Reflection on Practice

making Practice-Based Learning work Reflection on PRACTICE A resource commissioned by the Making Practice Based Learning Work project, an educational development project funded through FDTL Phase 4 Project Number 174/02 and produced by staff from the University of Ulster. www.practicebasedlearning.org Author Patricia McClure School of Health Sciences, University of Ulster www.practicebasedlearning.org contents Introduction 02 The Role of Reflective Practice 03 Time for Reflection 05 Pre-requisites for Effective Reflection and Supervision 09 The Process of a Supervision Session 11 Adopting a Mentoring Approach 12 Tensions and Anxieties in Practice Placement Learning for Students & Practice Educators 15 Appendix 1 16 Appendix 2 17 References 18 Reflection on Practice Reflection on Practice 01 REFLECTION ON PRACTICE Introduction This resource tool has been devised to; • inform practice educators about the importance of reflective practice • prepare practice educators for their role as facilitators in students/learners’ development of reflective practice skills • identify strategies to facilitate students/learners’ to reflect during supervision sessions • provide guidelines for the use of reflective diaries during practice placements. www.practicebasedlearning.org REFLECTION ON PRACTICE The Role of Reflective Practice The general aim of all placements is to promote clinical reasoning and analytical and evaluative abilities in students through reflective practice. Professional bodies incorporate the benefits of applying reflective practice for both students and health professionals in their learning strategies. The importance of developing professional practice and of the role of supervision to ensure high quality standards of care is emphasised in such documents as ”A Vision for the Future” (Department of Health 1993). Reflective practice is not a new concept – Boud, Keogh and Walker (1985) stated 20 years ago that it features the individual and his or her experiences, leading to a new conceptual perspective or understanding. They included the element of learning, as well as involvement of the self, to define reflective practice: “Reflection is a forum of response of the learner to experience” (Boud et al. 1985, page18). Johns and Freshwater (1998) also described the value of reflective practice as a means of learning. There is no doubt that “reflection” is a complex concept that has defied consensus on definition although some commonalities exist. It involves the self and is triggered by questioning of actions, values and beliefs. An understanding of the purpose of reflective practice and its components can be gained by considering some of the definitions provided in the literature. A few useful definitions include the following: “Reflection is a process of reviewing an experience of practice in order to describe, analyse, evaluate and so inform learning about practice” (Reid, 1993 p.305). “Reflective practice is something more than thoughtful practice. It is that form of practice that seeks to problematise many situations of professional performance so that they can become potential learning situations and Johns describes critical reflection as “ a window through which the practitioner can view and focus self within the context of his/her own lived experience in ways that enable him/her to confront, understand and work towards resolving the contradictions within his/her practice between what is desirable and actual practice” (Johns 2000:34). To maximise learning through critical reflection we need to contextually locate ourselves within the experience and explore available theory, knowledge and experience to understand the experience in different ways. Thus Boyd & Fales (1983 p.100) claim that critical reflection “is the core difference between whether a person repeats the same experience several times becoming highly proficient at one behaviour, or learns from experience in such a way that he or she is cognitively or affectively changed”. Critical reflection is thus viewed as transformational learning which according to Baumgartner (2001) can happen either gradually or from a sudden or critical incident and alter the way people see themselves and their world. Daloz (1999) advocated the concept of development. He believes in the role of a mentor in guiding the learner on a journey that is affected by their social environment including family dynamics and social class. Daloz (2000 p18) suggests that there are four important conditions in facilitating development which are; Reflection on Practice What is reflective practice? “the presence of the other, reflective discourse, a mentoring community and opportunities for committed action.” Schon (1983) suggests that we can engage in reflection in one of two ways; either by ‘reflecting on action’, after the experience, or by ‘reflecting in action’, during the experience. The latter is a more advanced skill while the former is the process more likely to be used when teaching student healthcare professionals. so the practitioners can continue to learn, grow and develop in and through practice” (Jarvis, 1992 p.180). 