Handout 3 –Models of Reflection

_{Greater Manchester AHP/HCS Life Long Learning Project Team}

HANDOUT 3 –Frameworks for Reflection
Introduction

Having established the need for experiential knowledge that arises out of reflection, this handout is exploring some of the models structures and frameworks that can facilitate the reflective process.

However, before we explore these frameworks some important distinctions are needed to be made about different types of reflection.
Donald Schon, an influential writer on reflection, described reflection in two main ways: reflection in action and reflection on action. Reflection on action is looking back after the event whilst reflection in action is happening during the event. To complicate matters there are different interpretations of reflection on action. Let’s now explore these terms.
Reflection in action means
“To think about what one is doing whilst one is doing it; it is typically stimulated by surprise, by something which puzzled the practitioner concerned” (Greenwood, 1993).
Reflection in action allows the practitioner to redesign what he/ she is doing whilst he/she is doing it. This is commonly associated with experienced practitioners. However, it is much neglected.
Reflection on action is defined as:
“The retrospective contemplation of practice undertaken in order to uncover the knowledge used in practical situations, by analysing and interpreting the information recalled” (Fitzgerald, 1994pp67)
We can see here that reflection on action involves turning information into knowledge, by conducting a cognitive post mortem.
Alternatively Boyd & Fales suggest reflection on action is:
“The process of creating and clarifying the meanings of experiences in terms of self in relation to both self and world. The outcome of this process is changed conceptual perspectives” (Boyd & Fales, 1983pp101)
We see here that Boyd and Fales focus more on self development. Here refection does not only add to our knowledge but challenges the concepts and theories we hold. Furthermore as a result we don’t see more, we see differently.
Atkins and Murphy (1994) take this idea one step further and suggest that for reflection to make a real difference to practice we follow this with a commitment to action as a result.
The problems with these views of reflection on action are that they do not take account of the importance of reflection before action.

This is when we plan out before we act what we want to do.

So what have we learnt about reflection? It can best be seen as:

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  Reflection before action
  
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  Reflection in action
  
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  Reflection after action.
  

Now lets see which frameworks best support these approaches.

Gibbs Framework for Reflection (Linked with the core skills of reflection)
Stage 1: Description of the event
Describe in detail the event you are reflecting on.

Include e.g. where were you; who else was there; why were you there; what were you doing; what were other people doing; what was the context of the event; what happened; what was your part in this; what parts did the other people play; what was the result.

Stage 2: Feelings and Thoughts (Self awareness)
At this stage, try to recall and explore those things that were going on inside your head. Include:

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  How you were feeling when the event started?
  
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  What you were thinking about at the time?
  
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  How did it make you feel?
  
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  How did other people make you feel?
  
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  How did you feel about the outcome of the event?
  
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  What do you think about it now?
  

Stage 3: Evaluation

Try to evaluate or make a judgement about what has happened. Consider what was good about the experience and what was bad about the experience or what did or didn’t go so well
Stage 4: Analysis
Break the event down into its component parts so they can be explored separately. You may need to ask more detailed questions about the answers to the last stage. Include:

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  What went well?
  
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  What did you do well?
  
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  What did others do well?
  
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  What went wrong or did not turn out how it should have done?
  
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  In what way did you or others contribute to this?
  

Stage 5: Conclusion (Synthesis)

This differs from the evaluation stage in that now you have explored the issue from different angles and have a lot of information to base your judgement. It is here that you are likely to develop insight into you own and other people’s behaviour in terms of how they contributed to the outcome of the event. Remember the purpose of reflection is to learn from an experience. Without detailed analysis and honest exploration that occurs during all the previous stages, it is unlikely that all aspects of the event will be taken into account and therefore valuable opportunities for learning can be missed. During this stage you should ask yourself what you could have done differently.
Stage 6: Action Plan
During this stage you should think yourself forward into encountering the event again and to plan what you would do – would you act differently or would you be likely to do the same?

Here the cycle is tentatively completed and suggests that should the event occur again it will be the focus of another reflective cycle

Gibbs model incorporates all the core skills of reflection. Arguably it is focused on reflection on action, but with practice it could be used to focus on reflection in and before action.
Bortons` (1970) Framework Guiding Reflective Activities

What?	So What?	Now what?
This is the description and self awareness level and all questions start with the word what	This is the level of analysis and evaluation when we look deeper at what was behind the experience.	This is the level of synthesis. Here we build on the previous levels these questions to enable us to consider alternative courses of action and choose what we are going to do next.
Examples What happened? What did I do? What did other do? What was I trying to achieve? What was good or bad about the experiences	Examples So what is the importance of this? So what more do I need to know about this? So what have I learnt about this	Examples Now what could I do? Now what do I need to do? Now what might I do? Now what might be the consequences of this action?

Bortons model incorporates all the core skills of reflection. Arguably it is focused on reflection on action, but with practice it could be used to focus on reflection in and before action.

