In UK Medical Schools it is becoming increasingly common now to require students to keep a Reflective Practice diary or portfolio (British Medical Journal vol 325 p.676)
 

Reflective Practice (RP)

What does RP offer?

Neither childhood learning, nor formal academic training, can fit us adequately for the many varied and challenging situations that we will face. There are three reasons why continuing personal and professional development are absolutely vital to personal effectiveness, health and welfare:

• Each life situation is a totally unique combination of a myriad factors - we cannot advance-learn the answer to billions of possible situations;
• The world is constantly changing - throwing up unforeseeable challenges;
• As old (health) problems are solved, expectations and practices change, creating new challenges.

Our "experience" is often judged and quantified by how much time we have spent doing a particular thing. However, looking around us we see that some people acquire, develop and continuously improve performance much more effectively than others. Experience is not determined by how much time we spend on an activity, but on what we derive from the time we spend. So reflective practice is a tool for:

• extracting more ("on the job") learning from our life experiences;
• creating new understanding, fresh approaches, new ideas, new behaviour patterns;
• testing these "new" insights and ideas in the "crucible" of practical situations.

Reflective practice makes the healthcare professional (or sufferer in search of healing) into a unique and valuable form of researcher - one who can derive, implement and test hypotheses in real-life situations. For example, a new health problem (or even a well-known one for which there is no cure) cannot wait years for controlled scientific investigations to come up with an answer - decisions have to be made now and options can be generated and explored now.

These activities must of course must be undertaken with the sense of responsibility that is inherent in the reflective (as opposed to impulsive) approach. We can useful take on board one of the wise precepts of Shotokan karate: "Guard against impetuous courage!"

Reflective practice must be used judiciously, because it has both advantages and disadvantages. It consumes time and effort, but can also generate great savings in time and effort as a result of wider accessing of resources and more efficient deployment of resources. It is best used in situations where there is some doubt, questioning or dissatisfaction about current results, or where current results seem to be a poor return on resources invested.

Personal healing and professional skill development are important by-products of our investment in reflective practice. Solving or optimising the current situation provides an immediate benefit from our investment in RP, but continuing application of what has been learned can greatly "leverage" the return on our RP investment.

On the debit side, there is the risk that affected individuals may not be able to cope with the doubt, uncertainty and range of choices that the reflective process may generate. Hopefully this will be a short-term crisis as the reflective process is worked through and tangible results emerge.

Schon (1988) found that people learned to reflect-in-action by first learning to identify and apply standard rules and techniques of practice. From that base, they were able to graduate from the general rules to special rules needed in problematic cases or situations. After that stage they began to develop and test new forms of understanding and action in situations where familiar behaviour patterns were failing.

Reflective Practice Pages...
 
Introduction
What is RP?
What does RP offer?
RP for Teachers
What does RP look like?
The "Sunflower Health" Reflective Protocol
References & Additional Resources
Personal interest & experience
Author details