reflective practice presentation

PERSONAL SKILLS
Personal Skills for the Mind

Reflective Practice

Search SkillsYouNeed:

Personal Skills:

A - Z List of Personal Skills
Personal Development
Career Management Skills
Creative Thinking Skills

Check out our popular eBook now in its third edition.

The Skills You Need Guide to Life: Looking After Yourself

Keeping Your Mind Healthy
Improving Your Wellbeing
Mindfulness
Keeping a Diary or Journal
Positive Thinking
Self-Esteem
Managing Your Internal Dialogue (Self-Dialogue)
The Importance of Mindset
Introducing Neuro-Linguistic Programming (NLP)
Memory Skills
What is Anxiety?
10 Steps to Overcome Social Anxiety
What is Depression?
Treatments for Depression
Types of Depression
Understanding Dyslexia
Understanding Dyscalculia
Understanding Attention Deficit Hyperactivity Disorder (ADHD)
Understanding Autism Spectrum Disorder
Understanding Dyspraxia
How To Adult: 9 Essential Skills to Learn as a Young Adult
Teenagers and Mental Health
Eating Disorders
Gender Identity and Body Dysphoria
Perimenopause and Health
Managing Seasonal Affective Disorder (SAD)
Status Anxiety
Social Media and Mental Health
Problematic Smartphone Use
10 Benefits of Spending Time Alone
Emotional Intelligence
Stress and Stress Management
Anger and Aggression
Assertiveness
Caring for Your Body

Subscribe to our FREE newsletter and start improving your life in just 5 minutes a day.

You'll get our 5 free 'One Minute Life Skills' and our weekly newsletter.

We'll never share your email address and you can unsubscribe at any time.

What is Reflective Practice?

Reflective practice is, in its simplest form, thinking about or reflecting on what you do. It is closely linked to the concept of learning from experience, in that you think about what you did, and what happened, and decide from that what you would do differently next time.

Thinking about what has happened is part of being human. However, the difference between casual ‘thinking’ and ‘reflective practice’ is that reflective practice requires a conscious effort to think about events, and develop insights into them. Once you get into the habit of using reflective practice, you will probably find it useful both at work and at home.

Reflective Practice as a Skill

Various academics have touched on reflective practice and experiential learning to a greater or lesser extent over the years, including Chris Argyris (the person who coined the term ‘double-loop learning’ to explain the idea that reflection allows you to step outside the ‘single loop’ of ‘Experience, Reflect, Conceptualise, Apply’ into a second loop to recognise a new paradigm and re-frame your ideas in order to change what you do).

They all seem to agree that reflective practice is a skill which can be learned and honed, which is good news for most of us.

Reflective practice is an active, dynamic action-based and ethical set of skills, placed in real time and dealing with real, complex and difficult situations.

Moon, J. (1999), Reflection in Learning and Professional Development: Theory and Practice, Kogan Page, London.

Academics also tend to agree that reflective practice bridges the gap between the ‘high ground’ of theory and the ‘swampy lowlands’ of practice. In other words, it helps us to explore theories and to apply them to our experiences in a more structured way. These can either be formal theories from academic research, or your own personal ideas. It also encourages us to explore our own beliefs and assumptions and to find solutions to problems.

Developing and Using Reflective Practice

What can be done to help develop the critical, constructive and creative thinking that is necessary for reflective practice?

Neil Thompson, in his book People Skills , suggests that there are six steps:

Read - around the topics you are learning about or want to learn about and develop

Ask - others about the way they do things and why

Watch - what is going on around you

Feel - pay attention to your emotions, what prompts them, and how you deal with negative ones

Talk - share your views and experiences with others in your organisation

Think - learn to value time spent thinking about your work

In other words, it’s not just the thinking that’s important. You also have to develop an understanding of the theory and others’ practice too, and explore ideas with others.

Reflective practice can be a shared activity: it doesn’t have to be done alone. Indeed, some social psychologists have suggested that learning only occurs when thought is put into language, either written or spoken. This may explain why we are motivated to announce a particular insight out loud, even when by ourselves! However, it also has implications for reflective practice, and means that thoughts not clearly articulated may not endure.

It can be difficult to find opportunities for shared reflective practice in a busy workplace. Of course there are some obvious ones, such as appraisal interviews, or reviews of particular events, but they don’t happen every day. So you need to find other ways of putting insights into words.

Although it can feel a bit contrived, it can be helpful, especially at first, to keep a journal of learning experiences. This is not about documenting formal courses, but about taking everyday activities and events, and writing down what happened, then reflecting on them to consider what you have learned from them, and what you could or should have done differently. It’s not just about changing: a learning journal and reflective practice can also highlight when you’ve done something well.

Take a look at our page What is Learning? to find out more about the cycle of learning (PACT) and the role that reflection (or ‘Considering’) plays in it.

In your learning journal, it may be helpful to work through a simple process, as below. Once you get more experienced, you will probably find that you want to combine steps, or move them around, but this is likely to be a good starting point.