03 REFLECTION ON PRACTICE The Role of Reflective Practice Becoming A Reflective Practitioner will thus complete the learning cycle and start over again with a view to refining his/her actions. This is an ongoing According to the educator Professor David Boud, effective process, so we will never achieve perfection. learning will not occur unless you reflect. To do this, you always find other ways of doing things based on our must think of a particular moment in time, ponder over it, learning from previous experiences. We will go back through it and only then will you gain new insights into different aspects of that situation. According to Kolb Building up experience is a gradual process. The student (1984) reflecting is an essential element of learning. This is will develop reflective abilities during the course of their shown through an experiential learning cycle illustrated learning on placement. Reflection should initially develop in below. safe environments where mistakes are tolerated. He/she can then reflect and discuss the decisions that were made Kolb’s Learning Cycle during their supervision sessions with their practice educator. Reflection should become integral to these sessions. Concrete Experience Concerned with something that has happened to you or that you have done. Concerned with adopting your new ideas into practice. When reflecting-on-action, the first step in the process is the description of the incident and it is advisable that student health care practitioners keep a reflective diary (as memory cannot be relied upon for the detail of events) in Reflective which they record details of incidents that either troubled or Concerned with reviewing the event or experience in your mind and exploring what you did and how you, and others felt about it. pleased them, recording details as soon after the event as Active Experimentation Concerned with trying out the new ideas as a result of the learning from earlier experience and reflection. Who is involved in practice education? possible. Much attention has been given to the value of recording Leaving aside for the moment the position of service events and experiences in written form, particularly through users themselves, Abstract the main parties involved in the use of reflective diaries and journals (Zubbrizarreta developing practitioners acting Concerned practice education - with students, 1999 and Tryssenaar 1995). The exercise of diary writing as managers, promotes both the qualities required for reflection, ie. open- ideas about ways of doing professional bodies, Strategic Health Authorities and mindedness and motivation and also the skills ie. self- Conceptualistation an understanding of what by seeking more practice happened educators, service information and forming new things in the future. the university. awareness; description and observation; critical analysis and problem-solving; and synthesis and evaluation (Richardson & Maltby, 1995). If you follow this cycle in a clockwise direction with your student, you will see that after having had an experience the student has to reflect on what he/she saw or did, by reviewing the whole situation in his/her mind. This may be assisted by: looking at it on film, discussing it with others, thinking abstractly about the event for a while, or seeking advice or further information. Eventually the student will probably come up with ideas for approaching the situation differently next time. He/she will then try out their ideas to see if they are effective. He/she www.practicebasedlearning.org REFLECTION ON PRACTICE Time for Relection For guidance on keeping a reflective diary, please see below Getting Started: Keeping a Reflective Diary & Reflective Questions. • Set aside time for writing • Allow time for the sifting of thoughts and ideas • Do not worry about style, presentation Time For Reflection • that it becomes part of your and the student’s way of Remember that the aim is to facilitate reflection on practice You as a practice educator must make time for reflection so • Find evidence to back-up your thoughts : what evidence do I have for what I have just written? working. Reflection is an integral part of practice and students need time to develop this skill. It is not a process that can be rushed, but neither is it a process that has to Begin by asking: occur at a particular time. Thus, the student can reflect on • How do I see my role as a healthcare professional(purposes and intentions)? his/her journey to and from placement, or between visits to patients/clients or during lunch break. It is a good idea to • Why did I become a healthcare professional? encourage the student to sum up each day with a reflective • What kind of healthcare professional/practitioner do I think I am? doing it. If the student knows that you expect them to • reflect on their practice in this structured way, they will be • What values do I believe in? How do I demonstrate that I am practising in a more likely to keep and benefit from their reflective diary. way that is consistent with professional values You may also set them an example by keeping a reflective and codes of conduct? diary of your own professional practice or indeed your experiences as a practice educator, thus demonstrating Exercise; that learning is always ongoing! Reflective Questions Exercise; The following is a set of questions that could be used to Keeping A Reflective Diary assist your thinking, perhaps when you are writing up your reflections on practice in a diary or when you are thinking Each individual will have a different way of keeping a back over an experience and discussing it with your reflective diary. There are, however, some general points to practice educator. Reflection on Practice comment in his/her diary, spending only a few minutes reinforce to learners about it. It should be: • What was I aiming for when I did that? • What exactly did I do? How would I describe it • A record which is useful to you • A cue to memory • Why did I choose that particular action? • Honestly written • What theories/models/research informed my • Enjoyable to you in its production It can be used: precisely? practice? • What was I trying to achieve? • What did I do next? • To describe key events in your practice • What were the reasons for doing that? • To evaluate key events in your practice • How successful was it? • To engage in focused evaluation of recurring • What criteria am I using to judge success? themes • What alternatives were there? • Reflect on what may have become habitual • Could I have dealt with the situation any better? • Develop and appraise action taken • How would I do it differently next time? 05 REFLECTION ON PRACTICE Time for