REFLECTIVE WRITING MARIE LEWIS 29/09/04

Reflection is a requirement of nurse, midwife and health visiting education and practice. [Nursing and Midwifery Council 2002] “The process of internally examining and exploring issues of concern, triggered by an experience which creates and clarifies meaning in terms of self, and which results in a changed conceptual perspective” Boyles and Fales [1983]

In English It is the process of looking at yourself, what you do and why. The purpose is to evaluate what works well, what not, and how to learn and develop. The end result is confident, competent midwives who provide a high standard of midwifery care.

We all reflect on aspects of our lives everyday, it is the natural process of assessing what you did, what you said, why you did it, was it the best thing to do. “ Should I have parked here?” “Perhaps I shouldn’t have let her go to the disco” “I wish I hadn’t told him I’d spent £50”

As Midwives We must reflect on our practice- Our knowledge Our skills Our attitudes The development of a professional portfolio is a requirement of maintaining registration, reflection on practice is an important element of this. [NMC 2002]

Reflection Reflection can take many forms: Private, individual, written or mental. Reflecting with a trusted colleague or supervisor of midwives. Group reflection Remember all reflection must remain anonymous to maintain confidentiality.

There are no hard and fast rules for how to do written reflection, if you explore the literature you will find many models for reflection which are designed to help you. Choose the one that suits you.

John’s model [1994] 1.Identify the incident/ describe 2.Reflection/ what was I trying to achieve, how did I feel, What influenced my decisions. 3.Alternative action/ What if anything would I do differently? 4.Learning/ What have I learned, how do I feel now?

Bouds Model [1995] 1.Reframe the incident through discussion with others. 2.Work through the experience using positive feelings, look at the positive aspects. 3.Re-evaluate the experience integrating new skills and knowledge.

Gibbs Reflective cycle [1988] Describe what happened. What were you thinking and feeling? Evaluation. What was good and bad? Analysis Conclusion What else could I have done? Action Plan What would you do next time?

Atkins and Murphy [1993] 1.Description/ record the main issues 2.Critical Analysis/ examine all aspects of the situation 3.Synthesis/ bring together new and old knowledge to problem solve. 4.Evaluation/ make judgements about the effectiveness of your care.

Remember The models are designed to help you, you can use any or a combination. Keep your writing anonymous to protect confidentiality. Don’t forget the good stuff! Reflection is not about beating yourself up.

Gibbs and Breakfast I woke up, I felt hungry, I thought I should eat something so I had a biscuit with my coffee. It was good to eat something, it was bad that I chose a biscuit. I chose a biscuit because it was quick and I like the taste though I was still hungry after and I still hadn’t got much energy. I could have chose a bowl of cereal but I had no milk. Maybe I should have had toast but I don’t really like it unless it is dripping with butter. There were some eggs in the cupboard and I had some fruit in the bowl. I could have made boiled eggs and used my new blender to make a fruit smoothie Tomorrow I am going to get up early and have boiled egg for breakfast with wholemeal toast and a fruit smoothie. That should give me more energy and I shouldn’t still feel hungry afterwards. NOT!

HAVE A GO! Choose something simple that happened to you yesterday.[ even if it is only what you had for breakfast!] Decide which model you would like to try. Have a go!