Guidance for trainees on ‘What is reflection?’


What is reflection?

Reflection is ‘the process whereby an individual thinks analytically about anything relating to their professional practice with the intention of gaining insight and using the lessons learned to maintain good practice or make improvements were possible’ as defined in the Academy of Medical Royal Colleges, Reflective practice toolkit (2018, p1). This toolkit contains many examples of medical reflection using different frameworks.


What is critical reflection?

As a critical reflector we are not only reflecting on our own actions and outcomes or results, we are also reflecting on whether or not we are doing the right things and in the wider context, reflecting on how we make decisions about what is right. This is sometimes referred to as triple loop learning (Tosey, Visser, and Saunders, 2012) as shown in the diagram below.

The HPCP and AoMP definition of a reflective practitioner expects the practitioner to critically reflect on and about assumptions and the wider context.

As a reflective practitioner we strive to reflect at the third loop level, critiquing and reflecting on and about established practices and procedures and whether or not they can be improved; as well as whether or not we can undertake these successfully, reliably, safely and appropriately.


Why is reflection important in clinical Science?

In Clinical Science, 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 (HCPC, 2019)”

By developing reflection as part of your ongoing practice you will be able to develop ideas and actions that can improve practice of individuals, teams and processes.


How to reflect?

There is no right or wrong way to reflect. What is important is that you move beyond simply describing what happened to analysing why it happened, what you felt and thought and what you have learned as a result. Your reflection should draw on an appropriate evidence base drawn from your portfolio to explain and justify your analysis and your learning and future practice. The evidence base you refer to could be any of the following:

  • Tests, interpreting results, writing reports
  • Workplace guidelines and protocols
  • Speciality or professional body guidelines
  • Literature (eg relevant theory from your MSc)
  • Case studies
  • Project reports
  • Discussions with senior colleagues
  • Presentations to peers
  • Teaching sessions
  • Conversations with supervisors
  • Legislation
  • Any signed off competency and/or evidence in your OneFile

What to reflect on?

Commonly reflection is about something you have done, e.g. a test, an analysis, a procedure, a diagnosis, a report, an encounter with a patient. In such cases reflection will be about analysing why you did what did, your decision-making processes, what you did well and areas where you might do things differently another time.

However, you can also reflect on observed encounters and interactions by other staff and see these as a learning process. These will form an important part of your reflections as you progress through your programme of work-based learning.

In order to get the most out of reflective practice you should have a systematic and structured approach and actively engage with the process. It is also important to reflect on all experiences, both positive or negative, large or small; for example a conversation with a colleague can generate meaningful insight and learning. (HCPC, 2019).

There is a tendency to think about reflection as what we do when something goes wrong. However, it is equally important to reflect when things go well, in order to build on and develop good practice and success.

Multi-disciplinary and professional team reflection is viewed as an excellent way to develop ideas and improve practice. (HCPC, 2019).

Your reflections on your practice must be evidence-based.