This report covers the role of reflection in health and social care practice. The second part will examine how to use the practice themes as a framework for reflection. In the next part I will demonstrate active, ongoing, critical reflection of learning experiences.
The final part of this report will assess the overall success of own reflective journey and consider future career pathway. P1 Explain the purpose of reflection in health and social care practice Introduction ”Reflective practice is something that you will first officially encounter at the university. This may be that they are reflecting on a person case, or other experience. On the other hand, what you may not have put into consideration is that you have been involuntarily reflecting your entire life: thinking about and learning from past experiences to avoid things that did not work and to repeat things that did work”. (Koshy et al 2017) Social Care Institute for Excellence 2012 (SCIE), ”define reflective practice as ‘the capacity to reflect on action so as to involve in a process of continuous learning”. What is reflection? ”Reflection is concerned with consciously looking at and thinking about our experiences, actions, feelings, and responses, and then interpreting or analysing them in order to learn from them”. (Atkins and Murphy, 1994; Boud et al., 1994). www.open.edu/openlearn Reflection is divided into two types: reflection-in-action and reflection-on-action. ”Reflection-in-action can be termed as the way that people think and theorise about practice while they are doing it. Reflection-on-action involves consciously exploring an experience and thinking about your practice after it has occurred, discovering the knowledge that was used in that situation”. (Schon 1983) According to (Chapman et al, 2008), ”reflection allows health practitioners to be able to share knowledge with others, to benefit practice and helps professionals make sense of challenging and complicated situations”. ”Engaging in regular reflection enables practitioners to manage the personal and professional impact of addressing their patients’ fundamental health and wellbeing needs on a daily basis”. (Eileen, 2012). The purposes of reflection in health and social care practice include the following:
• Identify learning needs
• Identify new opportunities for learning • Identify the ways in which we can learn best
• Identify the new course of action
• Explore alternative ways of solving problems
• For personal development
• For professional development
• To be aware of consequences of own action
• Demonstrate our competence to others
• Demonstrate our achievements to ourselves and others P2 Describe models and tools used for reflection in health and social care practice ”Reflection in health and social care practice is very essential for challenging and improving practices. Reflection can also provide a way for healthcare practitioners to deal with the difficult issues they are more likely to experience. In health and social care settings, reflecting on tasks gives them an opportunity to look at each stage of a caregiving process and also decide if an appropriate action has been taken”. (Kerrith Britland 2017) Kolb’s learning cycle The Kolb’s learning cycle consists four elements – a concrete experience, an observation and reflection, formation of abstract conceptualisation and active experimentation in new situations. Kolb et al (1975). The circular model does not mean that each stage should be weighted equally in time and emphasis. Vince et al (1998).
Kolb and Fry, in their theory, argue that the learning cycle can begin at any of those points. Although, in its simplified form, the cycle will begin by carrying out a task, the individual would reflect on that experience and also apply the learning in a new situation. In order to apply experience to the new situation, the ability to take a broad view through identifying principles and their connections to actions over a range of circumstances is needed. Throughout the process, learners will rate themselves which is an important element for adult learners (Kayes 2002) and might be considered relevant for professional development to continue. In Donald Schon work (1983), he concludes that the possible objects for reflection can be as varied as the situations faced and the systems in which they occur.
Reflection can be understood as the ‘ability to gain understanding of specific issues in practice through critically contextualizing, observing and analysing to generate new knowledge and insights which can enhance practice’ (Fleming 2007). This may mean that the person might reflect on the feeling for a situation which has led to the adoption of a particular course of action, the way in which the problem has been framed and/or the role this has created for the individual in the wider institution as a result. (Journal of Public Health, 2013) Gibbs’ reflective cycle (1998) Gibbs’ reflective cycle inspires a person to think thoroughly about the phases of an experience or activity, and to also use all the headings to structure your own reflection. According to Gibbs’ reflective cycle (1988), it encourages a clear explanation of the situation, analysis of feelings, evaluation of the experience and an analysis to make sense of the whole experience. This would be followed by conclusions where other options are put into consideration and reflection upon experience to analyse what one would do if the situation happened again.
