Nursing & Health Survival Guide: Portfolios and Reflective Practice

Susan Lillyman, Pauline Merrix

• Publisher: Routledge
• Year: 2014
• ISBN:
  9781317905776
• Edition: 1
• Topic: Medicina
• Subtopic: Atención sanitaria

Reflective practice is a requirement for all healthcare professionals. This essential guide will help you develop the skills to be effective as a reflective practitioner within any clinical environment.

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Reflection

■ Why do you Need to Reflect?

• Professional body requirements
• for the Knowledge and Skills Framework (KSF)
• course requirements
• self-development.

Professional body requirements

The Nursing and Midwifery Council (NMC) requires all nurses and midwives to maintain and develop their practice throughout their career. The Prep Handbook (Post-registration Education and Practice), produced by the NMC, provides an outline of what it expects from each nurse and midwife. These requirements include

• Keeping up to date with new developments.
• Thinking and reflecting for yourself.
• Demonstrating that you are keeping up to date and developing practice.
• Providing a high standard of practice and care.

To do this, you are required, after you register, to work as a nurse/midwife for a minimum of 450 hours over 3 years and to have completed at least 35 hours of learning activity relevant to your practice within that same 3-year period. The NMC also requires that you maintain a personal professional profile. For this reason, reflection is important and when recorded can demonstrate that learning and development are continuing throughout your career.

Other professional bodies will also identify their specific professional requirements for each practitioner.

Knowledge and Skills Framework (KSF)

As well as the NMC, the NHS has produced the Knowledge and Skills Framework for all staff working within the NHS. Through this framework, all practitioners are required to identify that they have met the standards in order to deliver quality services to patients. This framework is about the application of your knowledge and skills into your practice and will be followed up in development review and your personal development plan.

Course requirements

All nursing, midwifery and health care professionals’ courses will include some assignments that are reflective in nature. These will help you in developing those reflective skills for applying theory to your practice and prepare you to become a lifelong learner throughout your future career.

Self-development

As health care professionals there is a need to develop within practice, whether it is to become an expert practitioner within a specific speciality, develop and gain promotion or keep up to date with changes within the NHS.

All this reflection is expressive and is aimed at enhancing professional practice.

■ What is Reflection?

Reflection is a process that has been used through nursing, midwifery and other allied professional health education and practice for many decades. It is a process through which the individual can learn from, for and through their practice. It is usually

• local and related to your actual clinical work
• generated by you as the practitioner
• owned by you as a practitioner.

Reflection can help you to

• relate theory to practice
• learn through practice
• develop theory from your practice
• justify your practice
• identify your values in relation to your practice
• celebrate your practice
• identify the need for change within your practice.

Reflection-on-practice

Reflection-on-practice was a term developed by Donald Schön who suggests that it is looking back at an experience and then learning from it. Most of the reflection that you are about to complete for your essays and portfolios will include reflection-on-action, i.e. reflecting on events after they have occurred. Through this you might want to change some of your practice, justify your practice and even celebrate that practice.

Reflection-in-practice

Reflection-in-practice is another term developed by Donald Schön and refers to the reflection that happens while you are practising. You do not always have the luxury of taking time out to think about what you are doing, especially in an emergency situation, however, you can draw on past experience and bring those experiences/action plans into play. You do not work as a nurse, midwife or health care professional on ‘automatic pilot’. Practice involves thinking about what you are doing and reflecting on past experience. It is not always a formal written event but can be thought through at the time of the event.

Anticipatory reflection

Anticipatory reflection was identified by Van Manen as a way of action planning before the event occurs. Reflection is a cyclical event as you can see from the models examined later. Sometimes you start to evaluate, analyse and plan an experience that you are anticipating before you get there, for example your first day on a new ward or clinical area. You think about what you might do, how you might react, how you felt on your last placement; this is the analysis and action plan before the experience. Then you have that experience and reflect on the experience afterwards to see if it has worked out as you planned and maybe you decide it has or that you need to rethink this for the next time.

Reflective practice

■ What is Reflective Practice?

Reflective practice is the way in which you can conduct and learn from your practice. It is how you develop throughout your training and career. A reflective practitioner questions their practice, develops practice and learns from that practice.

■ What is a Reflective Practitioner?

A reflective practitioner is someone who is constantly learning from and for their practice. They are practitioners who have developed critical thinking skills and are able to make decisions about their practice based on solid and defensible knowledge.

A reflective practitioner is

• self-aware of their practice and behaviour
• ever changing and developing practice through problem-solving behaviour
• able to analyse and evaluate their practice
• a critical thinker who incorporates theory and evidence into practice
• able to use ethical decision making
• able to justify their practice through evidence-based practice
• able to hold reflective conversations with others.

■ What is Critical Thinking?

Critical thinking is central to reflection and becoming a reflective practitioner. It assists you in making those difficult decisions, justifying practice and identifying how you have arrived at your decisions based on a sound knowledge base.

Tools for reflection

There are a number of tools that can help you to reflect on your practice. These tools include

• critical incidents
• learning journals
• mind maps
• models of reflection
• critical friends.

■ Critical Incidents

Critical incidents were identified in 1954 primarily by John Flanagan, who worked as an aviation psychologist in the US Air Force. His particular interest was to review information in relation to effective and ineffective behaviours. Through observation, he was able to analyse incidents and produce critical behaviours for certain tasks. In 1984 Patricia Benner suggested that critical incidents could assist the development of expertise in nursing. She suggested that, by observing your practice, you can identify any effective or ineffective practice for the task you are undertaking.

Identifying a critical incident

Critical incidents happen all the time to all of us, but are unique experiences for each of us. For example, if this is the first time you have taken a manual blood pressure, it can be a critical incident in the way you learn from the process. Learning here comes in the form of the actual procedure, communicating with your patient, positioning your patient, record keeping, listening skills, etc. When you have been performing this task for many years and you have learnt the technique and perform the procedure as an expert, it is no longer a critical incident for you.

A critical incident can be

• an everyday experience
• something that is a new task/procedure
• something that went very well
• something that did not go to plan
• an experience that demonstrates theory learnt in class transferred into the workplace
• an exp...

Table of contents

• Cover Page
• Title Page
• Contents
• Dedication
• Introduction
• Reflection
• Reflective practice
• Tools for reflection
• Models of reflection
• Learning through reflection
• Writing a piece of reflection
• Writing a reflective essay
• Developing your portfolio
• Writing your CV
• Clinical supervision
• Action learning sets
• Summary
• Three important things to remember when using/writing for reflection
• References