Reflective practice is more than just thinking about practice, it is an active process
of reflecting, analysing and learning. Reflection is a necessary attribute for the
development of autonomous practice. Reflective practice should be a continuous
cycle in which experience and reflection on experiences are inter-related.
Hint: Clinically how is reflective practice applied? How does the patient benefit
from reflective thinking of the nurse? What are the key components of reflective
practice in nursing?
Reflective Practice
Introduction
With technological advancement and increase in patient acuity, the healthcare
environment is increasingly becoming sophisticated. This implies a greater need for
nurses to think critically and independently. Reflective practice is important for
continuous development of nursing skills in healthcare (Mansah et al., 2014). Reflection
in healthcare practice involves focusing on their daily interactions with their environment
and colleagues in order to get a clear picture of them. In addition, it helps develop
professional practices that are aligned with personal values and beliefs. In addition, it
helps uncover some assumptions, values or beliefs that construct the healthcare maps
(Thompson & Pascal, 2012). With the dawning of reflective practice in healthcare, this
paper will explore the concepts of critical reflection, its key components and its benefits
in clinical practice.
Clinical Application of Reflective Practice
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Errors in medical practice have been attributed to the lack of reflective practice
among medical practitioners, particularly nurses. Although reflecting on medical practice
is currently recognized as one that improves healthcare delivery, there is no one standard
defining how it should be carried out. Nonetheless, incorporating reflective practice in
healthcare is deemed effective in lowering failure rates in clinical reasoning, particularly
in highly-complicated cases (IpAC Unit, n.d.). Technological developments in healthcare,
alongside the greater need to become more attentive to patient needs due to an
increasingly aging population, have called on nurses to become more independent-
thinking – reflective practice enables just that, given that it enables them to think about
their past experiences on the job as a way of improving or rectifying healthcare delivery
(Boykins, 2014; IpAC Unit, n.d.).
Clinically applying reflective practice should involve both positive and negative
experiences, in that it such provides an impetus on how past successes can be replicated,
even improved, in the future, as well as how failures can trigger necessary reforms to
processes designed to deliver optimal healthcare (IpAC Unit, n.d.). Patient care, in the
process, improves due to fortifications to clinical reasoning, as reflective practice remains
expansive as long as its potential to further impact healthcare delivery is concerned
(Caldwell & Grobbel, 2013). Reflective practice also serves to improve learning in the
workplace, particularly when combined with leadership facets such as goal-setting and
social learning (Matsuo, 2012). Furthermore, better analysis of impacts of healthcare
decisions best describe the essence of reflective practice, particularly through debriefing
– a process that involves a synchronized application of both theory and evidence coming
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from the fields of educational research and the social sciences, as well as experiences on
the conduct and teaching of the field itself (Maestre et al., 2014).
Understandably, patients are at the center of reflective practices. Nurses practicing
reflective practices are asked to take a good clear look at themselves to check on whether
past experiences can teach them useful enhancements or solutions to any given medical
procedure. Nonetheless, such shouldn’t be made as simplified and non-complex as the
entire concept seems to be, given that healthcare delivery varies in intensity per every
given situation (Thompson & Pascal, 2012). In that sense, it makes sense to provide a
further discussion on how reflective practice is done – particularly through “reflection in
action” and “reflection on action.” “Reflection in action” requires the use of past
experience in crafting solutions when confronted with a specific medical problem, while
“reflection on action” applies after the situation has passed, prompting nurses to think
about what they’ve done to what happened and see for themselves if it’s suitable for
repetition or needs to be improved for future use (IpAC Unit, n.d.). For that, the use of
history is essential for making true professionals out of nurses. Applying reflective
practice through the use of history is essential, particularly in providing thorough
assessments on how nursing has contributed to several aspects of healthcare delivery
(Smith et al., 2015).
Moreover, a theoretical approach to reflective practice is critical to improving
healthcare delivery involving the nursing profession. The Interprofessional Ambulatory
Care Unit (IpAC Unit) of Edith Cowan University (n.d.) cited two learning cycles – the
Kolb’s Experiential Learning Cycle and Gibb’s Reflective Cycle, in order to explain
reflective practice thoroughly. The Kolb’s Experiential Learning Cycle involves the
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following stages in a continuous cycle: concrete experience, reflective observation,
abstract conceptualization, and active experimentation. Nurses under said learning cycle
utilize reflective practice through absorbing experiences, taking note of their
observations, conceptualizing on their experiences, and actively experimenting what
they’ve learned when given a particular healthcare situation (IpAC Unit, n.d.; Osman &
Koh, 2013). The Gibb’s Reflective Cycle, which similar to the Kolb’s Experiential
Learning Cycle incorporates the following stages in cyclical fashion: description,
feelings, evaluation, analysis, conclusion, and action plan. Ultimately, the Gibb’s
Reflective Cycle seeks to create an action plan for a particular healthcare situation based
on the nurses’ past experiences, as laid out by the five preceding stages (Husebo et al.,
2015; IpAC Unit, n.d.).
