Reflective Practice in Physiotherapy
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 ?
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
CSP
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
(Poulter 2004)
Competencies
Gibb’s Reflective Cycle
(1988)
Description
of the event
Feelings
Evaluation
Analysis
Conclusion
Action plan
The Task
Choose one of your examples from your
observation week
Think back and expand your thoughts
and reflective skills by completing the
proforma
Continued next slide
Five quick tips to start reflection
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
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
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
Tools to help reflection
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
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
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
Increase knowledge of reflective practice, review reflection models, grasp critical reflection's role in clinical placement, comprehend reflection's significance in physiotherapy practice, and prepare for assignments. Definitions of reflective practice, reasons for reflection, CSP expectations, developing expertise from novice to expert, and the importance of reflection in professional development are also discussed.
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Presentation Transcript
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 ?
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
CSP 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 (Poulter 2004)
Gap analysis Review & evaluation Learning plan Competencies Learning activities
Gibbs 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 And what could have been better? What went well 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 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
Goodmans 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 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.
Goodmans Example 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
Tools to help reflection 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
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 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