Relection • What do I feel about the whole experience? weeks. I found that using a reflective diary was an excellent • What knowledge/values/skills were way to clear my mind and ensure a positive, fresh start the demonstrated? following day. Make time- it’s worth it! • How did the client feel about it? • How do I know the client felt like that? Everyone feels under pressure at some point whilst on • What sense can I make of this in the light of my placement, especially if you are the only student at a past experience? placement centre. At the end of a stressful and demanding • Has this changed the way in which I will do things day it is a relief to be able to unload the burdens of the day in the future? on the pages of your reflective diary before they build up and become blown out of proportion. Often, when you Please see students’ accounts of their experiences come to look at the problems you have noted at a later of keeping a reflective diary during practice date, they are not as bad as they seemed at the time, or placements in the Case Studies outlined below (Case you have found ways of overcoming these difficulties. I was Studies 1-3). on my own for both my second year placements and regret that I did not make use of a reflective diary at this time. Case Study 1 They would have provided a release for pent up anxiety and I can remember sitting in my second year placement stress, and perhaps improved my performance throughout preparation classes, being advised of the benefits of placement. keeping a reflective diary and thinking…”what a waste of time!”. In fact, this was a very grave mistake; when will I What is often foremost in a student’s mind during learn that lecturers know what they are talking about?! I placement is the grade they will be awarded. However, didn’t use a reflective diary on either of my second year when it comes to completing half-way and final reports, not placements. At that time I thought the most important thing everyone has the confidence to argue their own case in was to throw my all into seeing through my placement and terms of their accomplishments and the marks they feel not waste time on keeping a diary. It wasn’t until my fourth entitled to. I myself tended to be a quiet student, often year practice educator encouraged me to spend some unaware of my achievements and always lacking the time recording my thoughts at the end of the day that I confidence to express these in the hope of gaining realised what I had previously been missing out on. recognition. This is where keeping a reflective diary was of greatest benefit to me; by noting my capabilities, strengths If you are anything like me, with university work piling up, a and daily accomplishments every day in my reflective diary part-time job, family commitments and an all-important I had the evidence I needed to chart a definite upward social life, you may be thinking ‘I don’t have time’. In actual progression in skills throughout the placement. Although fact, making fifteen minutes available to note a few things my practice educators never asked to see my reflective that have happened throughout the day is very therapeutic. diary, I often took it to supervision and allowed them to read I found that taking a little time out every evening to entries I thought to be important. By doing so, I not only complete my reflective diary helped me to get the day’s boosted my own self-esteem and confidence, but I also events in perspective, to focus on any achievements or provided my practice educator with evidence of my progress I had made that day and also things I had learned developing clinical reflection and skill acquisition. I would need to improve on. One method I found to be of great benefit was to make a special note at the end of each day’s entry; this was usually something I felt I had done well, or a goal I hoped to achieve throughout the following www.practicebasedlearning.org PRACTICE EDUCATION Time for Relection A final note… I spent about 10-15minutes at the end of each day • Reflective diaries are a private record of experiences completing my diary, and I drew up a simple outline on the throughout placement and so it is important to use them to computer which my practice educators kept as a template report thoughts, feelings and opinions rather than merely for future students. I used a text box with ‘date’ and ‘what the factual events of the day. Only by reporting personal I saw today’ as titles and used a page for each day. feelings following an event can experiences be built upon and improved. I really would recommend keeping a reflective diary throughout placement as it helps you to focus your • It is important to use your reflective diary to record thoughts about the day and keep note of important things positive experiences and achievements as well as the not to remember. It is also a useful resource to look back on so positive ones. A balanced view of what has taken place and remember; is essential. how different conditions presented in patients; how effective that process was; placement, I kept my reflective diary and think of it to be, what needed to be improved and new/other perspectives to some extent, rather like a personal ‘Record of on the situation. Achievement’. Case Study 3 Case Study 2 If I am being completely honest, I would have to admit that I did not make use of reflective diaries during my 2nd year before I went on my first practice placement I could not see placements, and now as a 4th year student looking back, I what the benefit of keeping a reflective diary would be. can see how it would have been beneficial for me to have However, I did keep a diary from day one. The first couple kept a reflective diary at that time. During my 4th year of days were really reflections of how I was feeling, what I placements I kept a reflective diary and found it very useful thought of the place, the people, etc. As time progressed at the