Gibbs defines a cycle of description, feelings, evaluation, analysis, conclusion and action plan. The description is questioning – what happened followed by the feelings brought about through the questions ‘what were you thinking and feeling?’. The evaluation constituent describes what was good and bad about the experience. The analysis should identify what sense can be made of the situation and the conclusion details what else could a person have done. The process of reflection is concluded with an action plan for what could be done if the situation happened again. (Journal of Public Health, 2013) Atkins and Murphy’s model 1993 Atkins and Murphy model suggest that for reflection to have a real outcome action commitment needs to be followed. Both the authors describe a cycle of awareness, description, analysis, evaluation and learning. The beginning of the reflective process starts with the awareness of uncomfortable feelings and thoughts from the action or new experience which was followed by a description of the situation including thoughts and feelings. This would need to include salient events and key features that are identified by the reflector.
The reflector would need to analyse feelings and the relevance of knowledge to the situation – identifying knowledge, challenging assumptions, imagining and exploring the alternatives. (Journals of Public Health, 2013) M1 Review the ways that reflective practice is applied in health, care or support service environments The ways that reflective practice is applied in health, care or support service environment is when reflective practice is an important part of your career progression in health care as well as you demonstrating evidence of competency but if it is done very well, it can greatly improve your own skills as a healthcare provider. Evidence of reflective learning and development need to be gathered using the practical learning and assessment documentation portfolio. Reflective practice is applied within the portfolio evidence of learning through records of one to one and also group assessments.
It can also be applied through assessment and feedback from professionals/assessors and service users. The other ways that reflective practice can be applied in healthcare or support service environments is through records of supervisor/assessor observation of practice. When using narratives and case studies in reflective practice, they must be used in the correct ways. Reflective practice is applied through collaborative action learning group reflection. This is when a group of people (usually 3-5 people) come together over a period of time and then learn through reflecting on recent problems or areas of investigation. (Reflective Practice CD ROM, 2007). Keeping diaries of practice is another way that reflective practice is applied in healthcare or support service environment because it has many benefits. These include improving your mental health, as well as giving you a place to vent your feelings, and an ability to process difficult experiences. It is also a way of keeping track of your feelings and views and how they have changed over the years, which can be mainly helpful in your personal development terms. Providing evidence of practice from other units is also a way of applying reflective practice. The ways that reflective practice is also applied in healthcare or support service environment is by producing development plan based on skills audit.
This is where you are able to analyse your current skills and preparing and implementing a personal development plan. D1 Evaluate how own reflections can impact on own personal and professional development and the experience of individuals using health, care or support service users To begin with I feel that it is important to define what reflect actually is. To reflect means to look back, and that is what I am going to do in regards to my personal and professional development. Reflection is a key skill to even have and is important to the health and social care environment as it helps to improve skills which I believe I have made positive progress and overcome my mistakes that I have previously made.
Personal development is the process of maintaining one’s well-being in terms of physical, social and psychological aspects. It is the constant process of developing and enhancing personality through learning and socialisation processes. During my summer holidays last year, my family and myself were at my sister’s apartment enjoying ourselves and also having a good time. My sister received a call from Port Harcourt, Nigeria, where her daughter, Blessing, studied. She disclosed that her daughter had met with a critical accident. I was shocked and difficult for me to gather my thoughts and comprehend the situation around me at that moment. I had never been in a situation where someone close to me was fighting for her life. Never being in a situation like this before in my life I felt the need to follow someone or do something to keep myself engaged.
I followed Richard my brother-in-law to the kitchen to make a tea for everyone that is present at the apartment. While in the kitchen I encountered awkward silence between us, feeling pressure of this silence, I intended to break the ice by approaching him to offer my support. Upon approaching him I noticed that he had a worried look on his face. He looked into my eyes and busted out into tears. This outbreak of his emotions left me feeling even more awkward and I lost all the sense of what to do or say.
Hearing the sobs of Richard, my mother came rushing into the kitchen and took control of him. I felt quite sad because of my niece’s accident and my own stupidity of not being able to handle my state of mind in an intense pressure situation. Upon examining this situation, I should have known that Richard was feeling tensed and anxious. I should have prepared myself to give Richard a bit of time alone, as well as I should have had someone that has got more experience to take control of the situation. But next time my action plan should be to control some of my own anxiety and also help them reduce their anxiety as well by showing a bit more empathy to someone who is feeling very emotional.
