Reflection is an essential part of the new CPD scheme. Not to burden you with extra paperwork or waste your time but so you reap far more benefits from CPD. You make a significant investment of time and money into your CPD and reflection gives you the opportunity to maximise on your professional development.
Reflective practice helps you to strengthen your day to day practice. It involves studying your own experiences to improve the way you work. It will help you to increase your confidence, be more proactive and improve the quality of care you offer. Reflection demonstrates you are striving for excellence. If you are starting to feel stale or bland and mechanical or have lost confidence through a bad experience or negative feedback, reflection can help you to get back on track.
The General Medical Council states that ‘Reflection drives change in performance and is the key to effective CPD. Good medical practice requires you to reflect regularly on your standards of medical practice.’
This is a beautifully crafted description of the purpose of reflection ‘Embody professional artistry, encourage critical self-aware evaluation and embrace transformation and change’, source unknown.
John’s is one of the leading writers on reflective practice and his model of reflection is widely utilised. He said “Reflective practice is the antidote to complacency, habit and blindness.”
You are already reflecting
As a practicing osteopath you may be unaware that you use reflection in practice daily. Whenever patients return with feedback on treatment – improvement, worsening, changes in symptoms etc. – you will reflect internally and often verbalise that reflection with patients – what went well, what didn’t, what are the options now etc.
There is however, an important distinction between reflecting IN practice and reflecting ON practice. Reflecting on practice is like a post-mortem of your actions. You will construct and reconstruct your ideas of good practice by asking the awkward questions. Reflecting on practice provides the fuel to drive change towards enhanced professionalism and clinical excellence.
A recent survey of osteopaths indicated that many do not reflect because they do not know how to. Reflection is a taught skill and as such once learned it takes practice to develop. Practice to identify opportunities for reflection and practice to refine the thought processes involved in effective reflection.
A reflective practitioner
In order to be a reflective practitioner you need to have a set of qualities and skills that enable you to engage in the process. These have been listed by Flying Start1 as:
- a willingness to learn from what happens in practice
- being open enough to share elements of practice with other people
- being motivated enough to ‘replay’ aspects of clinical practice
- valuing that knowledge for clinical practice can emerge from within, as well as outside clinical practice
- being aware of the conditions necessary for reflection to occur
- a belief that it is possible to change as a practitioner
- the ability to describe in detail before analysing practice problems
- recognising the consequences of reflection
- the ability to articulate what happens in practice
- a belief that there is no end point in learning about practice
- not being defensive about what other people notice about one’s practice
- being courageous enough to act on reflection
- working out schemes to personally action what has been learned
- being honest in describing clinical practice to others
A challenging list perhaps but this emphasises the point that reflection needs to be practised to develop good skills in reflective practice.
Opportunities for Reflection
There are many opportunities for reflection to take place within and around the Osteopathic practice:
- CPD courses
- Reading a journal or article
- Networking meetings or conferences
- Peer discussions
- Results of clinical audits
- Feedback from patients or colleagues
- Practice matters – environment, marketing, procedures
- Unusual presentations
- Management of common presentations
- A case that went well
- A case that didn’t go well
- A significant event in clinic
- A complaint received
How to Reflect
Essentially the process involved in reflection is to stop and think. It is to analyse your decision making, compare theory to practice and then modify actions, behaviour, treatments and learning needs.
Reflection can take place individually, with others or as part of a team. It can be verbal, visual or written. You may want to record it as a video, or write down the reflective process. Reflection is always best recorded in some way so you can use it as evidence of your professional development. It will need to be included in your portfolio under the new CPD scheme so best to start develop skills for recording reflection now.
There are several models to help guide you through the thought process of reflection. Gibb’s, John’s, Rolfe’s, SWOT and reflective narrative are all well-tested models. The model chosen will depend on the situation being reflected upon. Many of these models are for reflecting on a particular significant event, you will need to choose a different model for broader reflection.
Pick a situation from the list above, something that resonates with you – maybe a clinical scenario, some feedback or a recent CPD course, whatever you like. Look at the different models and then work through the reflective process to identify actions to inform practice.
The most important aspect of reflection is to apply it to practice. Make sure that reflection leads to action whether that be change in practice, further learning and development, whatever is needed for your professional development.
I hope you are now convinced about the benefits of reflective practice and feel ready to engage this aspect of practice. Mint has a module on self-reflection which includes templates of some of the reflective models – it’s available in the shop for only £10.
We now have a group on facebook where this month’s subject is reflection and we are demonstrating examples of reflection, do come and join in.
2 GMC www.gmc-uk.org
3 Reflective models available here: http://www.nottingham.ac.uk/nmp/sonet/rlos/placs/critical_reflection/models/index.html