time. It is also a useful resource that I will be able to I started to reflect more on practice – what had gone well look back upon in my future practice. and what had not. It is strange but when I started to write down what had happened each day I was able to analyse My practice educator at the time advised me to complete the events more clearly. I was able to pinpoint possible this diary, and gave me some basic ideas of the type of factors that had contributed to the outcomes in intervention content to include in it. I used the reflective diary as a tool that had been achieved. Some of the factors were that I for recording the type of things I had done during that day. was a novice others were that on occasions more This included the type of patients I had seen and their preparation was required. conditions, and how these conditions presented. Also any cataloguing events in the diary was that I could look back assessments I may have seen being used that day, or may over the previous weeks and see how I had improved. Reflection on Practice how the OT process was carried out with these patients; • Reflective diaries are not just important during One of the benefits of have carried out myself, or any treatment I may have carried out/observed, and also any administration and form It is important to write up the diary everyday – it doesn’t completion that I may have done. Any visits carried out take long to do. Trying to document events that happened were also noted and other general notes and points to two or three days previously is difficult and important facets remember as well. Any particular feelings I may have had can be forgotten. Also make diary entries on placements regarding activities throughout the day could also be noted. that may not be going as smoothly as you had hoped for. It helps to make sense of where things may be going wrong. 07 REFLECTION ON PRACTICE Time for Relection Keeping the diary is a useful tool for completing your end checklist. There should be considerable space for of placement evaluation. You can flick back through it and discussion and all issues must be addressed in a see what you have been doing over the weeks. It is then constructive way. Bear in mind that there are many ways easy to transfer this information to the evaluation sheet. of developing reflection as a crucial skill for practice. The diary is also useful when you come to fill in job application forms! Again you can scan the diary and select For further information concerning levels of reflecting and relevant information that can be matched with essential models of reflection refer to Alsop and Ryan (1996), Making and desirable criteria in the job specification. the Most of Fieldwork Education, chapter 15. In conclusion, keep your reflective diary up to date. It is a The practice placement is the learning environment in valuable tool during placement and long after placements which students from the healthcare professions realise their are completed. goals of integrating theory with the realities of practice and where they experience and absorb the contradictions and Recording experiences in reflective diaries has been conflicts of professional practice. It should be within the incorporated into many healthcare professional courses context of the supervisory relationship that students are however it is important to note that while individuals can assisted to reflect upon and understand their experiences complete stages of their reflective process model on their and where they are encouraged to face contradictions and own “there is a limit to what each of us can achieve inconsistencies within themselves and between themselves unaided”(Boud, Keogh & Walker, 1985 p.36). Errington and and other aspects of the practice environment. Therefore, Robertson (1998) emphasised the value of dialogue after the supervisory relationship is pivotal in assisting the studying how OT practice changed as a result of reflective emergent professional identity of the student/learner as a practice in a group forum where practitioners were given reflective practitioner. the opportunity to articulate ideas. Supervision Reflective practice could be implemented and encouraged in a group setting by practitioners and/or students. The relationship between the concepts of clinical Alternatively it can be implemented within a one-to-one supervision and reflective practice can be viewed in two forum such as formal supervision. When thinking about the ways. Firstly, clinical supervision can be seen as a purpose of clinical supervision, it is clear that reflection and legitimate tool in which practitioners engage in reflection. supervision are inextricably linked(Racey, 2005). Alternatively, reflection can be seen as an essential component of supervision. Creating A Reflective Context for the Learner Students should be given feedback informally throughout Reflection is an essential element of learning. For reflection the placement, preferably on a daily basis. Students should to be used to advantage during practice placement, much also have formal supervision once per week. This should will depend on the kind of experience that you as a practice be arranged at a specific time when the practice educator educator have had in developing an understanding of and and the student have time and privacy to discuss the using reflective skills. Reflection is relatively new and many learning experiences of the previous week and decide on healthcare professionals have not yet been exposed to or action plans for the following week. had experience in reflection themselves. Guard against using the framework as if it were a set of instructions or a www.practicebasedlearning.org REFLECTION ON PRACTICE Pre-requisites for Effective Reflection and Supervision Key stages of the reflective process • Informal Feedback an awareness of uncomfortable feelings and thoughts; Feedback, when given regularly and