The Benefits of Reflective Practice

Reflective practice has huge benefits in increasing self-awareness, which is a key component of emotional intelligence , and in developing a better understanding of others. Reflective practice can also help you to develop creative thinking skills , and encourages active engagement in work processes.

In work situations, keeping a learning journal, and regularly using reflective practice, will support more meaningful discussions about career development, and your personal development, including at personal appraisal time. It will also help to provide you with examples to use in competency-based interview situations.

See our pages on Organising Skills and Strategic Thinking to find out more about how taking time to think and plan is essential for effective working and good time management, and for keeping your strategy on track. This is an example of the use of reflective practice, with the focus on what you’re going to do and why.

Reflective practice is one of the easiest things to drop when the pressure is on, yet it’s one of the things that you can least afford to drop, especially under those circumstances. Time spent on reflective practice will ensure that you are focusing on the things that really matter, both to you and to your employer or family.

To Conclude

Reflective practice is a tool for improving your learning both as a student and in relation to your work and life experiences. Although it will take time to adopt the technique of reflective practice, it will ultimately save you time and energy.

The Skills You Need Guide to Personal Development

Critical reflection for assessments and practice

Reflective practice

Critical reflection for assessments and practice: Reflective practice

Critical reflection
How to reflect
Critical reflection writing
Recount and reflect

What is reflective practice?

"In general, reflective practice is understood as the process of learning through and from experience towards gaining new insights of self and/or practice. This often involves examining assumptions of everyday practice."

Linda Finlay - Reflecting on 'Reflective practice' (2008)

Reflection is critical to being a conscious, effective practitioner in any discipline. The important thing to keep in mind is that reflecting by itself is not reflective practice. Practice is tied into active, impactful change that emerges from deep reflective learning .

Thinking and doing

Reflective practice is the act of thinking about your experiences in order to learn from them to shape what you do in the future. It therefore includes all aspects of your practice (e.g. relationships, interactions, learning, assessments, behaviours, and environments). It also includes examining how your practice is influenced by your own world views and gaining insights and other perspectives to inform future decision making.

Why reflect?

Reflective practice benefits you on both professional and personal levels. Using critical reflection as a tool can give you insight and positively impact your study, your wellbeing and your worklife. Click the plus icons (+) to view some benefits of reflective practice.

When to critically reflect?

Critical reflection connects to past, current and future action. Click on each of the flip cards to learn the time-related actions you need to do as part of reflective practice.

Reflective practice and critical reflection

Reflective practice is part of your mindset and everyday doing for both uni and the workplace. The process also relies on using critical reflection as a tool to analyse your reflections and which allows you to evaluate, inform and continually change your practice.

Explore the infographic below for a visual depiction of the reflective practice and critical reflection relationship.

Reflective practice infographic

Critical reflection and areas of your practice

Reflective practice relies on your ability to be open to change and to consider relevant evidence that can challenge or inform decision making. Critical reflection is what allows you to deeply understand your study or work practice and then to take actions to improve it.

You should critically reflect on all aspects of your practice including:

Reflective practice and you

How would you define reflective practice for yourself? There's no right or wrong answer to this question because it's so contextual. The way you enact reflective practice is tied to you and how you think, feel and do. We know that writing down or verbalising your thinking can help you better understand what something means to you. With that in mind...

Take a few moments to think about how you define reflective practice. You can then record yourself using the interactive audio activity below and download the soundbyte. Any recording you make is only available to you. Keep this definition in mind as you move through this critical reflection guide.

<< Previous: Homepage
Next: Critical reflection >>
Last Updated: Mar 15, 2024 4:53 PM
URL: https://deakin.libguides.com/critical-reflection-guide

Academia.edu no longer supports Internet Explorer.

To browse Academia.edu and the wider internet faster and more securely, please take a few seconds to upgrade your browser .

Enter the email address you signed up with and we'll email you a reset link.

We're Hiring!
Help Center

Professional Practice - The Process of Reflective Practice

Reflective Practice

A presentation to assist in understanding Reflective Practice

Related Papers

Ulrich's Bimonthly, March-April 2008

Werner Ulrich

The aim of the series of "Reflections on Reflective Practice," which begins with the present introductory article, is to explore the potential of practical philosophy to become a new, third pillar of reflective professional practice, in addition to today's "reflective practice" mainstream (the focus of which is on psychological rather than philosophical and methodological issues of competent practice) and the conception of "applied science" (which tends to neglect the normative side of competent practice). The essay offers a critique of the soft (psychological) bent of the notion of reflective practice as it has developed in the professional education literature. It is found to neglect essential challenges that professional education faces today, and to have actually become the "reflective practice" literature's blind spot.

