The process of reflective learning and critical thinking is one that has been used for centuries. An early example of this was Socrates reflecting on concepts such as justice and knowledge with various interlocutors in ancient Athens. These interlocutors were sure of their knowledge of these concepts until questioned by Socrates who critically analysed their understanding of them. In doing so he highlighted that their knowledge was not as secure as they would like to have thought. This gave rise to the Socratic Method, perhaps one of the oldest examples of a reflective framework being used. 

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In healthcare the process of reflective learning has become a key cornerstone not only of continuing professional development (CPD) but also of professionalism. 

Boyd and Fales (1983) define reflective learning as:

“The process of internally examining and exploring an issue of concern, triggered by experience, which creates and clarifies meaning in terms of self and which results in a changed conceptual perspective.” 

Donald Schon (Schön D. The reflective practitioner: How professional think in action. London: Temple Smith. 1983) defines reflective learning as ‘knowing in action’ stating:

"When the practitioner reflects-in-action in a case he [she] perceives as unique, paying attention to phenomena and surfacing his intuitive understanding of them, his [her] experimenting is a once exploratory, move testing, and hypothesis testing. The three functions are fulfilled by the very same actions".

He also makes a distinction between reflection-in-action and reflection-on-action:

Reflection-in-action:

Reflecting whilst during an experience to help overcome often unexpected challenges which may arise. 

Reflection-on-action:

Reflecting on an experience once it has happened to help give insight and help implement improvements in your practices.

In ‘a joint statement of support from Chief Executives of statutory regulators of health and care professionals’ it is stated that reflective learning helps benefit clinical practice in the following ways:

“Being a reflective practitioner benefits people using health and care services by: 

• Supporting individual professionals in multi-disciplinary team work. 

• Fostering improvements in practice and services. 

• Assuring the public that health and care professionals are continuously learning and seeking to improve.”

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Models of Reflective Learning:

Gibbs Reflective Cycle (1988):

(Reference: Gibbs, Graham, Great Britain. Further Education Unit. Learning by Doing: a guide to teaching and learning methods. FEU, London. 1988)

1. Description -

• Describe the event in detail considering all the relevant aspects

2. Feelings 

• What did you feel before, during and after the experience?

• What did others, such as the patient or team members, feel regarding the experience?

3. Evaluation 

• What aspects went well and which aspects could you improve upon?

4. Analysis 

• This requires you to critically analyse the situation.

• How do you make sense of the experience?

• What body of knowledge can help you understand or improve in the future?

5. Conclusion 

• What did you learn from this experience and what are your learning needs?

6. Action Plan

• What would you do differently if you encountered the same or similar experience and what can you learn or develop to do so.

• It is important you put a plan in place to make sure that your learning needs are fulfilled.

  
  

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Terry Bolton (2009) - Three Stage Model of Reflection

(Reference: Bolton G. Writing Values: reflective writing for professional development. The Lancet. 2009;373:20-1.)

1. Description - 

• What happened? 

• Describe the event. 

2. Interpretation - 

• What are the relevant or useful reflections about the experience? 

• How can we understand or explain these? 

• What are the salient features of this experience? 

3. Outcome - 

• What have I learnt from this experience? 

• How will I implement these learning outcomes into my daily practice?

Scanlon and Chermanas (1997): Three stages to reflect

(Reference: Scanlan, J.M. and Chernomas, W.M. (1997), Developing the reflective teacher. Journal of Advanced Nursing, 25: 1138-1143. doi:10.1046/j.1365-2648.1997.19970251138.x):

3 Stages of Reflection:

1. Awareness - Via a process of reflection on an experience in which one struggled to understand or explain something

2. Reflection - Critical analysis of the situation and identification of your learning needs. This requires self awareness and critical thinking skills to be employed.

3. New perspective - Following the experience and the process of reflection one now has a new body of knowledge and insight. 

Resources:

https://www.ed.ac.uk/reflection/reflectors-toolkit/reflecting-on-experience/gibbs-reflective-cycle

https://www.gdc-uk.org/docs/default-source/reflective-practice/benefits-of-becoming-a-reflective-practitioner-joint-statement-2019.pdf?sfvrsn=3c546751_2

https://graysreadinggroup.wordpress.com/2012/12/18/the-reflective-practitioner-by-donald-schon/

https://www.gdc-uk.org/news-blogs/blog/detail/blogs/2019/07/24/how-do-we-put-reflection-into-practice