constructively, • critical analysis, including attending to feelings; stimulates learning. It may be defined as a form of non- • development of a new perspective on the situation. judgemental communication that can be both formal and informal (Henry, 1985). Informal discussions may take place Pre-requisites for effective reflection and supervision at any time, sometimes several times a day. They are part of the general process of enabling students to integrate Pre-requisites for effective supervision and reflective their educational needs with service delivery ensuring that practice include honesty and openness. Gillings (2000) they understand practice (Alsop and Ryan, 1996). These states that a commitment to self-enquiry and a readiness discussions usually take place before, during and/or after a to change practice are important if the individual is to get treatment intervention with a client. Feedback usually takes the most out of the process. place informally between sessions during refreshment breaks or while travelling between appointments. Many authors identify self-awareness as essential to the Feedback should have the following characteristics: be well informed/appraised of his/her own character, including beliefs and values. Many models of reflective • It should be sufficient. practice also include self-awareness and questioning of • It should be specific. beliefs, values and attitudes. • It should be timely. • It should be regular. The last stage of many models of reflection relates to a • It should be encouraging. willingness to change practice, where new conceptual • It should be relevant. perspectives are reached in order to inform practice. If the • It should be reciprocal. learner is not willing to change practice he/she will not gain • It should not be unexpected by students. the potential benefits from the process in terms of practice • It should include recommendations for improvement. development, advances will not be made and professional practice will not evolve. • It should be provided while the behaviour is still Many of the skills identified as essential for a good • It should relate to behaviours that are remediable. supervisor are required by the practice educator to guide • It should deal with specific problems rather Reflection on Practice reflective process. This implies that the individual needs to fresh in the student's memory. than generalisations. the reflective practitioner. A willingness to commit time to the process and to listen to the learner helps foster a • • There are many similarities between reflective practice and It should deal with decisions and actions rather than assumed intentions or interpretations. relationship that can bring challenging issues to the fore. It should be based on information which is objective by first hand observation. supervision, therefore learners can make effective use of reflective practice as a learning tool within the context of supervision. It is however important that the learner and the practice educator are committed to the process and have a shared understanding of the process to make the experience effective. 09 REFLECTION ON PRACTICE Pre-requisites for Effective Reflection and Supervision Formal Supervision REFLECTING ON PRACTICE STUDENT SUPERVISION FORM Formal supervision, by contrast, should occur regularly at prearranged times in a quiet environment free from the To Be Competed Weekly. distractions of service delivery. Supervision sessions should last about one hour and form an essential feature of the Date: ___________________ Student: placement and supervisory process. Alsop and Ryan (1996) state that formal supervision should be used for four What has gone well? What has not gone well? main purposes: 1. reflection, feedback on and dialogue about practice; 2. review of the achievement of learning goals; 3. revision of the learning contract, until the next supervision session; 4. exploration of practice issues to a deeper level of understanding. What does the student see What does the practice as his/her learning needs? educator see as the student’s learning needs? Therefore, formal supervision is essentially a time for exploring practice, a time for learning, where the real objective is facilitating the students' growth. Practice educators must therefore ensure that they acknowledge the importance of these sessions and allocate appropriate time for them. Both the practice educator and the student need to What has the student learnt from these experiences. What will be done differently? What does the practice educator feel the student could have learnt? What could be done differently or improved? prepare well for the formal supervision sessions. The student needs to be encouraged to think through selected experiences, reviewing them in his/her mind, so that he/she learns from what happened. The practice educator may See Appendix 1 for copy of form. guide the discussion, prompting the student and probing his/her knowledge and understanding, but essentially the The following outline of the process of a formal supervision student must do the work. Please see the Reflecting on session summarises how learners should prepare for, Practice Student Supervision Form provided within this participate in and learn from the supervision session. resource as an example of a tool designed to assist students in developing reflective skills. The student should complete this form prior to the supervision session and it can serve as a stimulus for discussion within the session. www.practicebasedlearning.org REFLECTION ON PRACTICE The Process of a Supervision Session The Process of a Supervision Session needs clearly and honestly with the practice educator. Open discussion allows a practice educator to gain an Prior to the supervision session the student/learner should: accurate assessment of the level of development at which the student is functioning. - review his/her learning