Fernando Batista

"Maybe reflective practices offer us a way of trying to make sense of the uncertainty in our workplaces and the courage to work competently and ethically at the edge of order and chaos…" (Ghaye, 2000, p.7) Reflective practice has burgeoned over the last few decades throughout various fields of professional practice and education. In some professions it has become one of the defining features of competence, even if on occasion it has been adopted-mistakenly and unreflectively-to rationalise existing practice. The allure of the 'reflection bandwagon' lies in the fact that it 'rings true' (Loughran, 2000). Within different disciplines and intellectual traditions, however, what is understood by 'reflective practice' varies considerably (Fook et al, 2006). Multiple and contradictory understandings of reflective practice can even be found within the same discipline. Despite this, some consensus has been achieved amid the profusion of definitions. In general, reflective practice is understood as the process of learning through and from experience towards gaining new insights of self and/or practice (Boud et al 1985; Boyd and Fales, 1983; Mezirow, 1981, Jarvis, 1992). This often involves examining assumptions of everyday practice. It also tends to involve the individual practitioner in being self-aware and critically evaluating their own responses to practice situations. The point is to recapture practice experiences and mull them over critically in order to gain new understandings and so improve future practice. This is understood as part of the process of lifelong learning. Beyond these broad areas of agreement, however, contention and difficulty reign. There is debate about the extent to which practitioners should focus on themselves as individuals rather than the larger social context. There are questions about how, when, where and why reflection should take place. For busy professionals short on time, reflective practice is all too easily applied in bland, mechanical, unthinking ways,

Reflective Practice and Professional Development

Development of professional practice through reflection, including an originally created model of reflection.

The Veterinary Nurse

Samantha Fontaine

Physiotherapy

Lynn Clouder

Elizabeth Anne Kinsella

Journal of In-service Education

Ruth Leitch

Cisca Domingo

Loading Preview

Sorry, preview is currently unavailable. You can download the paper by clicking the button above.

Reflective Practice: Thinking About the Way You Do Things

Reflective practice involves actively analyzing your experiences and actions, in order to help yourself improve and develop.

For example, an athlete can engage in reflective practice by thinking about mistakes that they made during a training session, and figuring out ways to avoid making those mistakes in the future.

Reflective practice can be beneficial in various situations, so it’s worthwhile to understand this concept. As such, in the following article you will learn more about reflective practice, and see how you can engage in it yourself, as well as what you can do to encourage others to engage in it.

Examples of reflective practice

An example of reflective practice is an athlete who, after every practice, thinks about what they did well, what they did badly, why they did things the way they did, and what they can do in the future to improve their performance.

In addition, examples of reflective practice appear in a variety of other domains. For instance:

A student can engage in reflective practice by thinking about how they studied for a recent test and how they ended up performing, in order to figure out how they can study more effectively next time.
A medical professional can engage in reflective practice by thinking about a recent procedure that they performed, in order to identify mistakes that they’ve made and figure out how to avoid making those mistakes in the future.
A human-resources representative can engage in reflective practice by thinking about recent interviews that they conducted with potential new hires, in order to determine whether all the steps in the interview are necessary, and whether any other steps are needed.

The benefits of reflective practice

There are many potential benefits to reflective practice. These include , most notably, the following:

Acquisition of new knowledge.
Refinement of existing knowledge, for example by correcting current misconceptions.
An improved understanding of the connections between theory and practice.
An improved understanding of the rationale behind your actions, in terms of factors such as why you do the things that you do, and why you do things a certain way.
Improvement of your goals and of the rules that you use for decision-making (this is also associated with the concept of double-loop learning ).
A better understanding of yourself, in terms of factors such as your strengths and weaknesses.
Development of your metacognitive abilities, for example when it comes to your ability to analyze your thoughts more effectively.
Increased feelings of autonomy, competence, and control.
Increased motivation to act.
Improved performance, for example due to learning how to take action in a more effective way, or due to having more motivation to take action.

These benefits can apply not only to the specific domain in which you engage in reflective practice, but also to other domains. For example, if a musician engages in reflective practice with regard to how they play their instrument, they might improve their understanding of their preferences as a learner, which could help them when it comes to their academic studies.

Finally, note that in some cases, reflective practice is viewed as not only beneficial, but outright crucial to people’s goals. As one scholar notes:

“It is not sufficient simply to have an experience in order to learn. Without reflecting upon this experience it may quickly be forgotten or its learning potential lost. It is from the feelings and thoughts emerging from this reflection that generalisations or concepts can be generated. And it is generalisations which enable new situations to be tackled effectively. Similarly, if it is intended that behaviour should be changed by learning, it is not sufficient simply to learn new concepts and develop new generalisations. This learning must be tested out in new situations. The learner must make the link between theory and action by planning for that action, carrying it out, and then reflecting upon it, relating what happens back to the theory.” — From “Learning by Doing: A Guide to Teaching and Learning Methods” by Graham Gibbs (1988)

Overall, there are many potential benefits to reflective practice, including a better understanding of the rationale behind your actions, increased feelings of control, and improved performance, and these benefits can extend to additional domains beyond the one in which you engaged in reflective practice.

How to engage in reflective practice

Broadly, reflective practice involves thinking about how you do things, and trying to understand why you do what you do, and what you can do better. As such, there are many ways you can engage in it, and different approaches to reflective practice will work better for different people under different circumstances.

