Posted: September 30th, 2024

Cycles of Reflection in Nursing Essay

Cycles of Reflection in Nursing.

Oelofsen (2012) defines reflective practice as the process in which an individual makes sense of situations, events and actions that occur in the workplace (Natius, 2012). Reflective practice is a crucial aspect of professional development, enabling individuals to learn from their experiences and improve their practice. In the light of nursing practice, the concept of reflection plays a critical role by enabling practitioners (nurses) to, competently manage the impactful and precarious nature of care giving (Natius, 2012). Effective reflection in nursing practice can lead to improved patient outcomes, enhanced job satisfaction, and reduced stress levels among nurses.

According to Keeling and Somerville (2004), reflective practice facilitates the understanding and development of self-awareness, inter-personal skills and also the ability to influence positive change in others (David & June, 2004). Reflective practice also enables nurses to develop a deeper understanding of their own values, attitudes, and biases, which is essential for providing culturally sensitive care. These skills are key to nurses in mapping out the most appropriate action plans to take in any given situation. By developing these skills, nurses can provide high-quality care that meets the unique needs of each patient.

Comparative examination of four models of reflection as applied in the context of nursing

Model of reflection

Key features

Gibbs model of reflection 1988

It is fairly straightforward (Marshall et al., 2006). This simplicity makes it accessible to practitioners at all levels. It gives a clear description of the situation, analysis of feelings, evaluation of the experience, and subsequent analysis of the experience to make sense of it (Marshall et al., 2006). This structured approach aids in comprehensive understanding. Repeats the same loop of action several times (Marshall et al., 2006). This repetition reinforces learning and adaptation. It creates room for an alternative course of action. This flexibility is crucial in dynamic healthcare settings. It reflects on the current experience with the view to developing appropriate action plans should a similar situation arise again. This forward-thinking approach prepares nurses for future challenges.

Johns model of reflection 1994

A structured model with steps that have questions, prompts, and activities that aid in reflection (Davey, 2011). This structure provides a clear pathway for reflective thinking. The concern of questions lies in describing the experience and its main issues, reflection on what the practitioner was trying to achieve, and why he acted in a certain way. It also looks at the consequences of the action to the self (practitioner) and to the client (patient), the feelings that the action evoked, and academic sources of knowledge that possibly influenced the decisions made. This comprehensive approach ensures a thorough evaluation of practice. This model explores the different angles to how the situation could be handled differently and also what would be done in the future should the situation recur. Such exploration encourages continuous improvement and learning.

Kolb’s model of reflection 1980

Based on the experiential learning cycle and covers four phases. The stages are: Concrete Experience (CE)-Learning by experiencing. In this phase, the learner (Nursing student) learns from specific experience, relates to people (patients), and becomes sensitive to their feelings (Martin, 2006). This phase emphasizes the importance of empathy in nursing. Reflective Observation (RO)-Learning by reflecting. This stage entails making careful observation before judging, viewing issues and situations in different perspectives, and looking for meaning in the situations. This encourages open-mindedness and critical thinking. Abstract Conceptualization (AC)- Learning by thinking. It is a critical stage where a learner logically analyzes ideas, plans systematically, and acts on the situation from an intellectual understanding. This stage fosters analytical skills essential for problem-solving. Active Experimentation (AE)- Learning by applying/doing. This is the last phase where the learner shows the ability to get things done, takes risks, and influences people and events through action. This phase highlights the importance of practical application in learning.

Goodman model of reflection 1984

This approach is premised on three levels of reflection: Level 1: Reflection to attain given objectives. In this level, the criteria for reflection are limited to technocratic issues of effectiveness, efficiency, and accountability. Students, for example, are expected to give an account of an occurrence and demonstrate some degree of learning (Robotham & Frost, 2006). This level focuses on achieving specific learning outcomes. Level 2: Reflection is on the basis of the relationship between principles and practice. Assessment of the consequences and implications of beliefs and actions, as well as the rationale employed in practice, is done. At this level, students begin to link theoretical perspectives to practice and also apply their experiences in similar circumstances. This level bridges the gap between theory and practice. Level 3: reflection that integrates ethical and political concerns. At this level, there is deliberation of emancipation and justice over the value of professional objectives and practice. The practitioner links the everyday practice to the broader social structure and forces such as economics, health, and resources. This level encourages a holistic view of nursing practice.

Gibbs model of reflection is commonly employed in the Health profession because of its clarity and precision (Brock, 2014). Its straightforward nature makes it a popular choice among practitioners. It allows for easy description, analysis, and evaluation of experiences and thus helps the reflective practitioner (nurse) to clearly make sense of her experiences as well as examine her nursing practice (Holland & Roberts, 2013). This clarity aids in effective learning and application.

