ࡱ> + :bjbj²  ШDhШDhu2Uzz  T@@@@@Y&###2Y4Y4Y4Y4Y4Y4Y$[^XY# ###XY  1 mY(((# 2Y(#2Y((Q0@jUЂL#$S$YY0Y*S@C_&C_HjU@C_Ut##(#####XYXY'###Y####C_#########zX :  INCLUDEPICTURE "http://www.fablevision.com/education/clipart/girl_thinking.gif" \* MERGEFORMATINET  COMMITMENT TO ACTION IS AN ESSENTIAL COMPONENT PROMOTING NEW KNOWLEDGE AND A SOCIAL/ PRACTICE CHANGE SOME MODELS OF REFLECTION (with original dates): Carper (1978) 4 ways of knowing:- empirical, ethical, personal, aesthetic Mezirows Levels of Reflectivity (1981) Gibbs Reflective Cycle (1988) Schn (1991) 2 types: Reflection-on-action that following an experience Reflection-in-action thinking while doing (This involves intuition and the capacity to use past experiences to facilitate appropriate responses and actions) Christopher Johns Model for Structured Reflection (first produced 1993, with modifications until 10th version in 1994) Stephenson (1993) developed by a student nurse, with a similar but simpler structure to Johns Model Atkins and Murphys Framework for Reflection (1994) Driscolls 1994 WHAT cycle De Bonos Six Thinking Hats (1996) to generate critical thinking MEZIROWS LEVELS OF REFLECTIVITY Mezirow J (1981) A critical theory of adult learning and education. Adult Education 32(1) p3-24 (Source: Atkins and Murphy 1994 p52) Reflectivity The act of becoming aware of a specific perception, meaning or behaviour of your own or the habits you have of seeing, thinking and acting. Affective Becoming aware of how you feel about the way you are perceiving, thinking or acting. Discriminant Assessing the efficacy of your perceptions, thoughts and actions. Recognising the reality of the contexts in which you work and identifying your relationship to the situation. Judgemental Making and becoming aware of your value judgements about your perceptions, thoughts and actions, in terms of being positive or negative. Conceptual Being conscious of your awareness and being critical of it (for example, being critical of the concepts you use to evaluate a situation). Psychic Recognising in yourself the habit of making precipitant judgements about people based on limited information. Theoretical Becoming aware of the influence of underlying assumptions upon your judgement. CARPERS FUNDAMENTAL PATTERNS OF KNOWING incorporated into JOHNS MODEL OF STRUCTURED REFLECTION (9th edition, July 1993) Carper B (1978) Fundamental patterns of knowing in nursing. Advances in Nursing Science 1 p13-23 (Source: Johns (1994) p72) The following cues are offered to help practitioners access, make sense of, and learn through experience. Description Write a description of the experience What are the key issues within this description that I need to pay attention to? Reflection What was I trying to achieve? Why did I act as I did? What were the consequences of my actions for the patient and family - for myself - for the people I work with 2.4 How did I feel about this experience when it was happening? 2.5 How did the patient feel about it? 2.6 How do I know how the patient felt about it? Influencing factors What internal factors influenced my decision making and actions? What external factors influenced my decision making and actions? What sources of knowledge did or should have influenced my decision making and actions? Alternative strategies 4.1 Could I have dealt better with the situation? 4.2 What other choices did I have? 4.3 What would be the consequences of these other choices? Learning How can I make sense of this experience in light of past experience and future practice? How do I NOW feel about this experience? Have I taken effective action to support myself and others as a result of this experience? How has this experience changed my ways of knowing in practice? - empirics - ethics - personal - aesthetics CHRISTOPHER JOHNS MODEL OF STRUCTURED REFLECTION (10th version) (Source: Johns (1995) p227) Write a description of the experience Cue questions: Aesthetics 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 feeling? (Or these persons?) How did I know this? Personal How did I feel in this situation? What internal factors were influencing me? Ethics How did my actions match with my beliefs? What factors made me act in incongruent ways? Empirics What knowledge did or should have informed me? Reflexivity How does this connect with previous experiences? Could I handle this better in similar situations? What would be the consequences of alternative actions for: the patient? others? myself? How do I now feel about this experience? Can I support myself and others better as a consequence? Has this changed my ways of knowing? STEPHENSON (1993) MODEL FOR REFLECTION (Source: Palmer et al (1994) p137) Choose a situation on your placement Ask yourself. - What was my role in this situation? - Did I feel comfortable of uncomfortable? Why? - What actions did I take? - How did I and others act? - Was it appropriate? - How could I have improved the situation for myself, the patient, my mentor? - What can I change in future? - Do I feel as if I have learnt anything new about myself? - Did I expect anything different to happen? What and why? - Has it changed my way of thinking in any way? - What knowledge from theory and research can I apply to this situation? - What broader issues, for example ethical, political or social, arise from this situation? - What do I think about these broader issues? GIBBS REFLECTIVE CYCLE (1988) (Source: Chesney (1996) p8) Description (what happened)  Feelings/ thoughts Action plan (if occurred again  what would you do?)  