One notable way to engage in reflective practice is to ask guiding questions. For example, when it comes to reflective practice in the context of a recent event, you can ask yourself the following:

How did I feel while the event was happening?
What were my goals?
What were the main things that I did?
What went well?
What went badly?
What should I do the same way next time?
What should I do differently next time?

Similarly, you can engage in reflective practice through reflective writing , which can also take various forms, such as answering guiding questions, creating a detailed narrative of a recent event, or sketching a diagram to analyze your thoughts. This can be beneficial when it comes to improving your ability to reflect, and it also has the added benefit of giving you the option to review your original reflections, especially if you collect your writings in a consistent location, such as a reflection journal.

When deciding how to engage in reflective practice, it’s crucial to find the specific approaches that work best for you in your particular situation. This means, for example, that if you try to engage in reflective writing but consistently find that thinking aloud works better for you, then it’s perfectly acceptable to do that instead. Similarly, while peer feedback can facilitate reflection in some cases, it can also hinder it in others, so you should use it only if you find that it helps you.

Finally, keep in mind that it’s generally more difficult and time-consuming in the short-term to engage in reflective practice than to act without reflection, especially when it comes to reflecting as events are unfolding , and this can make people prone to avoiding reflection. Furthermore, the difficulties of reflective practice sometimes make it impractical, meaning that people must avoid it in certain situations. However, in cases where it’s possible to engage in reflection in a reasonable manner, doing so often ends up being beneficial in the long-term, both when it comes to performance, as well as when it comes to related benefits, such as personal growth.

Overall, you can engage in reflective practice in various ways, such as by asking yourself guiding questions about your actions, or by writing about your experiences. Different approaches to reflective practice will work better for different people under different circumstances, so you should try various approaches until you find the ones that work best for you.

The reflective cycle

Gibbs' Reflective Cycle: description, feelings, evaluation, analysis, conclusion, action plan.

Gibbs’ reflective cycle is a process for guiding reflective practice. It involves the following steps, in order:

Description. Describe what happened, without judgment or analysis. For example, you can ask yourself where you were, who else was present, and what happened.
Feelings. Describe how you felt, what you were thinking, and how you feel now, again without judgment or analysis.
Evaluation. Evaluate everything that happened, for example, by asking yourself what went well and what went badly.
Analysis. Analyze the situation, to try and make sense of everything that happened. For example, you can ask yourself why the things that went well went well, why the things that went badly went badly, and why you acted the way that you did.
Conclusion. Draw conclusions based on the information that you generated so far. Start with general conclusions, and then move on to specific ones that pertain to your particular situation. For example, you can start by forming general conclusions about how people act in certain situations, and then move on to form more specific conclusions about what that means for the type of situation that you’re in.
Action plan. Figure out what you are going to do differently next time, based on everything that you’ve learned. For example, if you realize that things went badly because you’ve made a certain mistake as a result of carelessness, figure out how you’re going to act in the future to avoid making that mistake again.

Note : in addition to Gibbs’ reflective cycle, there are other models that can be used to guide reflective practice, such as Kolb’s experiential learning cycle . These models generally revolve around the concept of experiential learning , which is learning that is based on experience (i.e., “learning by doing”).

Types of reflection

A distinction can be drawn between three types of reflection, based on your temporal relation to the event that you’re reflecting about. Based on this distinction, there are three main types of reflection:

Anticipatory reflection. Anticipatory reflection is reflection that’s performed before an event occurs. For example, this type of reflection can involve asking yourself what might happen, what challenges you’re likely to face, how should you respond, and what you can do to prepare.
Reflection-in-action. Reflection-in-action is reflection that’s performed while an event is occurring. For example, this type of reflection can involve asking yourself what’s currently happening, whether things are going as expected, how you’re feeling, and whether there’s anything you should be doing differently.
Reflection-on-action. Reflection-on-action is reflection that’s performed after an event has occurred. For example, this type of reflection can involve asking yourself what happened, what went well, and what you should have done differently.

These types of reflection are similar conceptually, though there are some minor differences between them. For example, when it comes to anticipatory reflection, you must rely on predictions of future experiences, rather than on those actual experiences or your recollections of them, though you can use your past experiences to inform those predictions. Similarly, when it comes to reflection-in-action, you might need to engage in reflection faster and while under heavier pressure, if you want to be able to use the reflect to inform your actions as the event in question unfolds.

Levels of reflection

You can engage in reflection in different ways and to different degrees . For example, when it comes to reflection, there’s a difference between simply asking yourself “did I do well?” and asking yourself “how well did I do, why did I do what I did, and what can I do better?”.

These different forms of reflection can be viewed as distinct from one another , and as different levels of reflection within a single hierarchy or continuum. A common example of how reflection might be categorized based on this is by differentiating between superficial reflection and deep reflection , where deep reflection involves reflection that is more in-depth in various ways.

