This report contains the role of reflection in health and social care. The second section will explore how to use the practice themes as a framework for reflection. In the next section, I will demonstrate active ongoing central reflection of my learning experience. The final part will assess the overall success of my own reflection.
To become a professional practitioners in health and social care field, we will be enabled to reflect on our experiences, learn from that and take action to improve our skills and knowledge’s. Through the reflective practice, we will demonstrate professional principles and values with consist to put the person in the focal point of all assessment, understand right from wrong and know the importance of caring and supporting individuals. The word Reflection in health and social care means more than a reaction, which implies simply an immediate, gut, response, and is more useful when it is informed reflection. The reflective practitioner must do at least three things which are: thinks how to work out with the service user, draws on previous experience of work with others and Makes links with knowledge of theories, approaches and methods of practice.
According to Melanie Jasper, Reflective practice is seen as one of the ways that professionals learn from experience in order to understand and develop their practice. There are two types of reflection: is the way that people think and theorize about practice whilst they are doing. (Melanie Jasper, second Edition, p7). involves consciously exploring an experience and thinking about your practice after it has occurred, discovering, and the knowledge used in that situation. (Melanie Jasper, p7, Beginning Reflective Practice)
We reflect to develop strategies for survival throughout our lives and those strategies help us to ensure that we do learn as a result of what happens to us. The main purpose of reflection in health and social care practice aim to: Identify learning needs and new opportunities for learning, help us to make decisions or resolve uncertainty, to build theory from observations, for professional development, be aware of the consequences of our action, empower or emancipate ourselves as individuals. (Beginning Reflective Practice, Second Edition, page 6)
Reflect to identify learning needs: for example, learning Blind Sign Language will be the best action to take for a healthcare assistant to communicate with patients. Reflect to demonstrate our achievements to ourselves and others: delivering a proper specific centre care to each service user depending to their needs could be an example of demonstrating our competence to other. If they were not taking care properly of their patients, through someone’s competences they will reflect and change their ways to do things. Reflect for professional development: to develop professional skills for example, a health practitioner should reflect on his own experiences, and understanding himself first. He can plan to build on his previous knowledge and skills by recognizing his strengths, weakness, opportunities and barriers. For example, updating ours knowledge as care provide.
Reflect to help us make decision or resolve uncertainty: If there is a reasonable degree of uncertainty about whether a particular treatment will provide overall benefit for a patient who lacks capacity to make the decision, the treatment should be started in order to allow a clearer assessment to be made. You must explain clearly to those close to the patient and the healthcare team that the treatment will be monitored and reviewed and may be withdrawn at a later stage if it proves ineffective or too burdensome for the patient in relation to the benefits.
To overcome barriers that make the reflection been ineffective, models and tools are used for reflection in health and social care. Model is a representation of the relationship between theoretical principles that underline practice (Gillie and Russel, 2018). There are many models of reflection used in educational experiences and in the literature, they can be list as follows: Goodman’s Levels of reflection, Gibbs’s Reflective cycle, John’s model, Borton’s development framework, Rolfe & AL’s model, the 4Mat Model. Model is used for reflection because it helps practitioners focus on learning and self- awareness after an incident, models can also prompt them to think more deeply about the whole process of reflection and finally becoming a reflective practitioner.
Tools are objects which aim to support people to perform a function or achieve a desired outcome that otherwise would be more difficult or even impossible.(Gayle Rice, Leon Cruickshank, Roger Whitham, Hayley Alter and Josie Vallely,31Oct 2016). Tools are important because it aid people to develop opinions or responses on issues for which they do not always have words. Use a specific tool make us different from other people.
Borton’s development framework is a fairly straightforward and easy to implement reflective framework. This enables you to reflect without having the structure in front of you, therefore a favoured one of many health care professionals and advocated by professional bodies. According to Melanie Jasper, (Beginning Reflective Practice, p99) Borton’s framework can be used both for novice practitioners and student at any level. This model helps students to become more adept at reflecting on their practice and more critically analytical as they need to operate in the real world of practice. It is based on three questions:
What? This question helps to describe in detail the situation or the incident. It is the description and self-awareness level. We can ask ourselves this type of questions such as (what happened? What was I doing? What were others doing?) For example: a career who has a responsibility to safeguarding autistic service users, falls asleep for an hour because of fatigue and leaves them unattended. When he wakes up, he notices that one of the patients has seriously bitten the other in his left ear. He will ask these questions starting why what?
So, what? Is the second level of this model and questions arise here can be: so, what more do I need to know about the incident to understand it. So, what could I have done that was different? At this level, a practitioner analyze and evaluate when look deeper at what was behind the experience also can interpret the incident. For example: the career, to understand the incident need to know more about it. For that he can ask to other services users or colleagues if they were presents when it happened. After that, find the way he/she could have done that different.
Now what? Is the third level, where the synthesis is made because the practitioner builds on the previous levels questions to enable him to plan intervention and action to do next? The types of questions are: Now what will I do? Now what do I need do to make things better? Now what might be the consequences of this action? For example: the healthcare who made a mistake when treating a patient’s wound would reflect on the consequences of this action and how to improve the care to give to the patients.