contract - review the work undertaken to date Feedback, both informal and formal, from a practice - identify and note his/her achievements during educator is an essential feature of supervision but the that week student must also take responsibility for participating - review the University's assessment form actively in the supervisory process and for monitoring - identify his/her further learning needs his/her own performance in practice. Adopting a mentoring - note any concerns he/she has and topics for partnership can be an effective way of achieving this. discussion in supervision - make an agenda. - agree the agenda with the practice educator - take initiative and participate equally in the discussion - review his/her performance to date, expressing both strengths and limitations - explore any issues that have given him/her special cause for concern - specify particular learning needs which he/she has identified and prioritise them - establish which needs might be met and how - ensure that the learning contract is updated - give his/her practice educator feedback on the Reflection on Practice During the supervision session the student/learner should: strengths and limitations of feedback - agree a course of action for the next few days - clarify the practice educator’s and his/her own responsibilities in the action plan After the supervision session the student/learner should: - review the session - make summative notes of the session - prepare to fulfil the action plan. Supervision is a multi-faceted concept. It is an educational process which relies on effective relationships and open communication between the student and the practice educator. Good communication enables a student to feel comfortable about discussing strengths, limitations and 11 REFLECTION ON PRACTICE Adopting a Mentoring Approach As part of the mentoring relationship, sessions or meetings Adopting a Mentoring Approach occur which provide an explicit arena for the learner to The term mentoring/mentorship is interpreted in different articulate what has been occurring in both their ways groups, professional and personal life (Clutterbuck, 1998; particularly with reference to nursing where the term Megginson & Clutterbuck 1997). These discussions allow mentorship refers to a very specific role but for the the learner to link actual experiences and the attainment of purposes of this project we are suggesting that practice particular skills and/or knowledge. In doing this, the learner educators may wish to adopt a mentoring approach with arguably becomes more acutely in tune with the inherent their students/learners rather than taking on the full role of complexities of ‘real’ experiences and begins to perceive being a mentor. and understand situations with heightened awareness across the healthcare professional (Sayce et al, 2002). Mentoring can be characterised in numerous ways but two leading scholars on the subject, namely David Megginson There is much debate in the literature as to whether an and David Clutterbuck, (1997) have defined the concept effective mentoring relationship can exist when the mentor as: is in a position of authority over the mentee. Some theorists think that a practice educator may be able to adopt the “Off-line help by one person to another in making mentoring role but if you feel that you can’t, you should significant transitions in knowledge, work or re- identify a colleague within your practice setting who might thinking” (1997 : 13) undertake this role. The above definition raises some important issues about What is Mentoring? practice-based roles and the manner in which the transfer of skills and knowledge occurs between an experienced "Mentoring is essentially about helping people to develop practitioner – the mentor, and a student – the learner. more effectively. It is a relationship designed to build Firstly, there is the issue of a mentorship being an “off-line” confidence and help the learner take an increasing initiative relationship. for his/her own development ". It is most effective that someone who is assuming a mentorship role not be the line manager of the Manchester Metropolitan University individual they are mentoring, as the line association has the undeniable pressure for immediate results (Clutterbuck, "Mentoring is a professional relationship within an 1998, Megginson & Clutterbuck, 1997). In contrast the organisation in which an experienced member of staff mentoring relationship tends more towards giving time and provides support and guidance to assist in the integration space for taking a wider view of a situation where and career development of a new member of staff”. significant transitions are taking place. Mentoring is not University of Salford about merely sponsoring another person’s career, but more explicitly focussed on a deeper learning or understanding Benefits of introducing a mentoring approach in of complex situations (Butterworth, 1998; Clutterbuck, practice education: 1998). In addition, issues of trust are paramount to the “development” of the learner and their acquisition of • increased skills and knowledge; it is often difficult for an reflective practice in the context of leading to action and development individual in a position of judgement, such as a practice • integration of learning into the work place educator, to build a necessary level of trust with the learner. • support for mentees/learners in dealing with the pressures of work www.practicebasedlearning.org REFLECTION ON PRACTICE Adopting a Mentoring Approach • encouragement with the course Benefits to the mentor: • identification of common problems and successes • makes it necessary to question what we are doing • individual ownership of the learning process • can learn from mentees is increased • challenging relationship • encourages reflective practice Adopting a mentoring approach with a learner or a student • adds to own personal and professional