Johns Model of Structured Refection
Chris John’s (1994; 1995) model arose from his work in the Burford Nursing Development Unit in the early 1990’s. He envisaged this model as being used within a process of guided reflection. His focus was about uncovering and making explicit the knowledge that we use in our practice. He adopted some earlier work by Carper (1978) who looked at ways of knowing in nursing.

Ways of knowing	Cues
Aesthetics – the art of what we do, our own experiences	What was I trying to achieve? Why did I respond as I did? What were the consequences of that for the patient? Others? Myself? How was this person (people) feeling? How did I Know this?
Personal – self awareness	How did I feel in this situation? What internal factors were influencing me?
Ethics – moral knowledge	How did my actions match my beliefs? What factors made me act in an incongruent way?
Empirics – scientific	What knowledge did or should have informed me?

The framework uses five cue questions which are then divided into more focuses to promote detailed reflection.

Cue Questions
1. Description of the experience

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  Phenomenon – describe the here and now experience
  
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  Casual – what essential factors contributed to this experience?
  
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  Context - what are the significant background factors to this experience?
  
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  Clarifying – what are the key processes for reflection in this experience?
  

2. Reflection

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  What was I trying to achieve?
  
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  Why did I intervene as I did?
  
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  What were the consequences of my actions for:
  
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    Myself?
    
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    The patient / family?
    
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    The people I work with?
    
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  How did I feel about this experience when it was happening?
  
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  How did the patient feel about it?
  
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  How do I know how the patient felt about it?
  

3. Influencing factors

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  What internal factors influenced my decision – making?
  
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  What external factors influenced my decision – making?
  
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  What sources of knowledge did / should have influenced my decision – making?
  

4. Evaluation: Could I have dealt with the situation better?

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  What other choices did I have?
  
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  What would be the consequences of these choices?
  

5. Learning

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  How do I now feel about this experience?
  
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  How have I made sense of this experience in light of past experiences and future practice?
  
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  How has this experience changed my ways of knowing
  
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    Empirics – scientific
    
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    Ethics – moral knowledge
    
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    Personal – self awareness
    
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    Aesthetics – the art of what we do, our own experiences
    

Smyth’s Framework for Reflection on Action

Activity	Cues
Describe	What did I do?
Inform (Analysis)	What does this mean?
Confront (Self awareness)	How did I come to be like this?
Reconstruct (Evaluation and Synthesis)	What do my practices say about my assumptions, values and beliefs? Where did these ideas come from? What social practices are expressed in these ideas? What is it that causes me to maintain my theories What views of power do they embody? Whose interests seem to be served by my practices? What is it that acts to constrain my views of what is possible in my practice?

We can see with a number of models they go through, some, or all of the following phases.

	Descriptive phase	Reflective phase	Emancipator phase
Processes	Description of practice events	Reflective analysis against espoused theories	Critique of practice regarding conflicts distortions and inconsistencies
	Examination of descriptions for genuiness and comprehensiveness	Reflective analysis of the situations Reflective analysis of intentions	Engagement in emancipatory & change process
Products	Descriptive accounts/narrative	Knowledge about practice processes and applications	Learning and change in practice
		Self awareness	Self critique and emancipation

Phases in critical reflective inquiry Kim 1999

References
Atkins, S & Murphy, K (1994) Reflective Practice Nursing Standard 8 (39) pp49-54
Borton, T (1970) Reach, Teach and Touch. Mc Graw Hill, London.

Boud D, Keogh R & Walker D (1985): Promoting reflection in learning: A model. IN Reflection: Turing Experience into Learning (Eds: Boud D, Keogh R & Walker D). Kogan Page, London.

Boyd E & Fales A (1983): Reflective Learning: the key to learning from experience. Journal of Humanistic Psychology 23 (2) pp99-117
Carper B (1978) Fundamental ways of knowing in nursing. Advances in Nursing Science 1 (1) pp13-23
Gibbs G (1988) Learning by doing: A guide to teaching and learning methods. Oxford Further Education Unit, Oxford.
Fitzgerald M (1994): Theories of Reflection for learning IN Reflective Practice in nursing, A Palmer and S Burns (eds). Blackwell Scientific, Oxford.
Kim HS (1999): Critical Reflective inquiry for Knowledge Development of nursing practice. Journal of Advanced Nursing 29 (5) 1205-12
Greenwood J (1993): Reflective practice a critique of the work of

Argyris & Schon. Journal of Advanced Nursing 19 1183-1187

Johns C (1995) Framing learning through reflection within Carper’s fundamental ways of knowing in nursing. Journal of Advanced Nursing 22 226-234
Schon DA (1983): The Reflective Practitioner. Basic Books, New York.
Smyth J (1989): Developing and sustaining critical reflection in teacher education. Journal of Teacher Education 40(2) 2-9