Reflective learning is another way of learning. It is a means by which you learn by thinking about things that have happened to you. As a consequence of reflection you may see things in a different way, which in turn enables you to take some kind of action (Jasper 2003).  The aim of reflection is to encourage you to examine and explore your behaviour, thoughts, feelings and attitudes.

Please read the following example of reflection by a first year nursing student.

1^st year nursing student Joe O’Shea is with his preceptor engaged in reflection on his first experience of caring for a patient who was dying. Through the process of reflection he learns that in such a situation he finds it incredibly difficult to know what to say, feeling a large degree of unease anxiousness and indeed vulnerability.   Reflecting on the experience, he identified that much of his time with the patient was simply spent being present and remaining silent. His unease he uncovered was in his silence, believing he should have been distracting them from the enormity of their situation, offering condolences and sympathy, ‘doing something’.

 

In critically thinking about his experience with his preceptor in light of empirical evidence, theoretical opinion, and her experiential knowledge, he identified that the simple act of  ‘being present’ with the patient was a powerful means of providing comfort and support in and of itself.

 

Nurses, he learned, have a potential to alleviate existential and spiritual suffering through ‘consoling presence’ (Tornøe et al, 2014). Hospice nurses revealed that sharing silence with patients can have a powerful consoling effect and that embracing the silence demands a mental shift from focusing on “doing something for the patient” to focusing on “being with the patient”. This, he learns, demands enormous personal courage. Not having a “professional mask or task” to hide behind can make a nurse feel open and vulnerable.

This was a revelation, giving voice to Joe’s initial feelings of vulnerability. He learned that what initially felt like inaction on his part was in fact a powerful means of caring for a dying patient. His need to ‘do something’ though powerful, was resisted, demonstrating personal courage on his behalf. Thinking back on it, Joe identified it was an unconscious act, one engaged in by accident, rather than design. Equipped now with this new understanding and learning, Joe plans to actively incorporate ‘consoling presence’ and ‘sharing silence’ as part of his plan of care for those he has the privilege of caring for in their final days.

This example demonstrates Joe critically examining his experience in order to look for the possibility of other explanations and alternative approaches to doing things.  He has learned from it. This is evidenced by a change in the following;

Behaviour: Will now actively engage in the skill/practice of ‘consoling presence’

Knowledge: Of the concept of ‘consoling presence’, its impact, its pre-requisite (courage) 

Attitude: Self-confidence – ‘can do’ when faced with similar situations.

 

2. Why do I need to reflect on my practice?

There are many reasons why you need to reflect on your practice and your learning. Reflection helps you to acknowledge your thoughts and feelings, thereby enabling you to scrutinise and learn from what you do. Reflection may prompt you to embrace new ideas and better ways of doing things, it enhances your learning and provides a mechanism and structure from which you can develop consistent methods of improving your practice. Reflection helps you to evaluate and improve your skills and make clearer links between theory and practice. Reflection assists you to identify your own learning needs and develop your practice further by creating a learning plan to fulfil those learning needs. Reflecting on practice will identify for you your own core decision making skills, help you to problem-solve and assist you in developing your critical thinking and self-evaluation skills.

 

3. What should I reflect on?

You can reflect on anything that occurs

• In your formal learning environment, i.e. in classroom based tutorials, in workshops in laboratory practical’s etc.
• In non-formal learning environments for example learning during your clinical placement. In everyday life referred to as informal or impromptu learning, for example from an occurrence in your weekend work, on the choice of cough medicine that you got from the pharmacist etc.

It may be an experience that went well, an experience that was particularly demanding, a very ordinary, everyday experience or an experience in which things did not go as planned. It is important that you link your reflection back to behaviours, competencies and domains in the professional framework, and that it informs your future action.

 

4. How can I reflect?

• Your course coordinator may suggest a particular framework to guide your reflection. Examples include Gibb’s Cycle (1988), Kolb’s learning cycle, the IIoP (Irish Institute of Pharmacy) or COD (Continuing Professional Development Cycle)
• Use the chosen framework to structure your reflection
• Keep a personal diary to help capture and record your thoughts and feelings as they occur. This will be an invaluable reminder when you complete subsequent reflections.
• Start writing as early as possible, in your own words. You may find it helpful to refer to the literature for examples of how to write reflectively e.g. Burns & Bulman (2000). While there is no right or wrong style of writing up your reflections, these guidelines may make it easier for you.
• You should make reference to local policies, procedures and literature that have relevance to your reflective notes, particularly in the analysis section.
• You need to make time to write up your reflections
• A good tip when writing reflections is to write something, leave it, return to it later and then try to question yourself on different aspects of this experience
• Remember when reflecting on clinical or community placement experiences to maintain confidentiality and anonymity of the individual, staff and placement area
• Your placement tutor, preceptors, link lecturer, and/or other students may advise you on structuring your reflective notes. It may help you to get started by talking through an experience with someone in your support network.
• Remember reflection is a skill that you can develop, so the more you practice the better you will become.