From a practical perspective, what matters most is understanding that in different situations you might benefit from different levels of reflection. For example, in some cases, it might be preferable to engage in superficial reflection, and simply identify the fact that you’ve made a mistake, while in other cases, it might be preferable to engage in deep reflection, by figuring out why you’ve made a mistake and what you can do to avoid making it again.

Note : other terms are sometimes used to differentiate between superficial and deep reflection, such as shallow reflection or surface reflection (in place of superficial reflection ), and thorough reflection (in place of deep reflection ).

Using self-distancing to help reflection

In some cases, it can be beneficial to use self-distancing to aid the reflection process. This can help you get better insights into your actions, by reducing issues such as the egocentric bias , which can hinder reflection. To use self-distancing in this manner, you can do things such as the following:

Ask yourself what advice would you give someone else if they were in the same situation as you.
Avoid first-person language when considering your performance (e.g., instead of asking “what could I have done differently?”, ask “what could you have done differently?”).
When considering events you were in, try to visualize them not only from your own perspective, but also from the perspective of other people involved, or from a general external perspective.

Reflective practice as a shared activity

It’s possible to engage in reflective practice as part of a shared activity. This type of reflection can take various forms, such as discussing your experiences with a group of other people, or having someone with expertise ask you guiding questions in order to help you reflect.

Shared reflective practice has both potential advantages and disadvantages. For example, shared reflection as part of a group might help people identify more issues with their actions than they would be able to identify by themself, as a result of being exposed to more perspectives. At the same time, however, this approach might also make the reflection process much more stressful for people who are shy.

Accordingly, it’s important to consider the potential advantages and disadvantages of the various approaches to reflective practice, when deciding whether to use shared practice in your particular circumstances, and if so then in what wait.

Note : a phenomenon that’s related to shared reflective practice is the protégé effect , which is a psychological phenomenon where teaching, pretending to teach, or preparing to teach information to others helps a person learn that information. Specifically, the protégé effect means that helping others engage in reflective practice can improve your own ability to do so, and can also help you when it comes to learning other things.

How to encourage reflective practice in others

To encourage others to engage in reflective practice, you can start by doing the following:

Explain what reflective practice is.
Explain why reflective practice is beneficial.
Explain how to engage in reflective practice.

This can be guided by the material provided in the earlier sections of this article, on how to engage in reflective practice yourself.

Once you’ve done this, you can create an environment that is conducive to reflective practice, and help people engage in it, while keeping in mind that different people will benefit from different approaches to reflection. For example, some people might benefit from having someone go with them through each stage of the reflection cycle, while others will benefit more from simply being shown how reflection works and then being left to do reflect on their own.

Alternatively, you can also take a more externally driven approach to reflective practice, by guiding people through reflective practice, without fully explaining the concept to them.

Finally, note that you should generally avoid forcing the reflection process, or forcing people to “confess” what they’ve done wrong, since this can lead to ineffective reflection, as well as to various other issues. For example, when people know that they will be graded based on their responses during the reflection process, they might answer in a dishonest and strategic manner , by giving responses that they think the person evaluating them wants them to give. Similarly, this kind of forced reflection can also lead to issues such as increased stress, as well as increased hostility toward the reflection process and the people who guide it.

Accordingly, in cases where it’s possible and beneficial, you should allow people to make their reflections private. In addition, you should also avoid sticking to a strict reflection template in cases where doing so is counterproductive, and instead allow people to engage in reflection in the way that works best for them.

Related concepts

Two concepts that are often discussed in relation to reflective practice are reflexivity and critical reflection :

R eflexivity describes people’s ability and tendency to display general self-awareness, and to consider themselves in relation to their environment.
C ritical reflection describes an extensive and in-depth type of reflection, which involves being aware of how your assumptions affect you, as well as examining your actions and responsibilities from moral, ethical, and social perspectives.

In addition, another closely related concept is reflective learning , which involves actively monitoring your knowledge, abilities, and performance during the learning process, and assessing them in order to find ways to improve.

The terms reflective practice and reflective learning refer to similar concepts, and because their definitions vary and even overlap in certain sources , they are sometimes used interchangeably.

Nevertheless, one notable way to differentiate between them is to say that people engage in reflective learning with regard to events where learning is the main goal, and in reflective practice with regard to events where learning is not the main goal. For example, a nursing student might engage in reflective learning when learning how to perform a certain procedure, whereas an experienced nurse might engage in reflective practice while performing the same procedure as part of their everyday routine.

Alternatively, it’s possible to view reflective learning as a notable type of reflective practice, which revolves around improving one’s learning in particular.

Overall, there is no clear distinction between reflective practice and reflective learning, and these terms are sometimes used interchangeably. However, potential distinctions between these terms are generally not important from a practical perspective, since they are unlikely to influence how the underlying concepts are implemented in practice.