judgement during practice placement provides the following benefits • aid to other aspects of job eg appraisal skills for the mentee and the mentor. • involvement with new courses • positive effects of being involved in the professional development of colleagues Benefits to the mentee: practical application of knowledge • development of operational skills • personal development in terms of greater • wouldn't otherwise have found the time to air • • additional insights into the processes of teaching and learning (because seen from a different confidence and inter-personal skills • opportunity to discuss professional issues that viewpoint) intellectual development through the sharpening of analytical abilities • opportunity to examine the basis of own knowledge gaining insight into own performance (and the • a fresh perspective on ideas for current and future projects adequacy thereof) • overcomes isolation/insularity • enhances organisational reputation • personal support mechanism • improved job satisfaction • provides a second opinion • increased peer recognition • develops networks • increased understanding of learning needs • advice and encouragement • turning mistakes to profit • exchange of ideas, focus attention on how ideas • expansion of networks agree and differ • provides self-confidence in professional approach • opportunity to analyse learning outcomes • professional development The role of the mentor There are two distinct roles that mentors play; one in • helps newcomers settle in more quickly relation to career functions and the other more concerned • helps to reflect and examine the principles with the needs, thoughts and feelings of the individual informing practice mentee. It would be almost impossible for any one person learning to cope with the formal and informal to have the ideal personality to fulfil all the roles that a • structure of the organisation mentor may be required to perform, or indeed to possess • career advice and advancement the vast range of skills that could be attributed to the • watching and learning from the strategies of others perfect mentor. The aim of this checklist is to show some • learning to take calculated risks of the roles that mentors have taken on in similar mentoring • solving and learning from problems (rather than programmes. Above all the mentor should be flexible and causing concern) responsive to the needs of the mentee. • Reflection on Practice • handling people 13 REFLECTION ON PRACTICE Adopting a Mentoring Approach The role of the mentor might include undertaking the following roles and tasks: • An advisor: offering support and guidance • Providing an objective viewpoint, a stable point of reference • An observer: of treatment sessions, preparation etc • A sounding board: someone to bounce new ideas around with and to generate new ideas • Providing an opportunity to reflect • A counsellor: a sympathetic, non judgemental ear • A problem solver: to discuss and • A questioner: someone who will challenge ideas • A supporter: providing encouragement, consider problems reassurance, motivation and building confidence • Providing feedback • A coach • A good listener • A helper in setting standards • A task setter • An information source/resource • A networker, friend and ally. www.practicebasedlearning.org REFLECTION ON PRACTICE Tensions and Anxieties in Practice Placement Learning for Students & Practice Educators Tensions and Anxieties in Practice Placement Quality supervision is a balance between support for the Learning for Students & Practice Educators student in the new environment and new role, and appropriate challenge. Practice placements are generally very enjoyable aspects of the educational programme for the majority of students A positive student-practice educator relationship is one and their practice educators. However it must be that is: acknowledged that during the periods of practice based learning the students often experience anxiety-provoking • open; situations and this is sometimes also the case for the • caring; practice educators (when dealing with the failing student). • mutually meets each other's needs; Although anxiety may be a positive factor that enhances • honest; performance, too much anxiety can inhibit student learning • tolerant; and and supervisor effectiveness. • respectful of each other. Student anxieties are centred around fitting into a new Dealing with Negative Feedback educator, adapting to the as yet undefined new role, taking Some students who are with practice educators who responsibility for patient/client progress, coping with the constantly criticise them, are unapproachable and feeling of being constantly observed and of course passing unsupportive, feel afraid and tense. The student's the assessment. performance continues to decline in this environment. These students are unable to ask for the assistance they so Practice educators can help students deal with the desperately need and are in constant fear of making anxieties of the practice environment by: mistakes. • supporting students through the different stages Some ideas for how practice educators should deal with of the practice placement; problems once they have been identified: • providing a supportive learning environment; • encouraging students to use more effective • coping behaviour; create an accepting environment in which learning can take place; • role modelling appropriate professional behaviour; • providing clear and realistic expectations; knowledge base, skills, attitudes or behaviours as • giving honest feedback which provides clear soon as they are identified; • Reflection on Practice unknown environment, getting on with the practice • communicate any problems about the student's guidelines for improved performance; and • document feedback and give the student a copy; using learning contracts. • share your concern with the student and the university tutor; • establish measurable objectives for change that • remember no matter how appropriate the are explicit, overt and observable; and supervision, there are some students who need more time to develop competency. 