The aim of this essay is to prove an understanding of my perception of reflection and how reflective practice impacts on the clinical environment and the learning process. The essay is based on my practice and training in the cardiac ward during my Foundation degree in Health and Social Care. I have selected 5 extracts from my Reflective Journal concerning a patient experiencing shortness of breath which led to a cardiac arrest. In order to be able to use this situation for my reflective process the patient will be referred to as “Jane” for the maintaining of confidentiality according to the Nursery and Midwifery Council (NMC, 2008).I have chosen to discuss on the case of Jane as the situation I was confronted with at the time made me reflect on issues of decision and the importance of communication and interpersonal skills in the relationship with the patient. I will be using the What? Model of Structured Reflection (Driscoll, 2007) a framework that uses three simple questions as guidance in reflective practice, namely What? So what? Now what? I have chosen this model as I believe is a practical solution that can be applied by health care professionals in a rapid and efficient manner. It stimulates an in depth meaningful reflective process that leads to an actual plan for future actions. According to Johns (2013) reflection can be viewed as a window through which a practitioner can see himself in the context of his practice and have a clear view of his/her experience, being able to make an analysis between what should be done and the actual practice. Searching for a deeper understanding of the decisions and actions taken in one’s activity can generate evolution of each professional and the development of his/her work practice (Benner, 2001). The process of reflection can be developed on two levels depending on its complexity and the details it comprises. Therefore reflection can be made in a deep and meaningful manner that considers all aspects of the situation or in a superficial manner that leads to solving problems based on factors such as tradition or work pressure (Lowe et.al, 2007). Another downfall of reflection can be the focusing on the negative aspects of the way a situation has been managed instead of concentrating on the potential for development based on a critical evaluation (Bradbury-Jones, et.al, 2009). When trying to improve knowledge from practice, there are several models of reflection aimed at directing individual reflection. Among them, the Gibbs’ model of reflection (1988, cited in Callara, 2008) has stages that include the description of the situation, feelings experienced during the situation, an evaluation regarding the positive and negative aspects, an analysis process followed by a conclusion which should include what could have been done in the situation and an action plan for future actions if a similar situation occurs (Gibbs, 1988, cited in Callara, 2008). Johns’ model of reflection (2013) on the other side focuses on questions regarding the intention of the action taken, the reason that was at the base of action, the practical and affective consequences on the patient, the patient’s family, the practitioner and his/her work colleagues. Johns (2013) also highlights the importance of influencing internal and external factors in the decisional process and the possible alternative solutions that could have been found. The reflection process suggested by Johns (2013) ends with a learning phase that aims at understanding the effects of the experience and how it reflects on practice. Although there are numerous reflective frameworks, none of them should be used as a rigid tool which asks questions that need to be answered. They are all intended to offer a certain structure of the reflective process and guide the practitioner towards deeper understanding (Lowe et.al, 2007). I have chosen Driscoll’s model as I believe it is a practical tool that allows free thinking and rapid...
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