Summary and conclusions

There are many potential benefits to reflective practice, including a better understanding of the rationale behind your actions, increased feelings of control, and improved performance, and these benefits can extend to additional domains beyond the one in which you engaged in reflective practice.
You can vary the way you engage in reflective practice based on the circumstances, your preferences, and your goals; for example, in some cases, you might benefit from quick reflection as events are still unfolding, while in others you might benefit from more thorough reflection after an event has concluded.
A notable process that you can use to engage in reflective practice is Gibbs’ reflective cycle , where you (1) describe what happened, (2) consider what you were feeling and thinking during your experience, (3) evaluate what was good or bad about it, (4) analyze what else you can make of the situation, (5) draw generalized and specialized conclusions, and (6) create an action plan for the future.
To encourage others to engage in reflective practice, you can explain what it is, why it’s beneficial, and how they can engage in it, or help them engage in it directly, for example by asking them guiding questions.

Study Skills

Reflective practice toolkit.

Introduction
What is reflective practice?
Everyday reflection
Models of reflection
Barriers to reflection
Free writing
Reflective writing exercise
Bibliography

Who is this resource for?

Being able to reflect is a valuable skill to have both during your education and as you move on to the workplace. It helps you to think about your experiences, why things happened the way they did and how you can improve on these experiences in future. This resource will guide you through the basics of what reflective practice is, its benefits, how to integrate it into your everyday life and the basics of reflective writing.

This resource is designed to be flexible so you can use it in the best way for you. You can read the whole resource to guide you through from the basics to a selection of top tips for putting reflection into practice. If you are short on time you can follow one of the suggested pathways below:

Pathway 1: Beginners

Why reflect?
Models of reflection (focus on ERA and Driscoll models)

Pathway 2: Intermediate

Reflective writing with exercise

Throughout the resource there are activities to get you thinking about reflective practice and how it might work for you.

Next: What is reflective practice? >>
Last Updated: Jun 21, 2023 3:24 PM
URL: https://libguides.cam.ac.uk/reflectivepracticetoolkit

The Ultimate Guide to Reflective Practice in Teaching

Last updated: 12th May, 2024

Posted by: Rico Patzer

Two teacher's exploring the IRIS Connect platform on a laptop.

What is reflective practice in teaching?

The importance of reflection in teaching, the effect of reflective teaching in schools, 5 benefits of being a reflective teacher.

How to reflect on teaching: getting started

7 reflection activities for teachers

Using video for reflective practice: what the teachers say

Introduction

Good teachers reflect on what, why and how they do things in the classroom. Great teachers adapt as a result of this reflection, to continually improve their performance. In this guide we share everything you need to know about the benefits of reflective teaching, how to become more reflective and encourage others to do the same.

Naturally, most teachers will spend time thinking about what they did in the classroom, why they do certain things, and if it’s working.

Reflective practice is purposeful reflection at the heart of a structured cycle of self-observation and self-evaluation for continuous learning. It’s central to effective professional development (PD) and becoming a more highly skilled teacher.

“Reflective Practice”

Purposeful reflection at the heart of a structured cycle of self-observation and self-evaluation for continuous learning.

Teacher reflection helps you move from just experiencing a lesson, to understanding what happened and why.

Taking the time to reflect on and analyze your teaching practice helps you to identify more than just what worked and what didn’t. When reflecting with purpose, you can start to challenge the underlying principles and beliefs that define the way that you work.

This level of self-awareness is a powerful ally, especially when so much of what and how you teach can change in the moment.

If you don’t question what your experiences mean and think actively about them on an on-going basis, the evidence shows you are unlikely to improve.

Reflective practitioners can better ride the waves of change

Schools with a reflective teaching culture have an edge in times of rapid change. The shift to blended and online teaching as a result of Covid-19 in 2020 is a great example. Even the most experienced teachers found themselves in uncharted waters. Strategies needed to be reconsidered and delivery forms adapted to the new learning environment. Reflection, collaboration and iteration were critical skills and key for adapting quickly in challenging times.

Reflective cultures support excellence in teaching AND learning

A culture of reflective practice creates a strong foundation for continuously improving teaching and learning.

In an environment where teachers collectively question and adapt, draw on expertise and support one another – student learning benefits too. In fact, developing excellence in teaching has the greatest impact on student achievement.

Encouraging reflective practice in schools, not only benefits individual teachers but the school as a whole.

Developing a culture of reflective practice improves schools by creating a strong foundation for continuously improving teaching and learning. It sends the message that learning is important for both students and teachers, and that everyone is committed to supporting it.

Reflecting practice creates an environment of collaboration as teachers question and adapt both their own practice and that of their colleagues. Teachers can team-up, drawing on expertise and offer each other support. This helps to develop good practice across the school, resulting in a more productive working environment.

But reflective practice in teaching is not just important for teachers and schools.

Provide your teachers with opportunities for effective reflection:

The best teachers are reflective, and they’re also the first to say that their practice can always be improved. Here’s why it’s worth taking the time to reflect on your teaching regularly – and encouraging your colleagues to do the same:

1. Reflection is at the heart of effective professional development

If you don’t spend time giving purposeful thought to your professional practice you cannot improve. Once you take ownership of your CPD by actively reflecting, evaluating and iterating on your practice, your confidence will sky-rocket.

