Reflection practice is an approach that allows practitioners to understand how they use their knowledge in realistic situations and how they mix action and learning in a more successful manner (Henderson, 2002). Kondrat (2004) claims that the aim of critical reflection is to be conscious of the influence of the subject self in relations to prejudices so that such prejudices may be reduced or removed. However, Smith (2002: 138) argues that “for reflection to be critical it need to also embrace the capacity to consider social structures and power relationships analytically and apply this analysis in practice”. This assignment aim at researching the benefits and challenges of reflection in work practice by reflecting on an incident at work and examine what went wrong and what went well (see appendix 1). It will evaluate my progress about how I used reflection to develop professional practice after an incident. It will also assess how feedback from manager and colleagues may help me to maintain my continuing professional development.
According to Taylor and Beverly (2000) reflection is a significant human activity in which people recall their experiences, think about it, ponder over, evaluate it; and it is this working with experience that is important in learning. Du Gay (2005) claims that we learn through critical reflection by putting ourselves into the experiences and exploring personal and theoretical knowledge to understand it and view it in different ways. However, Swan (2008) argues that it may be hard to reflect in work practice due to time constraint and lack of understanding about how to reflect. Swan (2008) further argues that others practitioners may not be motivated enough in finding time to reflect. However, Taylor (2000) proposes that improved self-awareness, though not the principle reason for reflection, may create important changes in normal reactions to challenging clinical circumstances that may affect a beneficial change in the outcome observed.
As a health and social care practitioner I appreciate that reflection offers a number of benefits such as improvement in practice and in patient service. Improved self-knowledge may offer this additional benefit, as contending with the behaviour of persons in strange circumstances outlines an important part of health care practitioners Taylor (2000). Wilkin (2002), Paget (2001) and Taylor (2000) cited in Hayden, (2005) agree with the notion that reflection allows practitioners to broaden themselves intellectually and improves their professional role especially when pressure is wielded to behave more technically. However, Smith and Jack (2005) argue that practitioners need to be aware of personal advantages, improved self-awareness and improved confidence in progressing professional development as it may affect how they relate with patient.
In relation to my individual learning plan (ILP) as identified in appendix one I have encountered problem such as involving colleagues and my manager in giving me feedback. This may be because of work demands placed on my manager and change in staff structure due to an incident which occurred in work. Therefore I had to reconsider using a diary to record activities identified in ILP and record of incident; this meant that I can only rely on my own feedback and the understanding of my work practise in order to achieve the best possible outcome.
According to Boud (2000) health and social care professionals often work one on one with service users who may be experiencing various levels of emotional distress. Young and Henquinet (2000) claim that more than half of challenging behaviour occurs in social services and health care settings, therefore safety is paramount. Boud (2000) claims that it is vital that professionals and service users do not exist in blankness, as both parties are influenced by societal, community and organizational behaviour this is supported by Bronfebrenner’s theory (Adams, 2007).
Smith (2002) states that these factors may impact on service users’ relationship and interactions therefore a key skill is needed to work in partnership with service users. When the service user went absent without authorised leave I had to respond immediately as it was apparent that I was the only person with sufficient knowledge. Having experience this before and knowing my work practice procedures on missing person prompted me to react as I did as identified in Schon (1991) reflection in action.
Smith (2002) further argues that to attain this, it is essential for professionals to be able to make logic of their practice, and to understand their involvement in therapeutic functioning. This was evident in my practice as I had to support other service users who were in distress and also I had to write an incident report whilst offering re- assurance. This was challenging as I am working as part of a small team which meant that I had to carry some of the task individually. However, being part of a small team meant that I was able to interact and communicate more easily with peers and gained their sense of commitment level as pointed out by (Young and Henquinet 2000).
Northouse (2004) states that ethics in a small teams are important because as team progress through the decision-making or problem-solving process, several questions may arise that may need to be dealt with and the people’s behaviour or actions surrounds the communication process. Engleberg and Wynn (2003) suggest that staff member or team members need to consider how their verbal and nonverbal communication and listening skills may affect how they construct and construe these messages. Fujishin, (2007) argues that communicating in an unethical way may include misrepresenting a position or stance on a topic, and pretending to be informed about a topic.