Benefits of Reflective Practice to Patients
Patients, as emphasized earlier on, are at the center of reflective practice. The fact
that reflective practice treats nurses as independent-thinking agents meant to deal with
problem-solving situations with as less rigidity as possible only means that innovation
formed with the help of past experiences is highly needed to make reflective practice an
effective driver of excellent healthcare service. With that, foremost to the benefits
reflective practice has on patients is the idea that it enables nurses to exhaust whatever
knowledge they have in their profession as appropriated by healthcare situations
confronting them, without entailing them to deal with unnecessary restrictions. As nurses
are given the opportunity to reflect on their past experiences, they have the choice to
tailor-fit or avoid specific processes within their knowledge in healthcare delivery.
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Patients, in turn, are afforded with the best possible form of healthcare they deserve
(Boykins, 2014; Caliendo & Abraham, 2016; IpAC Unit, n.d.; Maestre et al., 2014).
Secondly, patients benefit from the attitude of openness imparted by reflective
practice unto nurses. Under reflective practices, nurses aren’t just restricted to whatever
their past experiences tell them to do. In fact, the rigors of reflective practice – as seen in
both the Kolb’s Experiential Learning Cycle and Gibb’s Reflective Cycle, trains them to
become more flexible in the name of their key purpose – to help save patients’ lives and
lead them towards better health. In the process, nurses become more independent-
thinking – reflective practice explicitly provides that their agency should increase as a
matter of increasing their efficiency (Husebo et al., 2015; Osman & Koh, 2013).
Lastly, patients have more therapeutic respite from reflective practice. Nurses
using reflective practice constantly communicate with their patients, in a bid to provide
them with immense psychological improvements that go well with their physiological
well-being (Boykins, 2014; Mansah et al., 2014). Humor, for instance, is best delegated
to patients by nurses as it allows them to experience lower problems with anxiety and
stress (Tremayne, 2014). In that way, patients become even more interactive as they learn
to forget about the fear and uncertainty brought forth by their respective illnesses.
All told, reflective practice stands to provide patients with healthcare from nurses
with a more human touch. As nurses gain greater learning opportunities from reflective
practice, patients benefit from the further expansion of their knowledge, them being the
recipients. Protocols are by no means prevalent when it comes to reflective practice –
nurses are therefore not limited to delivering healthcare according to a strict set of rules.
What is expected of nurses in reflective practice is their prioritization of patient care. For
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that, one may regard reflective practice in healthcare as a truly pro-patient approach that
also helps nurses – alongside other medical professionals, grow to their fullest (Jayasree
& John, 2013; Thompson & Pascal, 2012).
Key Components of Reflective Practice in Nursing
Boykins (2014) aptly provided for the key components that characterize reflective
practice in nursing. Firstly, recognizing patient differences is essential for nurses to adjust
their healthcare delivery with the help of reflective approaches. Nurses can reflect on
their multiple experiences in dealing with patients subject to differences brought forth by
the nature of illnesses, physiological and psychological limitations, and other
circumstantial elements borne out of varying personal backgrounds (Asselin & Fain,
2013). Although nurses aren’t necessarily advised to be intrusive of their patients’
peculiarities, their reflective stance should allow them to keep an observing eye on
crucial healthcare needs and details (Boykins, 2014; Parrish & Crookes, 2014). Secondly,
a reflective perspective to patient care should focus on relieving pain and suffering.
Nurses should always be attentive to their patients’ physiological and psychological
needs, in a bid to help them ease the burden brought forth by their illnesses (Boykins,
2014; Mansah et al., 2014). Thirdly, nurses should help promote healthy lifestyles to their
patients, subject to provided peculiarities of course. Patients should always receive
treatment that promotes their overall well-being so that they’d be able to get out of their
illnesses as they make sure to become healthier (Boykins, 2014). Fourthly, patient
education should be thoroughly practice by nurses, as part of their bid to promote
healthier living. Constant communication with nurses helps empower patients with
greater knowledge on how to treat themselves from their illnesses. Lastly, involving
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patients in decision-making is an approach nurses should prioritize. That would entail the
passage of reflectiveness from nurse to patient, with the latter becoming more
empowered (Boykins, 2014).
Conclusion
There is sufficient empirical evidence which proves that reflective practice
improves quality of care and patient outcomes. Nurses are encouraged to engage in
reflection promotes critical enquiry because it enables the practitioner learn through their
experiences making the healthcare practice to be task oriented. Central to its values in
nursing, reflective practice enables the nurses to develop clinical expertise towards
attaining the desirable healthcare practice through collaborative research and aids in
establishing a valid nursing knowledge that is grounded in a nurse personal knowledge.
From this analysis, it is evident that critical reflection helps healthcare provider focus on
effective strategies that improves their knowledge, cultural competence and nurse skills
to meet the complex demands of this dynamic environment.
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