Reflective Practice : An Essential Attribute For The Development Of Autonomous, Critical And Advanced Practitioners

Throughout personal professional development reflection is essential, allowing health care professionals to self-develop by revisiting events and analysing areas in which improvements and learning would ensure a positive impact on their future practice. The Nursing and Midwifery Council, (NMC, 2010) notes that all health care practitioners must be self-aware in their own values and principles which could affect their practice. Ensuring they maintain personal and professional development while learning through supervision, feedback and reflection.

Critical reflection is vital to develop evidence based practice for safe and quality approaches to professional nursing practice. Nursing professionals should critically reflect on events to identify what health professionals might do to improve their practice and reduce the risk of a similar error. Reflective practice can help to learn from their mistakes, be empowered and most importantly to deliver best possible care to patient as nurses must work closely with their patients to develop a therapeutic relationship. Critical reflection is a valuable skill to ensure patient centred care. This practice promotes personal development by enhancing students’ self-awareness, their sense of community, and their sense of their own capacities for

Burns, S. Bulman, C. Palmer, A. (1997) Reflective Practice in Nursing - The growth of the professional practitioner. London: Blackwell Science.

Reflection is a process of exploring and examining ourselves, our perspectives, attributes, experiences and actions / interactions. It helps us gain insight and see how to move forward (Nursing Times 2018). I believe reflection is particularly important when it comes to Nursing, as medicine is constantly changing/ improving and us ourselves medical professionals must adapt with the changes in medicine. I find that reflection is extremely useful in doing this as we can look over procedures or experiences that we have had, how that made us feel, whether we would change anything, then in the future we can see the changes that may have been made, whether this has changed our feelings and opinions on medical practice.

Reflective practice in nursing is the process where we examine our nursing ability’s and practice in order to critically think and analyze the way we work and think about the views of others in our practice, what we could have done and we could have achieved a greater result by doing this also allows us as nurses to include best practice and use our own judgment in patient care to show the factors that either aid and hinder nurse to patient relationship. (Lowenstein, Bradshaw and Fuszard, 2001) described reflecting in nursing practice “the nurse must first come to understand what he or she defines as ideal practice”.

Reflection is defined by Howatson-Jones (2013), as “a way of examining your experience in order to look for the possibility of other explanations and alternative approaches to doing things” (p. 6). The practice of reflection is important for numerous reasons. As stated by Hargreaves and Page (2013), reflections promote good practice and in the occurrence of a difficult or challenging situation, they can help to identify where things went wrong and how to improve the outcome for future incidents. As identified by Jasper, Rosser and Mooney (2013), reflection offers benefits to both the patient and the practitioner. Practitioners are more likely to avoid routine practice, continuously develop their knowledge and identify faults to improve on. Patients are more likely to receive higher standards of safety and better quality of care

Experience is sometimes regarded as the best teacher. Many things can be learned in a classroom and by formal academic study, but many cannot. Reflective practice is a form approach to learning through experience. Reflective practice is a lifelong learning process to promote continual development of the nurse. Reflective writing practice helps the nurse to gain knowledge and to challenge their own ideas and concepts. The idea of reflective practice is not only to see what happened, but to see the situation through new eyes, eyes that can help in personal growth and to develop ways to respond differently in the future.

For the purpose of this essay, I have selected Gibbs (1988) Reflective Learning Cycle to reflect on an aspect of individual professional practice, which requires development in preparation for my role as a Registered Nurse. Gibbs (1988) Model of Reflection provides a clear description of a situation, analysis of feelings, evaluation of the experience, conclusion, and action plan to make sense of the experience to examine what you would do if the situation happens again.

The ability to become reflective in practice has become a necessary skill for health professionals. This is to ensure that health professionals are continuing with their daily learning and improving their practice. Reflective practice plays a big part in healthcare today and is becoming increasingly noticed.

Reflective practice in nursing is considered an important aspect to nursing. Durgahee ( 1997) defines reflective practice as a process of learning and teaching professional maturity through the critical analysis of experience, whilst John ( 2009) up to date explanation of reflection is learning through our everyday experience towards realising one vision of desirable practice as a lived reality.

In recent years, reflection and reflective practice have become well-known term with in the health care arena. They are words that have been debated and discussed with in the health care setting (Tony and Sue 2006). Reflective practice is essential for nurses, as nurses are responsible for providing care to the best of their ability to patients and their families (NMC, 2008). Reid (1993) states reflection is a process of reviewing an experience of practice in order to describe, analyse, evaluate and so inform learning about practice. Johns (1995) notes that reflection enables practitioners to assess, understand and learn through their experience. Reflective practice, therefore, offers nurses an opportunity to review their decisions and

Schon (1987) identified two types of reflection that could be applied in the nursing practice. He described “refection-on-action” that involves assessing and analyzing an action while performing the action and “reflection-in-action” which involves going back to previous actions and situations and analyzing them to gain new insights and to improve the nursing practice (Schon 1987). Schon further argued that for reflection to take place there should be a commitment to action as there is to results. Coined in 1970, Borton’s theory on the other hand, proposes the use of three stem questions in the reflective practice (Borton, 1970). These questions were originally proposed by John Driscoll who described the experiential learning cycle (Driscoll, 1994) where practitioners are able to learn from their experiences to improve their practice. According to Driscoll (1970) these trigger questions could be used to complete the experiential learning cycle leading to a practitioner gaining new information and insights on how to improve their practice (Driscoll, 1994). The importance of Driscoll’s three stem questions in improving practice reflection among nurses cannot be underestimated. By answering these stem questions, nurses develop a better insight into the situation regarding how and why it occurred and identifies the next courses of action in case the situation recurs.

Personal reflection in nursing is essential and critical as it allows for continuous development and re-assessment of skills whilst working within a health care setting (Reflective practice: a tool to enhance professional practice 2011, pp.1-3). Personal reflection is important as reflective practice allows for the ability for one to reflect and examine their actions and experiences which overall will increase and enhance their clinical knowledge, as well as developing and improving their practice (Reflective practice: a tool to

As higher standards expected are from the public and higher patient safety demands are expected from health boards, therefore, there is a need for a way of measuring standards of practice which can be achieved through active thinking in a clinical environment brought about by critical reflection (Rolfe, Jasper & Freshwater 2011). Reflection has become such a key component in the role of a nurse that the Nursing and Midwifery Council (NMC) have seen it fit to include it in their professional code of conduct the Code: Professional Standards of Practice and Behaviour for Nurses and Midwives, hereafter referred to as the Code (Nursing & Midwifery Council [NMC], 2015). With reflection being a vital skill for nurses to continue their professional development (Parrish & Crookes, 2013), an analysis of what it means to reflect within nursing is needed by all who intend to enter the profession to ensure its effective use is applied.

Reflection is used by nurses and health care professionals to incorporate theoretical and practical knowledge (Cowen et al 2009). On the other hand, Rolfe et al (2011) noted that reflecting on the event and thinking about any action that could have been taken differently. For effective changes to occur when reflecting, the reflector should pay attention to what they are thinking, how they are feeling and what they recall (Taylor 2010 cited in Howatson-jones 2013)