Evaluation (the good/ bad) Conclusion  (what else could be done?)  Analysis (what sense can be made?) DRISCOLLS 1994 WHAT CYCLE (Source: Driscoll 1994) What - is the purpose of returning to this situation? - exactly occurred in your words? - did you see? Did you do? - was your reaction? - did other people do? - do you see as key aspects of this situation? So what - were your feelings at the time? - are your feelings now? Are there any differences? Why? - were the effects of what you did (or did not do)? - good emerged from the situation? - troubles you, if anything? - were your experiences in comparison to your colleagues? - are the main reasons for feeling differently from your colleagues? Now what - are the implications for you, your colleagues, the patient? - needs to happen to alter the situation? - are you going to do about the situation? - happens if you decide not to alter anything? - might you do differently if faced with a similar situation again? - information do you need to face a similar situation again? - are my best ways of getting further information about the situation should it arise again?   Future Practice  WHAT?  (Returning to the situation)   SO WHAT? (Understanding the context)  NOW WHAT? (Modifying future outcomes)  DE BONOS SIX THINKING HATS TO GENERATE CRITICAL THINKING (Source: Chesney (1996) White Hat Pure facts Red Hat Feelings Grey Hat Negative Aspects Yellow Hat Right and Constructive Green Hat Creative Thinking Blue Hat Summary ATKINS AND MURPHYS FRAMEWORK FOR REFLECTION (Source: Atkins and Murphy (1994) p51) Awareness of uncomfortable feelings and thoughts  Action / new experience  Describe the situation, including thoughts and feelings - salient events  - key features Identify any learning which has occurred  Analyse feelings and knowledge relevant to the situation - identify knowledge - challenge assumptions - imagine and explore alternatives  Evaluate the relevance of knowledge - does it help to explain/ solve problems? - how complete was your use of knowledge? References in handout: Atkins S and Murphy K (1993) Reflection: a review of the literature. Journal of Advanced Nursing 18 p1188-1192 Atkins S and Murphy K (1994) Reflective practice. Nursing Standard 8(39) p49-54 Boud D, Keogh R and Walker D (1994) Reflection: Turning Experience into Learning. London: Kogan Page Carper B (1978) Fundamental patterns of knowing in nursing. Advances in Nursing Science 1 p13-23 Chesney M (1996) Sharing reflections on critical incidents in midwifery practice. British Journal of Midwifery 4(1) p8-11 Driscoll J (1994) Reflective practice for Practice. Senior Nurse 13(7) p47-50 Johns C (1994) Nuances of reflection. Journal of Clinical Nursing 3 p71-75 Johns C (1995) Framing learning through reflection within Carpers fundamental ways of knowing in nursing. Journal of Advanced Nursing 22(2) p226-234 Mezirow J (1981) A critical theory of adult learning and education. Adult Education 32(1) p3-24 Mong-Chue C (2000) The challenges of midwifery practice for critical thinking. British Journal of Midwifery 8(3) p179-183 Palmer A, Burns S and Bulman C (eds) (1994) Reflective Practice in Nursing. Oxford: Blackwell Science Schn DA (1991) The Reflective Practitioner. Hampshire: Arena Other useful reading, but also search for more recent references: Brechin A, Brown H and Eby MA (eds) (2000) Critical Practice in Health and Social Care. London: Sage and Open University Bulman C and Schutz S (2008) (ed) Reflective Practice in Nursing 4th edition Chichester: Blackwell Science Burns S and Bulman C (eds) (2000) Reflective Practice in Nursing the Growth of the Professional Practitioner 2nd edition Oxford: Blackwell Science Danarek M and Dykes AK (2001) The meaning of problem solving in critical situations. British Journal of Midwifery 9(3) p179-186 Ghaye T and Lillyman S (2010) Reflection: Principles and Practices for Healthcare Professionals London: Quay Books Jasper, M. (2013) Beginning reflective practice. 2nd edition Cheltenham: Nelson Thornes Johns C (2004) Becoming a reflective practitioner 2nd edition Oxford: Blackwell Science ( Johns C & Freshwater D (2005) Transforming nursing through reflective practice Oxford:Blackwell Science (available at Plymouth University Midwifery e-books) White S, Fook J and Gardner F (2006) Critical Reflection in Health and Social Care. Maidenhead: Open University Press Yearly C (2003) Guided reflection as a tool for CPD. British Journal of Midwifery 11(4) p223-226 SOME OTHER EXAMPLES OF MODELS FOR STRUCTURED REFLECTION DO Apply Review Learn fghim{|}~     g h  - . 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