2. Remain relevant and innovative

Self reflection helps you to create and experiment with new ideas and approaches to ensure your teaching is relevant, fresh and impactful for your students.

3. Stay learner focused

Reflective practice will help you better understand your learners, their abilities and needs. By reflecting, you can better put yourself in your students’ shoes and see yourself through their eyes.

4. Developing reflective learners

Reflective teachers are more likely to develop reflective learners. If teachers practise reflection they can more effectively encourage learners to reflect on, analyse, evaluate and improve their own learning. These are key skills in developing them to become independent learners, highlighting the important role of teachers as reflective practitioners.

5. Humility

When you reflect you must be honest. At least honest with yourself about your choices, success, mistakes, and growth. Self-reflection acts as a constant reminder to stay humble and continue working hard to achieve results.

If you’d like to find out more about teacher reflection, download our FREE practical guide to ‘Enabling effective teacher reflection’.

Woman smiling, writing in a black book whilst staring at a laptop.

How to reflect on teaching: getting started with reflective practice and tools to help

Do you want to get better at reflecting on your own teaching, or are you supporting colleagues to get started with reflective practice? Either way there’s some simple steps you can take.

Step 1: Gather insights

First, you need to gather information about what happens in the classroom, so it can be unpicked and analyzed. Here are some different ways you can do this

Keep a teacher diary/journal

After each lesson, write in a notebook or in the notes section of your phone about what happened. You could even send yourself a voice note. Note your reactions and feelings as well as those of the students. This relies on you remembering to do it, and your ability to recall the details, which means it’s not as thorough or reliable as other methods.

Invite a peer to observe

Invite colleagues to come into your class to collect information about your lesson and offer feedback. This may be with a simple observation task or through note-taking on a specific area you’ve said you’d like to reflect on. Of course, there are challenges with this approach. Timetabling is an obvious one, and another drawback is the potential for differing memories and perceptions about what went on in the lesson.

Record your lesson

A video recording of your lesson is valuable because it gives you an unaltered and unbiased view of how effective your lesson was from both a teacher and student perspective. A video also acts as an additional set of eyes to catch behaviors that you may not have spotted at the time. It also means you can come back to it at a convenient time, and watch a short clip, rather than having to remember to take notes or rely on your memory.

Have reflective discussions

Does videoing or analyzing your own practice feel like a big hurdle? A great starting point can be to simply get together in a small group (in-person or online) to watch a publicly available video of another teacher and then encourage discussions about the teaching and learning they’ve observed.

Teacher helping students, IRIS Connect camera recording in the background

Get IRIS Connect for your school and provide your teachers with a powerful tool for video reflection:

Once you’ve gathered information on your lesson, the next step in reflecting on your teaching is to analyze it. But what should you be looking for? Here are some suggested reflection activities.

7 reflection activities for teachers:

The ratio of interaction

How much are children responding, versus how much are you talking to them? Is there a dialogue of learning in their classroom or is the talking one-sided?

G rowth vs. fixed mindset

The way you respond to your students can inspire either a fixed or growth mindset. Praising students for being ‘smart’ or ‘bright’ encourages fixed mindsets, whilst recognising when they have persistently worked hard promotes growth mindsets. Carol Dweck found that people with growth mindsets are generally more successful in life…so, which are you encouraging students to have? Read more about Carol Dweck’s theory of the growth mindset .

Consistent corrections

Are you correcting the students consistently? Teachers should avoid inconsistency; such as stopping a side conversation one day but ignoring it the next, as this causes confusion with students and the feeling that the teacher is being unfair.

Opportunities to respond

Are you giving your students enough opportunities to respond to what they are learning? Responses can include asking students to answer questions, promoting the use of resources such as whiteboards or asking students to discuss what they have learnt with their neighbor.

Type and level of questions

Do the questions being asked match the method of learning that you want to foster in their classroom? The type of questions you ask students can include open or closed, their opinion on certain topics, or right or wrong. Is the level of questions being asked appropriate for the students’ level of learning? To find out more about open questions read our blog: Questioning in the classroom.

Instructional vs. non-instructional time

The more students are engaged in learning activities, the more they will learn. Try to keep track of how much time they give to learning activities compared to how much is spent on other transitional things such as handing out resources or collecting work at the end of the lesson.

Teacher talk vs. student talk

Depending on the topic, decide how much students should be talking about what they’re learning compared with how much they should be talking to them.

David Rogers, a multi-award winning geography teacher and Deputy Headteacher at Focus Learning Trust, Hindhead says: “Video provided me with a powerful opportunity to reflect upon and develop my own practice based upon capturing what actually happened. Having led the adoption of lesson capture software in a number of settings, I know that these platforms are not for anyone to judge lessons. If you don’t believe me, video yourself and share the recording with colleagues.” Discover what else David learned from recording his practice here >

Assistant Headteacher Ryan Holmes says: “In the middle of the whirlwind of a teacher’s day, finding the opportunity to take a step back and reflect is not easy. I have found filming my lessons a valuable opportunity that provides me with the space I need to more objectively look back at my lessons, away from the hustle and bustle of the lesson itself. It is an opportunity to identify strengths and areas of improvement.” – Read more about Ryan Holmes experience here >

The IRIS Connect video technology enables teachers to easily capture their lessons and review an objective record of their teaching and learning. Using the IRIS Connect mobile app, teachers record their lessons which are automatically uploaded to a web platform. Once there they can privately view the videos and annotate their teaching practice using time-linked notes and analytical tools. If they choose too, they can also share their videos with trusted colleagues, inviting them to give their professional feedback and advice.

