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Reflective Practice is encouraged in the healthcare sector as a medium of learning which is based on self-evaluation. Reflective Practice suggests that an individual’s lived experience can be taken as the initial learning point from where knowledge could be developed, and further action could be taken to stimulate growth. As such, a Reflective Practice would comprise of three elements. First, the subject would need to have certain experiences. Secondly, the subject would have to undertake a reflective process whereby they scrutinize their own experiences. Thirdly, there would be resulting actions informed by the knowledge earned during the reflective process. When reflection is considered as a part of Reflective Practice, it becomes a skill which must be nurtured and developed over time. To help professionals with Reflective Practice, several Reflective Models have been suggested, the popular ones being Driscoll’s Reflective Cycle, Gibbs’ Model of Reflection, Kolb’s Reflective Cycle & John’s Model of Reflection.
Driscoll’s Reflective Cycle was developed by John Driscoll in 1994; it inspires reflective thinking by asking three simple questions, which were first suggested in the context of Reflective Practice by Terry Borton in the 1970s. The three questions are:
Healthcare interns or medical students are often asked to write reflective reports based on their experiences where they might be asked to follow Driscoll’s Reflective Cycle. While writing such a report, they should first elaborately explain the situation that took place. This can be done by answering the questions demarcated for the ‘What?’ phase, but the answers should be framed in a coherent manner with a consistent flow in narrative. This first step is crucial because by describing the situation or experience, they would paint a clear picture of the experience that is being dealt with. An example of such a situation could be the administering of wrong medicine to a patient. However, the situation does not have to be a negative one necessarily.
In the second stage, one has to analyse the situation and their own response, describing both in detail in their report. Here, it is important to mention the new things the they have learned from their experience. In the third stage, they should mention in the report what possible initiatives can improve their response and help them to better manage such situations in future. Here, it is significant to note that upon reflection, the subject might realise that their responses and actions were quite accurate, and no further changes need to be made. Such an inference would also be valid.
Driscoll’s Reflective Cycle provides a structured approach to be followed with a specific beginning point, which helps people to know how to conduct reflective thinking in a systematic manner. It attempts to assess all levels of the situation which results in a complete analysis of the situation as well as of the individual’s response. In addition, it is a fast process which yields result quite quickly. When the subject needs a prompt assessment of a situation, the simple ‘What? So What? Now What?’ approach can be immensely helpful because it is easy to remember and follow with unambiguous directions about the starting and ending points.
While Driscoll’s Reflective Cycle is quick, structured, easy to remember and follow, it has been argued that it does not facilitate a deep analysis of the situation. It is more of a quick fix, but if someone wishes to study an experience in greater detail to radically modify their response to such an experience, they should consider other detailed models of reflection like Gibbs’ model.
While details about Driscoll’s model has already been discussed above, a brief study of alternative model of reflections could highlight how they differ from Driscoll’s model, and which of them have advantages over the other.
This model was proposed by Graham Gibbs in 1988 and it follows six stages, namely:
Like other reflective models, it begins with a description of the situation or experience, but eventually concentrates on the feelings of the subject rather than on the situation itself. In the evaluation stage, one is supposed to demarcate positive or negative aspects of the situation, which can be analysed in detail in the following stage. This analysis would lead to a conclusion about possible steps which could have been taken to improve the situation, and the model would end with a detailed action plan that would outline the things that ought to be done for better outcomes when the situation occurs again. Gibbs’ Model is different from Driscoll’s in the respect that it is an elaborate and time consuming one, while Driscoll’s is a quick and short model. Besides, Gibbs model is considered to be one of the most complicated models while Driscoll’s is immensely simple. Gibbs model is focused on the subject’s feelings/ response while Driscoll’s model pays more attention to an analysis of the situation.
David Kolb proposed this model in 1984; it follows four crucial stages which are:
This model is evolved based on theories of how people learn, and it attempts to develop understanding through lived experiences. This too begins with a description of the experience but encourages the subjects to note things that they have never encountered before. This leads to the development of new ideas based on this new experience. Subjects are encouraged to apply these newly gained ideas to future experiences. This model is similar to the ones used by children when they are learning new concepts like hot or cold. They might touch something hot (a new experience), and burn their finger, and use this knowledge to avoid touching hot objects in future. Kolb’s Experiential Learning Cycle is considered to be a good model for beginners in reflective thinking, but when it is compared to other feasible models like Driscoll’s Reflective Cycle, it seems to lack critical thinking and analysis, thereby appearing superficial. While both of these models can be applied promptly, Driscoll’s model contains more probing queries and is simpler and easier to remember and follow, making it a better alternative for beginners.
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