Skip to main content

Nursing Guide: Reflective Practice

This Guide has been created to help Nursing students find Library resources

What is reflective practice?

"Reflective practice occurs when you explore an experience you have had to identify what happened, and what your role in the experience was – including your behaviour and thinking, and related emotions. This, allows you to look at changes to your approach for similar future events. If reflective practice is performed comprehensively and honestly, it will inevitably lead to improved performances" (La Trobe University, 2015).

"Reviewing experience from practice so that it may be described, analysed, evaluated and consequently used to inform and change future practice. Importantly, reflection also involves opening up one's practice for others to examine, and consequently requires courage and open-mindedness as well as a willingness to take on board and act on criticism" (Bulman, 2008, p. 2).

Gibbs' model of reflection

Gibbs' reflective cycle involves 6 steps:

Gibbs, G. (1988). Learning by doing: A guide to teaching and learning methods. Oxford: Further Education Unit, Oxford Brookes University.

Description

  • Describe in detail the event you are reflecting on.
  • What happened; where were you; who else was there; why were you there; what were you doing; what were other people doing; what was your part in the event; what parts did other people play in the event; what was the result?

Feelings

  • What were you thinking and feeling?
  • Try to recall and explore the things that were going on inside your head.
  • How were you feeling when the event started; what were you thinking about at the time; how did the event make you feel; how did other people make you feel; how did you feel about the outcome of the event; what do you feel/think about the event now?

Evaluation

  • What was good and bad about the experience?
  • Evaluate and make a judgment about what has happened.
  • What was good about the experience/event; what was bad about the experience/event; what didn't go so well; what did you and other people do to contribute to the situation (positively or negatively)?

Analysis

  • What sense can you make of the situation?
  • Break the event down into its components.
  • Explore the various components.
  • Look back and ask more questions about previous answers like: What went well; what did you do well; what did others do well; what went wrong; what didn't turn out the way it was supposed to; who and what contributed to how things turned out?

Conclusion

  • What else could you have done?
  • Having worked through the different stages you now have more information to base your judgment on.
  • What insights have you gained by working through the cycle; what have you learnt from the experience; what could you have done differently; what skills do you need to develop, so that you can handle this type of situation better; how could this have been a more positive experience for everyone involved?

Action plan

  • If it arose again, what would you do?
  • What would you do; would you do things differently; would you do things the same way; what actions do you need to take?

(MindTools, 2016)

Atkins & Murphy's model of reflective practice

http://api.ning.com/files/U4nVIpmxyNMaaNxfDN4GfgVwkUY5xSF8et6YF9JAx*lJK9CN*fxSF*Cvb8fWdrD3haCtttcclNG7bgMvbX90EYOssl2LdO47/atkinsmurphy.jpg

(http://www.open.edu/openlearn/education/learning-teach-becoming-reflective-practitioner/content-section-6.3)

Atkins, S., & Murphy, K. (1994). Reflective practice. Nursing Standard, 8(39), 49-56.

Books

Johns' model of reflection

Johns' model of reflection uses 5 cues to help the practitioner reflect on an event/experience, to make sense of it and to learn through it:

There are various questions that can be asked for each section.

Description

  • Describe the experience.
  • What are the key issues that I need to pay attention to?
  • What were the significant factors?

Reflection

  • What was I trying to achieve?
  • What were the consequences of my actions?
    • For the patient and family
    • For myself
    • For the people I work with
  • How did I feel about this experience when it was happening?
  • How did the patient feel when it was happening?

Influencing factors

  • What internal/external factors influenced my decision-making and my actions?
  • What knowledge influenced my decision-making and my actions?

Could I have dealt with it better

  • What sources of knowledge should have influenced my decision-making and my actions?
  • How could I have dealt better with the situation?
  • What other choices did I have?
  • What would have been the consequences of these alternate choices?

Learning

  • What will change because of this experience?
  • How can I make sense of this experience in light of past experience and future practice?
  • How has this experience changed my ways of knowing (scientific knowledge, moral knowledge, self awareness, my own experience and what I do)?
  • How do I now feel about this experience?
  • Have I taken effective action to support myself and other as a result of this experience?

 

Johns, C. (1994). Nuances of reflection. Journal Of Clinical Nursing, 3(2), 71-74 4p. doi:10.1111/j.1365-2702.1994.tb00364.x

 

Rolfe's model of reflective practice

Rolfe's framework of reflective practice is based on Borton's (1970) model. It consists of three key questions:

  • What?
  • So what?
  • Now what?

What ...? - Descriptive level of reflection

  • ... is the problem/difficulty/reason for an event?
  • ... is the reason for feeling bad?
  • ... is the reason why something happened?
  • ... was my role in the situation?
  • … was I trying to achieve?
  • … actions did I take?
  • … was the response of others?
  • … were the consequences for the patient, for myself, for others?
  • … feelings did it evoke in the patient, in myself, in others?
  • … was good/bad about the experience?

So what ...? - Theory and knowledge building level of reflection

  • … does this tell me?
  • ... does this teach?
  • ... does this imply/mean about me, my patient, others?
  • ... does this imply/mean about my patient's care?
  • ... does this imply/mean about the model of care I'm using?
  • ... does this imply/mean my attitudes, my patient’s attitudes, other people's attitudes?
  • … was going through my mind as I acted?
  • … did I base my actions on?
  • … other knowledge can I bring to the situation (experimental, personal, scientific)
  • … could/should I have done to make it better?
  • … is my new understanding of the situation?
  • … broader issues arise from the situation?

Now what ...? - Action-orientated (reflective) level of reflection

  • … do I need to do in order to make things better
  • ... do I need to do in order to stop being stuck
  • ... do I need to do in order to improve my patient’s care
  • ... do I need to do in order to resolve the situation
  • ... do I need to do in order to improve my skills/knowledge?
  • … broader issues need to be considered if this action is to be successful?
  • … might be the consequences of this action?

(www3.hants.gov.uk/reflection-2.doc)

ABN 54 093 513 649 • Privacy StatementCopyright and DisclaimerLibrary Webmaster • CRICOS Provider No: 00300K • RTO Provider No: 0373