15 REFLECTION ON PRACTICE Appendix 1 Reflection on Practice: Student Supervision Form To Be Competed Weekly. Date: ___________________ Student: What has gone well? What has not gone well? What does the student see as his/her learning needs? What does the practice educator see as the student’s learning needs? What has the student learnt from these experiences. What will be done differently? What does the practice educator feel the student could have learnt? What could be done differently or improved? www.practicebasedlearning.org REFLECTION ON PRACTICE Appendix 2 Supervision Session; Action Plan An Introduction to Practice Education Action Agreed - Practice Educator; Action Agreed - Student; Signed.................................................................... Date.................................... Signed.................................................................... Date.................................... 17 REFLECTION ON PRACTICE References REFERENCES Alsop A & Ryan S (1996) Making the most of fieldwork Gillings B (2000) Clinical supervision in reflective practice education: A practical approach. Stanley Thornes, cited in Burns S & Bulman C, Reflective practice in nursing. Cheltenham. Blackwell Science, Oxford. Baumgartner LM (2001) An update on transformational Jarvis P (1992) Reflective practice and nursing. Nurse learning. New Directions for Adult and Continuing Education Today, 12, 174-181. Education. No89:15-22. Jossey-Bass, San Francisco. Johns C & Freshwater D (1998) Transforming nursing Boud D, Keogh R & Walker D (1985) Reflection: turning through reflective practice. Blackwell Science, London. experience into learning. Kogan Page, London. Johns C (2000) Becoming a reflective practitioner. Boyd E & Fales A (1983) reflective learning: the key to learning from experience. Journal of Blackwell Science, Oxford. Humanistic Psychology, 23 (2): 99-117 Kolb DA (1984) experiential learning: Experience as the source of learning and development. Prentice Hall, New Butterworth, T., Faugier, J., and Burnard, P., (eds) (1998) Jersey. Clinical Supervision and Mentorship in Nursing (2nd ed). Stanley Thornes, Cheltenham Megginson, D., Clutterbuck, D. (eds) (1997). Mentoring in Action: A Practical Guide for Managers. Kogan Page, Clutterbuck, D. (1998) Learning Alliances: Tapping into London. Talent. Institute of Personnel and Development, London. Racey A (2005) Using reflective practice as a learning tool Daloz LA (1999) Mentor: Guiding the journey of adult in clinical supervision. Therapy Weekly April 14 learners. Jossey-Bass, San Francisco. Reid B (1993) ‘But We’re Doing it Already!’ Exploring a Daloz LA (2000) Transformative learning for the common Response to the Concept of Reflective Practice in Order to good. Cited in Chapter 4 Mezirow J and associates(eds) Improve its Facilitation, Nurse Education Today, 13: 305- Learning as transformation: Critical perspectives on a 309. theory in progress. Jossey-Bass, San Francisco. Richardson G & Maltby H (1995) reflection on practice: Department of Health (1993), A Vision for the future: the enhancing student learning. Journal of Advanced Nursing. nursing midwifery and health visiting contribution to health 22:235-242. and healthcare. HMSO, London. Sayce, S., Lewis, A., Swann, P., & Squib, B., (2002) Work Errington E & Robertson L (1998) Promoting staff Based Learning for the Built Environment: A Literature development in Occupational Therapy. British Journal of Review. Occupational Therapy 61(11), 497-503. Schon D (1983) The Reflective Practitioner. Basic Books, London. www.practicebasedlearning.org REFLECTION ON PRACTICE References Tryssenaar J (1999) Interactive journals: an educational strategy to promote reflection. American Journal of Occupational Therapy 49 (7), 695-702. Zubrizarreta J (1999) Teaching portfolios: an effective strategy for faculty development in occupational therapy. American Journal of Occupational Therapy 53(1), 51-55. USEFUL TEXTS Boud D. Keogh R. Walker D. (1985) Reflection: Turning experience into learning. Kogan Page, London. Ghaye T & Lillyman S (1997) Learning Journals & Critical Reflective practice for Healthcare professionals, Mark Allen, Salisbury.. Ghaye T & Lillyman S (2000) Reflection: Principles and Practice for Healthcare Professionals. Quay Books, Dinton. Jasper M (2003) beginning Reflective Practice. Nelson Thornes, Cheltenham. Moon J (1999) Reflection in Learning & Professional Development. Kogan Page, London. Reflection on Practice Incidents: Moon J (1999) learning Journals: A Handbook for Academics, Students and Professional Development. Kogan Page, London. Redmond B (2004) reflection in Action: Developing reflective practice in health and social care services. Ashgate Publications, Aldershot. Rolfe G Freshwater D Jasper M (2001) Critical Reflection for Nursing and the Helping Professions: a user’s guide. Palgrave Macmillan, London. Schon D (1983) The Reflective Practitioner. Basic Books, New York. 19 PROJECT AIMS The Project aims to make practitioners more effective at supporting & supervising students in the workplace across a range of healthcare disciplines. The professions involved in the project are: • Dietetics • Nursing • Occupational Therapy • Physiotherapy • Radiography The principal questions to be addressed in this project are: • What constitutes effective practice in placement education? • How can effective practice be implemented at organisational, professional and practitioner levels so as to maximise student learning on placement? • How can this good practice be developed and embedded in the contexts of health and social care within a multicultural workforce? Project Administrator Telephone: 028 90 368 458 www.practicebasedlearning.org