Nursing: Communication Skills in Practice, edited by Lucy Webb
Exercise for chapter 16: Continuing Professional Development in
Communication
Reflective Practice-The Frameworks
Suitable for all levels of nurse students
This can be used in conjunction with the practice
exercise for reflective practice in the ORC
Introduction
• Reflective practice is associated with learning from
experience, and is viewed as an important strategy
for health professionals who embrace life long
learning
• The act of reflection is seen as a way of promoting
the development of autonomous, qualified and selfdirected professionals
• Engaging in reflective practice is associated with the
improvement of the quality of care, stimulating
personal and professional growth and closing the gap
between theory and practice.
Introduction cont.
• The process of reflective writing leads to
more than just a gain in your knowledge; it
should also challenge the concepts and
theories by which you make sense of
knowledge
• When you reflect on a situation you do not
simply see more, you see differently. This
different way of viewing a situation is reflected
in statements about a commitment to action
Schon (1983)
• The Ineffective
• The Effective
practitioner is confined
reflective practitioner
to repetitive and routine
is able to recognise
practice, neglecting
and explore confusing
opportunities to think
or unique (positive or
about what he/she is
negative) events that
doing
occur during practice
Reflective process
• There are numerous frameworks for
structuring the process of reflection.
• All reflective models comprise of three
fundamental processes:
– Retrospection: thinking back on events
– Self-evaluation: attending to feelings
– Reorientation: re-evaluating experiences
Models/Frameworks
Gibbs Reflective Cycle
• The Gibbs (1988) reflective cycle is
considered fairly straightforward
• It encourages a clear description of the
situation, analysis of feelings, evaluation of
the experience, analysis to make sense of the
experience, conclusion where other options
are considered and reflection upon
experience to examine what you would do if
the situation arose again
Gibbs reflective cycle
DESCRIPTION
(What happened)
Action Plan
(If it arose again
what would you do?)
Feelings
(What were you
thinking + feeling?)
Conclusion
Evaluation
(What was good
and bad?)
Description
(What sense can you make of the situation)
Stage 1: Description of the event
• Describe in detail the event you are reflecting
on
• Include: where you were; who else was
there; why you were there; what you were
doing; what other people were doing; what
the context of the event was; what happened;
what your part was; what parts the other
people played; what the result was
Stage 2: Feelings
• Try to recall and explore what was going on
inside your head i.e. why does this event stick
in your mind?
• Include: how were you feeling when the event
started; what you were thinking about at the
time; how it made you feel; how other people
made you feel; how you felt about the
outcome of the event; what you think about it
now
Stage 3: 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
Stage 4: 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: what went well; what you did well;
what others did well; what went wrong or did
not turn out how it should have done; the way
you, or others, contributed to this
Stage 5: Conclusion
• This differs from the evaluation stage in that
now you have explored the issue from
different angles and have a lot of information
to base your judgement
• It is here that you are likely to develop insight
into your own and other people’s behaviour in
terms of how they contributed to the outcome
of the event
Conclusion cont.
• Remember the purpose of reflection is to
learn from an experience
• Without the 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
• Therefore valuable opportunities for learning
can be missed
• During this stage you should ask yourself
what you could have done differently
Stage 6: Action Plan
• During this stage you should think about
encountering the event again and plan what
you would do – would you act differently or
would you be likely to do the same?
• Here the cycle is tentatively completed and
suggests that should the event occur again it
will be the focus of another reflective cycle
Other models of reflection
• There are other models of reflection and
there are brief explanations for some in the
next few slides
– John’s model of reflection
– The What? model of structured reflection by
Driscoll
John’s model of structured reflection
• John’s model can be used as a guide for
analysis of a critical incident or general
reflection on experience. This would be useful
for more complex decision making and
analysis at levels 3 & 4
• He supports the need for the learner to work
with a supervisor throughout their learning
experience
• He refers to this as guided reflection, and
recommends that students use a structured
diary
John’s model of structured reflection
cont.
• John feels that through sharing reflections on
learning experiences, greater understanding
of those experiences can be achieved than
by reflection as a lone exercise
• John also uses Carper’s (1978) four patterns
of knowing, aesthetics, personal, ethics and
empirics adding a fifth pattern ‘reflexivity’
Driscoll’s ‘The What?’ model (2000)
• A description of events (What? trigger
questions)
• An analysis of events (So What? trigger)
• Proposed actions following events (Now
What? trigger)
Reminder - why we should reflect
• Reduces the theory-practice gap
– (Perkins 1996; Fonteyn & Cahill 1998; Getliffe 1996; Foster
& Greenwood 1998; Smith 1998; Burton 2000; Carney 2000;
Duke & Appleton 2000; Maudsley & Scrivens 2000b; Stewart
& Richardson 2000; Koh 2002).
• Encourages critical thinking ability
– (Patton et al 1997; Durgahee 1998; Foster & Greenwood
1998; Burton 2000; Maudsley & Scrivens 2000b; Cotton
2001)
• Helps practitioners to make more sense of
difficult and complex practice
– (Driscoll & Teh 2001)
Reminder - why we should reflect
cont.
• Enhances personal development by leading
to self-awareness
– (Cotton 2001)
• The focus of reflection is improvement in
patient care therefore it helps to expand and
develop clinical knowledge and skills
– (Graham 2000; Platzer et al 2000; Driscoll & Teh 2001;
Paget 2001)
• Slows down activity thereby providing time to
process material of learning and link it to
previous ideas
– (Moon 2002)
Reminder - why we should reflect
cont.
• Enables greater ownership of the learning taking
place
– (Moon 2002)
• Promotes optimum effectiveness and efficiency
in an ever evolving and complex health care
system through practitioners auditing their own
practice
– (Degazon & Lunney 1995; Carr 1996; Clark et al 1996;
Durgahee 1996; Heath 1998; Hinett & Weeden 2000)
• “Reminds qualified practitioners that there is no
end point to learning about their everyday
practice”
– (Driscoll & Teh 2001: 98).
Top tips for reflecting (Taylor 2000)
• Be spontaneous – it is from the frank and
honest self that important insights arise
• Express yourself freely – you don’t need to
observe the normal academic practices
involved in writing
• Remain open to ideas – early conclusions
can inhibit further insights and solutions
References and Bibliography
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Bulman, C., Schutz, S. (2004) Reflective Practice in Nursing. 3rd ed. Oxford,
Blackwell Publishing
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Burton, A.J. (2000) Reflection: Nursing’s practice and education panacea?, Journal
of Advanced Education, Vol. 31 (5) pp.1009-1017
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References and Bibliography cont.
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