Reflection – “a beautiful notion” may not be how you would describe this term!
Reflect, reflect, reflect, was all I heard from my tutors during the first three years of my nursing degree. I remember telling my friend ‘if they ask me to reflect one more time I think I am going to scream’. I could not get my head around what I was being asked to do. Why was it so important that every essay I wrote had to be reflective? As a consequence of my ignorance you can perhaps realise that most of my assignments barely scraped a pass and I was perceived as not the brightest of nursing students.
Then I met my last and final clinical assessor as a pre-reg nursing student, who opened my eyes to the wonderful world of reflection. I was fortunate enough to spend my 4th year in the company of a nurse who could see beyond my inability to pass assignments well and saw a student nurse with a brain who really wanted to learn (honestly!).
Every day after placement we would spend an hour going through the service users we had seen that day. I was asked questions about how I felt in different situations that had presented themselves to me. Not just what was good or bad, but if I was anxious we looked at why I was anxious and where had that anxiety stemmed from. If I felt confident about something we followed the same process. I was asked about why I had chosen a particular course of action, why was I concerned, where was my evidence for that intervention for that particular patient? What could I take away from today that would help me in the future, but importantly what had I learned about myself? During the course of my last year I grew in confidence as a practitioner and as a person. My assignments went from low level passes to A grades.
The difference between my attempts at reflecting on my own for assignments and my reflections with my clinical assessor was remarkable. I now realise that what my assessor was helping me to do was reflect ‘on action’, a retrospective contemplation of practice undertaken in order to uncover the knowledge used in a particular situation, by analysing and interpreting the information recalled, Schon (1983). But not only that my assessor was offering me ‘guided’ reflection. Johns, (2000), acknowledges that there are limits to reflecting alone and that guided reflection with a second person can allow the reflective process to become more meaningful. Students and practitioners often bring situations of emotional disturbance, grounded in such feelings as guilt, anger, anxiety, distress, conflict and inadequacy to guided reflection. The guide is there to help the student/practitioner to find meaning to the event, in order to understand and learn through and from it. As a consequence I matured and developed as a human being. I got to know myself better and became a healthier and more productive practitioner.
Burns and Bulman, (2000) suggest self-awareness is the foundation skill upon which reflective practice is built. I am not suggesting that final year taught me everything I needed to know about myself to be the perfect practitioner or human being, but what it did do was open my eyes to the wonderful world of reflection and raise my self awareness to a point that I no longer stumbled through life hitting the same road blocks over and over again. I still run into things every now again but never the same thing twice!
I am not sure that self awareness is something that we can teach our students but I do feel that our job as tutors and as clinical assessors is to offer the students the time and process that I was offered to help the student get to know themselves better and develop into good/healthy nurses.
I urge students to not shy away from reflection and to demand more from your personal tutors and clinical assessors.
I would enjoy hearing your thoughts on this.