Reflective Practice
Amanda Deaves
Clinical Tutor
Objectives
To increase knowledge of reflective
practice
 To review models of reflection
 To understand the role of critical
reflection on clinical placement
 To understand the role of reflection
within physiotherapy practice
 To prepare for assignment ?
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Definitions
 ‘A process of reviewing an experience of
practice in order to describe, analyses,
evaluate and so inform learning about
practice’ (Reid 1993 in Schutz 2007)
 ‘A process of internally examining and
exploring an issue of concern, triggered by an
experience, which creates and clarifies
meaning in terms of self and results in a
changed conceptual perspective’ (Boyd and
Fayles 1983 in Schutz 2007)
Why Reflect?
Hallmark of professional practice
 To improve complex decision-making
and clinical reasoning skills
 To achieve experiential learning
 Critical to the learning process
 Central to the process of self-appraisal
 CSP expectation that physiotherapists
should be reflective practitioners
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CSP
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The Chartered Society of Physiotherapy
expects its qualified members, student
members and associate members to maintain
and develop their skills, knowledge and
competence in order to practise safely and
effectively through continuing professional
development (CPD). There is a strong link
between evaluation, learning and the
enhancement of patient care and quality of
service. (Policy Statement CPD Sept 2007)
Developing Expertise
Novice – follows rules – performance often
halted and mediocre
 Expert – knowledge is a by-product of
experience and reflection, ability to unpick a
complex (new) situation and find effective
interventions, able to ‘go beyond’ rules,
confident in own expertise
 Reflection is key in novice to expert journey
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(Poulter 2004)
Gap
analysis
Review &
evaluation
Competencies
Learning
activities
Learning
plan
Gibb’s Reflective Cycle (1988)
Description
of the event
Feelings
Action plan
Conclusion
Evaluation
Analysis
The Task
Choose one of your examples from your
observation week
 Think back and expand your thoughts
and reflective skills by completing the
proforma

Describe a recent experience in your professional life
Context
What happened?
Who was involved?
What was the context for the event?
Why is the event important to you?
What did you do..
And why?
Context
Thoughts / feelings
What happened
How did you respond to the event?
Thoughts / feelings
Analysis
What were you thinking at the time?
(during/after)
What was most demanding / rewarding
What went well…
And what could have been better?
How did you respond to the event?
What were you thinking at the time?
(during/after)
What was most demanding / rewarding
What helped?
Analysis
Evaluation good / bad
What hindered?
What assumptions, beliefs, values,
intuitions underpinned the
response/reaction?
Continued next slide
What would you now do differently, faced with a similar situation?
Conclusion
What else could be done
Alternative actions or approaches
What is the significance of what happened?
What else do I need to consider to understand better what happened and
why?
What sense can I make of the event/situation?
Describe what you have learnt from this experience?
In what ways was the sequence of events connected?
How did it influence or change: me, my learning, my practice?
What action would I take in a similar situation?
What do you need to learn?
How might you learn this?
Five quick tips to start reflection
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Initial write as if you are talking to a confident
– imagine their probing questions?
Talk – share your reflections with peers
Use a model to frame your reflections
Go beyond describing – follow up with the
question – so what?
Write quickly / naturally at first then add
layers, answer questions, develop themes
Critical Thinking
Achieved by recognizing and analyzing
multiple perspectives and is essential to
problem solving
 Meta-cognition
 Systematic critical enquiry will lead to a
better understanding of practice
 Questioning and challenging existing
beliefs, values, customs and rituals

Goodman’s levels of reflection

There are several frameworks which
can be used to facilitate the process of
reflection and reflective writing. One of
the simplest was developed by
Goodman (1984) who suggested that
there are 3 levels of reflection that a
practitioner can achieve.
Level 1

Reflection to reach given objectives.
These usually relate to efficiency,
effectiveness and accountability of own
actions.
– Mainly descriptive in nature
– Identify key features
– Recording of basic facts
– Indication of some awareness of what has
happened
– Some learning indicated
Level 2
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Reflection on the relationship between
principles and practice
This involves assessment of the
consequences of actions and beliefs as well
as the underlying rational for practice
Shows awareness of personal and
professional values
Identifies the reasoning and evidence base of
actions taken
It will trigger the need to know more and
search out more information
Level 3
Reflection which incorporates level 1 &
2 plus ethical and political dimensions
 Looks at the immediate event, it’s
implications for practice and then
broader social structures and forces.
 It acknowledges the wider influences of
ethical and political decisions with
regard to care delivery and practice.

Goodman’s Example
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Work through the example and add
bullet points to indicate how the
example could be expanded to achieve
Level 2 and then Level 3 reflection
Facilitation of Reflection
Identifying ‘critical incident’
 Awareness of feelings / attributes /
strengths / weaknesses
 Awareness of own learning
 Making connections with prior
knowledge / experience
 Recognition of / planning of next stage
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Tools to help reflection
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SWOT analysis
SWOB analysis
Johari’s window
Reflective log
Pebble pad CSP
eJournal
PHTY 223 Assignment
Reflect on one key learning incidents
which occurred during the placement
 Word limit: 1,000 words
 Different topics you may wish to
consider for your reflection
 You must demonstrate evidence of your
own Personal Development
 Guidelines for reflective writing
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Summarise - Reflection is……

Applied to any activities / situations
 Beyond the descriptive
 Intellectual: analytical, draws in evidence and
literature
 Personal: about your experience
– May include feelings
– May include wider perspectives

Intended to enhance learning and
performance
References
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Jasper M (2003) Beginning Reflective Practice, Nelson Thornes
Kember et al (2001) Reflective Teaching & learning in the
Health Professions, Blackwell Science
Plack M, Santasier A (2004) Reflective Practice: A Model for
Facilitating Critical Thinking Skills within an Integrative Case
Study Classroom Experience, Journal of Physical Therapy
Education, 18,1,4-12
Poulter (2004) Time to Reflect. Nursing Standard, 18, 21
Schutz S (2007) Reflection and Reflective Practice, Community
Practitioner, 80,9,26-29