Fujishin, (2007) suggests that to avoid this staff member should not keep back information from other members and should be truthful when sharing information. As a practitioner I am morally required to contemplate the likely benefit or harm that may result if I chose to do nothing in a given situation. My actions matched my belief in the human rights to be safe and contribute to decision making and information sharing (Beidler and Dickey 2001).
Controlled reflection may thus be an instrument to help professionals’ gain better understanding not only into professional practice but into their working relationship with service users Bould (2000). Gaining better knowledge and understanding into reflection is not new, Schon (1999) in Adams et al (2009) defines reflection in action as an approach taken by practitioners in work setting to instantly restructure and adjust their practice. However, Crisp and Green (2002) argue that uncontrolled reflection may not generate theory or understanding. Nevertheless, the practitioner who is able to reflect on a situation, make sense of what happened and coherent the process and variables involved may create a better understanding of the situation and of theory.
Another way of making sense of circumstances that affect us together individually and professionally is through organised reflective writing. The method of reflection does not have to be written, however Seymour (2003) and Ullrich et al (2002) suggest that more understanding may be gained if writing is involved as it may allow the professionals to structure opinions and reminiscences more subjectively. Ullrich and Lutgendorf (2002) also claim that it may also provide a lasting record for other professionals to access in future.
In work setting I had to keep record and times of incident this is refer to as incident report. Lindeman (2000) claims that writing an incident report allows practitioners to learn about individuals, organisation and others. For instance, I have learnt a lot about different agencies that gets involved when a service user is reported missing. I have also learnt about the importance of keeping accurate conversation records.
Duffy (2000) proposes that the process of reflective writing may offer time to reflect properly and make sense of happenings that may have affected work practice. Nonetheless, without a clear outline it may be problematic to know in what way or what to reflect upon. Burton (2000) argues that this is particularly applicable to trainee reflective professionals. Furthermore, Brennan and Hutt (2001) argue that another additional likely risk is that professionals only reflect upon circumstances that they perceive as gone wrong. Taylor (2000) states that in this case reflective writing then becomes possibly negative and not useful if left unstructured or un- facilitated.
This was apparent common in my work practice as staff focused more on the negative of the incident instead of encouraging the use of positive. McCabe (2004) suggest that it is the duty of the experienced practitioner to question the practice of another if they believe inappropriate treatment may harm or be negative to service user. It was extremely difficult to challenge my colleagues about their negative comments this may be because they have been in my work practice longer than me. McCabe (2004) argues that health practitioners may feel uncomfortable due to uncertainty in their work practice. Conversely, Paget (2001) argues that service user’s best interest must be conserved all the time even if conflict should arise.
According to Joyce (2005) common difficulties with using reflective journals involve procrastination, fading, eagerness, and also reluctance or lack of ability to reflect. Reflective diaries or periodicals may be an effectual tool for self – assessment and development of reflective skill, specifically reflection on practice (Joyce, 2005). The skill of reflective writing may be advanced either through working separate or within peer groups. Teekman (2000) believes that record keeping is part of showing consistency and caring about service user’s outcome. Caring is also paramount in health and social care, I feel strongly about this belief and try to practise continuously.
Ritz (2009) cited in Ritz and Weissleder, (2009) proposes that writing and thinking goes together when developing critical skills. According to Wilkie and Burn (2003) Health and social care have a spoken culture in which practitioners have restricted chances to develop critical, analytical skills through writing. I found it easy to use diary this may be due to the time I spent writing incident report. However, getting feedback from my colleagues proofed difficult as they had different views about giving me feedback. This may be due to what they perceive as of importance as pointed out by Bowers and Jinks (2004).
In conclusion reflecting about incident at work has been self- empowering and has provided me with a perception into personal understanding and control (McCabe 2004). This reflection has recognised the opinions, hindrances associated with working in Health and social care (HSC) practice. Additionally, it has also shown that the present-day premise of HSC is multifaceted. However using Schon’s context does aim to reveal the insufficiencies of a positivist attitude to knowledge and practice and this may result to new understandings (Teekman, 2000). Consequently, it is essential that the professional is allowed to reflect critically on practice so as to improve and extend knowledge and eventually the quality of service and care provided to service users. Reflective writing has helped me to cope with critical incident at work and I feel like I can pass this tool to my work colleagues.
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