Unlike the Gibbs model, the other models, for example, Kolb’s model 1980 and Goodman model 1984, are relatively complex. These models require, to a greater extent, some degree of experience (McKee & Eraut, 2012). Their complexity can be challenging for novice practitioners. The Kolb’s reflective model, for instance, is basically hinged on experiential learning that covers four stages (McKee & Eraut, 2012). This model emphasizes the importance of learning through experience. And since experienced nurses have enough experience, they can easily relate to the model and apply it in practice. This makes it particularly useful for seasoned professionals.

Model that is best suited for nursing practice

John’s model of reflection 1994 is best suited as a tool for the nursing profession. Its structured nature serves as a good platform for a complete assessment of the nursing practice (Rideout, 2001). This structure supports comprehensive evaluation and learning. The questions are excellent cues in prompting particular actions (Driscoll, 2007). These prompts guide practitioners in their reflective process. This approach is also wholesome in the sense that it explores all the areas of the nursing practice. It examines the practitioner’s experiences, her reflection on the experiences, actions taken by the practitioner, and the impact of the actions on self (practitioner) and the patient (Mohanna et al., 2011). This thorough examination ensures a holistic understanding of practice. It also looks at the aspect of the academic sources that may have influenced the decisions made as well as the possible angles to how the situation could have been dealt with differently and how it can be handled in the future (Moon, 2013). This forward-looking approach encourages continuous improvement.

Importance of the choice of framework of reflection in encouraging and supporting reflection

A desirable framework of reflection is helpful to nurses as it provides a structured process that guides the act of reflecting (Jasper, 2003). This structure is crucial for effective reflection. The choice of a particular framework of reflection is important because students face different experiences, and so is the need for an appropriate framework to offer the necessary support and encouragement throughout their learning process (Schon, 2008). This tailored approach ensures that reflection is relevant and effective.

Critical analysis of all the four models with respect to what is good and bad about them

The four models of reflection examined above all have their strengths and weaknesses in their application. Each model offers unique benefits and challenges. Below is a table summarizing their strengths and weaknesses.

Model of reflection

Strength(s)

Weakness(es)

Gibbs model 1988

Challenges assumptions (Devinder Rana, 2013). This attribute is important in validating data and drawing appropriate conclusions. It encourages critical thinking and questioning. Explores different approaches to thinking and acting and as such encourages creativity. This exploration fosters innovation in practice. Links practice and theory. It helps a learner to apply knowledge gained in practice. This linkage enhances practical application. It is not necessarily introspective (Watson & West, 2006). Reflection requires both introspective and retrospective perspectives. This limitation can hinder deep personal insight.

Johns model of reflection 1994

Its structured nature allows for wholesome analysis of learning. This structure supports comprehensive evaluation. Simple in nature thus easy to apply. Its simplicity makes it accessible to all practitioners. Its simplicity may not necessarily capture all the critical components of reflection. This limitation can lead to superficial analysis.

Kolb’s model 1980

Its four stages of experiential learning i.e. Concrete experience, Reflective observation, Abstract conceptualization, and Active experimentation provide a favorable framework for in-depth learning and application. This framework supports thorough learning. Mostly applies to experienced practitioners hence cut off less experienced ones. This limitation can exclude novice practitioners.

Goodman model 1984

This model is crucial in developing professional skills in learners as well as empowering them to be economically, socially, and politically competent individuals. This empowerment supports holistic development. Significantly cuts off young learners. Such learners are yet to fully understand the applicability of the tenets of this model. This limitation can hinder early professional development.

Reflective practice and its use to medical education

The ability to reflect plays a critical role in medical education. Reflective practice enables learners in the medical field to clearly understand and develop self-awareness, interpersonal skills, and analytical skills (Jack Mezirow, 2011). These skills are essential for effective patient care. These skills will come in handy in practice as medical students will be able to handle people (patients) in frontline settings such as a hospital scenario. This preparation is crucial for real-world application.

The importance of students developing a habit of assessing their own learning needs

Through self-assessment with regard to learning needs, students are able to constantly identify areas of weakness and improve on them (Earl, 2004). This self-awareness fosters continuous improvement. The fact that students are actively engaged in the process serves as a motivation for them and subsequently translates to better outcomes (Bonnie Beyer, 2014). This engagement enhances learning effectiveness.

References.

Amir, H., Permatananda, P. A. N. K., Cahyani, D. D., Langelo, W., Rosita, R., Sajodin, S., … & Syaiful, S. (2023). Enhancing skill conceptualization, critical thinking, and nursing knowledge through reflective case discussions: a systematic review. Journal of Medicine and Life, 16(6), 851.

Boyd, C. (2023). Reflective Practice for Nurses. John Wiley & Sons.

Clarke, N. (2024). The Student Nurse’s Guide to Successful Reflection: Ten Essential Ingredients 2e. McGraw-Hill Education (UK).

Contreras, J. A., Edwards‐Maddox, S., Hall, A., & Lee, M. A. (2020). Effects of reflective practice on baccalaureate nursing students’ stress, anxiety and competency: An integrative review. Worldviews on Evidence‐Based Nursing, 17(3), 239-245.

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Tags: Clinical Reflection, Nursing Education, Professional Development, Reflective Practice, Self-awareness