Guidance for trainees on ‘Models of reflection’

Last Updated: 28th July 2021

A number of different models of reflection exist and you will probably have encountered of one or more of these in your academic study or your professional body. We describe three models here. You may find it helpful to use one of these or another model you are familiar with, to give your reflection a structure and ensure you cover all the elements.

It is important to include data and, if appropriate references, in your reflective writing to provide the evidence-base for your discussion, analysis, evaluation and conclusions.

We would encourage you to try at least two different methods of reflection. This will give you the opportunity to experience a model of reflection you are less familiar with to see if you might find it useful if your preferred model is not appropriate in some contexts.

Model 1: Adapted Academy of Medical Royal Colleges’ Reflective Practice template (2018)

This model is closely aligned to the practice of clinical science and the additional guidance provides helpful prompts and check lists for your critical reflections.

This model has 4 stages:

  1. Outline skills, activity or event.
  2. What is the most important thing you have learned from this experience?
  3. How has this influenced your practice?
  4. Looking forward, what are your next steps?

1. Outline skills, activity or event

Examples could include:

  • significant event
  • complaint
  • teaching
  • test
  • diagnosis
  • report

2. What is the most important thing you have learned from this experience?

Describe how this activity contributed to the development of your knowledge, skills or professional behaviours. You may wish to link this learning to one or more of the Academy of Healthcare Sciences Good Scientific Practice (GSP) standards to demonstrate compliance with their principles and values, i.e.:

  • professional practice
  • scientific practice
  • clinical practice
  • research, development and innovation
  • clinical leadership

3. How has this influenced your practice?

  • How have your knowledge, skills and professional behaviours changed?
  • Have you identified any skills and knowledge gaps relating to your professional practice?
  • What changes to your professional behaviour were identified as desirable?
  • How will this activity or event lead to improvements in patient care or safety?
  • How will your current practice change as a result?
  • What aspects of your current practice were reinforced?
  • What changes in your team/department/organisation’s working were identified as necessary?

4. Looking forward, what are your next steps?

  • Outline any further learning or development needs identified (individual and team/organisation as needed)
  • If further learning and development needs have been identified how do you intend to address these? Set SMART objectives for these (i.e. Specific, Measurable, Achievable, Relevant and Time-bound)
  • If changes in professional practice (individual or team/department) have been identified as necessary how do you intend to address these?
  • Summary of discussion with Training Officer or other supervisor

Model 2: What? So what? Now what? (Rolfe, Freshwater & Jasper, 2001)

What? – a description of the event or the topic you are reflecting on.

What happened? What did I do? What did others do? What did I feel? What was I trying to achieve? What were the results? What was good or bad about the experience?

So, what? – an analysis of the event or topic.

So, what is the importance of this? So, what more do I need to know about this? So, what have I learned about this? So, what does this imply for me?

Now what? – propose a way forward

Now what could I do? Now what should I do? Now what would be the best thing to do? Now what will I do differently next time?

Model 3: Gibbs’ Reflective Cycle (1988)

The six stages of the reflective cycle are listed below and shown in the diagram below:

  1. Description – what happened?
  2. Feelings – what were you thinking and feeling?
  3. Evaluation – what was good and bad about the experience?
  4. Analysis – what sense can you make of the situation?
  5. Conclusion – what else could you have done?
  6. Action plan – if it arose again what would you do?

References

Academy of Healthcare Sciences (2012) Good Scientific Practice. Academy of Healthcare Science: Lutterworth. Version 1, Dec 2012. Available online at https://www.ahcs.ac.uk/2012/12/12/good-scientific-practice/ [accessed 16 March 2021].

Academy of Medical Royal Colleges (2018) Reflective Practice Toolkit. Academy of Medical Royal Colleges: London. Available online at https://www.aomrc.org.uk/reports-guidance/reflective-practice/ [accessed 15 March 2021]

Academy of Medical Royal Colleges (2019) The reflective practitioner: guidance for doctors and medical students. Academy of medical Royal Colleges: London. (January 2019). Available online at https://www.gmc-uk.org/education/standards-guidance-and-curricula/guidance/reflective-practice/the-reflective-practitioner—guidance-for-doctors-and-medical-students [accessed 16 March 2021].

Gibbs, G. (1988) Learning by doing. A guide to teaching and learning methods. Oxford Polytechnic: Oxford.

Harden, R.M., & Laidlaw, J.M. (2017) Essential Skills of a Medical Teacher (2nd Ed). Elsevier: Edinburgh.

HPCP (2014) Standards of proficiency: Clinical Science. HCPC: online (1 December 2014). Available online at https://www.hcpc-uk.org/resources/standards/standards-of-proficiency-clinical-scientists/ [accessed 16 March 2021].

HCPC (2016) HCPC Standards of conduct, performance and ethics. Heath and Care Professions Council: London. Available online at https://www.hcpc-uk.org/standards/standards-of-conduct-performance-and-ethics/ [accessed 16 March 2021].

HCPC (18 June 2019) HCPC joint statement on reflective practice across healthcare. Published online at https://www.hcpc-uk.org/globalassets/news-and-events/benefits-of-becoming-a-reflective-practitioner—-joint-statement-2019.pdf [accessed 16 Mar 2021]. HCPC: online, 18-06-2019.

Rolfe, G. Freshwater, D & Jasper, M. (2001) Critical reflection for nursing and the helping professions: a user’s guide. Basingstoke: Palgrave Macmillan.

Royal College of Physicians (2020) GIM400 Practicum 1 Handbook. Royal College of Physicians: London.

Tosey, P., Visser, M. and Saunders, M.N.K (2012) The origins and conceptualisations of ‘triple-loop’ learning: A critical review. Management learning, 43(pp 291-307). Available online at https://journals.sagepub.com/doi/abs/10.1177/1350507611426239 [accessed 16 March 2021].