Professor Graham Gibbs published his reflective cycle in his 1998 book “Learning by Doing”. With this model, people learn from their mistake and use it to explore the situation or to coaching someone else. (Mind Tools, essential skills for excellent care) It is about describing the situation without taking any conclusion stray a way. All information is useful and important to better understanding the situation. For example, if a patient had an incident, as care provider, we need to explain it clearly. Question to be ask here are: what happened? When did it happen? Where did it happen? Who were involve? The practitioner needs to explain what he/she is reflecting to other people.
It is about the things that the practitioner was thinking during the incident or the situation, what was his gut reaction on this? How he was feeling on that time? Maybe he could be happy, sad or dissatisfied with what happened. For example, after a service user had break his rips on the stairs, the care provider can feel very unhappy and sad with the event because of the pain that the service user had. Here the practitioner evaluates and measure the incident by asking himself those questions: what was good or bad about the experience? The result of these questions will help to improve where it is needed and to say what make him unhappy.
For example: the care provider can say that he is unhappy because there is no lift in the care home which it bad, and the service user twist his ankle and broke his hip on the stairs.so the care home needs lift for which will be good for service users and avoid other incidents. On this stage, the student makes a comparison between this experiences and others experiences.it is about the effects of his reaction regarding the situation. For example: as a care provider he could reduce the risk of accident on the stairs by always being with service user who needs to use the stair or ask to the administration to install the lift with will be benefit for all. The question here to ask are could be: what went well? What did I do well? What did others do? What knowledge did I use?
It is about what the practitioner has learnt with incident and what can he/she do to stop this situation or could have done differently? This is the purpose of reflection which is learn from experience. For example: the care provider has learnt to do not leave any service user alone on the stairs because it is no safe consists to take an action if a situation arises again. It means do not make the same mistake twice. Having used the various models to help in reflection, the outcome of the reflection is compiled in the portfolio demonstrate the level and skills acquired and this is used for career progression.
It is also used for re-validation of all clinicians. The evidence in the portfolio will demonstrate that clinicians are up to date and are fit to practice. This means that reflection is not done for the sake of doing it but is the means that can be used to demonstrate competency of health professional and help the progress in their career.
Evidence within the portfolio could be in the form of appraisals, assessment and feedback which are all use to demonstrate evidence of competency. Evaluate how own reflections can impact on own personal and professional development and the experience of individuals using health, care or supports services. Reflection is process of exploring and examining our experiences, actions and ourselves. It helps us as practitioner to gain insight and take action for the next plan. (www.ed.ac.uk). Own reflection can impact on personal and professional development in healthcare. For example, practitioners reflect on their experiences to enable future improvements and it contributes to learning.
Reflection helps us to keep our skills and knowledge up to date; we can have formal training (face to face) to meets our learning and development needs. Also shared learning through presentation, emails help to give feedback to other on what we leaned and how to apply it on our work.
- Gponline.com. (2019). GP magazine news, medical education, CPD and GP jobs | GPonline. [online] Available at: https://www.gponline.com/ [Accessed 5 Jan. 2019].
- Usherbrooke.ca. (2019). Accueil – Université de Sherbrooke (Québec, Canada). [online] Available at: https://www.usherbrooke.ca/ [Accessed 5 Jan. 2019].
- UCL. (2019). UCL – London’s Global University. [online] Available at: https://www.ucl.ac.uk/ [Accessed 5 Jan. 2019].
- Ford, S., Ford, S., Mitchell, G. and Shepherd, E. (2019). Nursing Times: Resources for the nursing profession. [online] Nursingtimes.net. Available at: https://www.nursingtimes.net/ [Accessed 5 Jan. 2019].
- Weinberg, N. (2001). Using Performance Measures to Identify Plans of Action to Improve Care. The Joint Commission Journal on Quality Improvement, 27(12), pp.683-688.
- My.sra.org.uk. (2019). mySRA – Login. [Online] Available at: https://my.sra.org.uk/website/Pages/Security/login.aspx [Accessed 5 Jan. 2019].
- Learning.surgery.ed.ac.uk. (2019). ChM. [online] Available at: https://learning.surgery.ed.ac.uk/discussions [Accessed 5 Jan. 2019].
- Cruickshank, L., Whitham, R., Rice, G. and Alter, H. (2017). Designing, Adapting and Selecting Tools for Creative Engagement: A Generative Framework. Swedish Design Research Journal, 15(1), p.42.
- Archive.org. (2019). Full text of ‘Bradbury’s fresh laurels for the Sabbath school: a new and extensive …” [Online] Available at: https://archive.org/stream/bradburysfreshl00bradgoog/bradburysfreshl00bradgoog_djvu.txt [Accessed 6 Jan. 2019].
- Afpp.org.uk. (2019). [Online] Available at: http://www.afpp.org.uk/filegrab/Gibbsmodelofreflection.pdf?ref=46 [Accessed 6 Jan. 2019].
- Stover Gingerich, B. (2009). Resource Review: Home Health Care Provider: A Guide to Essential Skills. Home Health Care Management & Practice, 22(1), pp.75-77.
- Adams, R. (2007). Foundations of health and social care. Basingstoke: Palgrave Macmillan.
- Rolfe, G., Jasper, M., Freshwater, D. and Rolfe, G. (2011). Critical reflection in practice. Basingstoke: Palgrave Macmillan.
- Gmc-uk.org. (2019). [Online] Available at: https://www.gmc-uk.org/ [Accessed 6 Jan. 2019].
- Jasper, M. (2014). Beginning reflective practice. Johanneshov: MTM.