences, responses, feelings, and problems.
So what – discuss what has been learnt; learning about self, relationships, models, attitudes, cultures, actions, thoughts, understanding, and improvements.
Now what – identify what needs to be done in order to; improve future outcomes, and develop learning

It is believed that the third and final stage is of the greatest importance in contributing to practice Rolfe et al (2001).

Introduction

Reflective practice promotes clinical reasoning and analytical and evaluative abilities in students and health professionals. It is the process of recognizing, analysing and questioning experiences in order to learn, develop, understand, and problem solve a given situation. This can take some time to perfect. (Department of Health 1993).
Reflection comes in many forms; this blog however will concentrate specifically on journaling or reflective writing. There is no correct way to reflect as it is a personal process, however it may be helpful to follow a framework to ensure that reflection is as effective as possible. It is important to identify a framework which you feel comfortable using and which you find best demonstrates your learning. It is often helpful to share reflections through peer supervision; this is an important part of Occupational Therapy (OT) practice and may assist in the process of identifying new perspectives. staffcentral.brighton.ac.uk
This blog will out line several models to reflect by, as well as give examples of reflections, and links to helpful sites.
This information was learnt and obtained through various fieldwork placements, and has proven to be invaluable to my development as a student and future health professional.