These videos become an invaluable resource for the individual teacher and wider school, allowing many teachers to benefit from the solutions of successful teachers.

Get blog notifications

Keep up to date with our latest professional learning blogs.

By clicking Subscribe you consent to us contacting you regarding our products and services, as well as other content that may be of interest to you. You also consent to us storing your personal data to provide you with the content you are requesting. You can unsubscribe at any time. To find out more about how we manage your data, please review our Privacy Policy.

Interested to find out more?

If you’d like to find out more about IRIS Connect and how our solution can help you to get the most out of your classroom observations and provide high qualitative PD for your teachers, get in touch!

Video Technology
Education Research
Classroom Observations
Technical Support
Security & Safeguarding
Support Hub
Accessibility Statement
Privacy Notice
Cookie Policy - Website

Engaging in Reflective Practice: A Practical Guide

First Online: 23 October 2020

Cite this chapter

Andy Curtis 5

Part of the book series: Second Language Learning and Teaching ((SLLT))

841 Accesses

We begin this chapter by contemplating the question: What is Reflective Practice? and highlighting the important difference between just thinking about our teaching and systematically reflecting on our professional practices. In considering that opening question, we also recognize the multiplicity of meanings of Reflective Practice (RP), and the different ways of engaging in RP. In the same way that ‘one size does not fit all’ in teaching and learning, RP should reflect the individuality of the teacher and their different learners. Some notes on the history of RP are also given, followed by details of the practical aspects of doing RP, using different levels of self-questioning, combined with, for example, video-recording and co-teaching. In the last main part of the chapter, we consider some of the challenges of engaging in RP, and some ways of meeting those challenges.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Available as EPUB and PDF
Read on any device
Instant download
Own it forever
Compact, lightweight edition
Dispatched in 3 to 5 business days
Free shipping worldwide - see info
Durable hardcover edition

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Bailey, K. M., Curtis, A., & Nunan, D. (1998). Undeniable insights: The collaborative use of three professional development practices. TESOL Quarterly, 32 (3), 546–556.

Google Scholar

Bailey, K. M., Curtis, A., & Nunan, D. (2001). Pursuing professional development: The self as source . Boston, MA: Heinle & Heinle.

Brunsting, N. C., Sreckovic, M. A., & Lane, K. L. (2014). Special education teacher burnout: A synthesis of research from 1979 to 2013. Education and Treatment of Children, 37 (4), 681–711.

Chang, M.-L. (2009). An appraisal perspective of teacher burnout: Examining the emotional work of teachers. Educational Psychology Review, 21 (3), 193–218.

Cheng, L. & Sun, Y. (2015). Teachers’ grading decision making: Multiple influencing factors and methods. Language Assessment Quarterly, 12 , 213–233.

Curtis, A. (1998). Teaching in the mirror: Self-reflection and self-development. Professional Perspectives, 3 (4), 1–2.

Curtis, A., & Cheng, L. (1998). Video as a source of data in classroom observation. ThaiTESOL Bulletin, 11 (2), 31–38.

Curtis, A. (2003). Paths to professional development: Part 3: Creating spaces and mapping relationships. The English Connection: Korea TESOL, 7 (2), 11.

Curtis, A., & Szestay, M. (2005). The impact of teacher knowledge seminars: Unpacking reflective practice. TESL-EJ, 9 (2), 1–16.

Curtis, A. (2012). Doing more with less: Using film in English language teaching and learning in China. Research on English Education, 英语教育研究, 1 (1), 1–10.

Curtis, A. (2017). Methods and methodologies for language teaching: The centrality of context . Basingstoke, UK: Palgrave MacMillan.

Famakinwa, J. O. (2012). Is the unexamined life worth living or not? Think, 11 (31), 97–103.

Article Google Scholar

Farrell, T. S. C. (2013). Reflective teaching . Alexandria, VA: TESOL Press.

Farrell, T. S. C. (2014). Reflective practice in ESL teacher development groups: From practices to principles . Basingstoke, UK: Palgrave MacMillan.

Farrell, T. S. C. (2015). Promoting teacher reflection in second language education: A framework for TESOL Professionals . New York, NY: Routledge.

Farrell, T. S. C. (2018). Research on reflective practice in TESOL . New York, NY: Routledge.

Freeman, D., & Johnson, K. (1998). Reconceptualizing the knowledge-base of language teacher education. TESOL Quarterly, 32 (3), 397–417.

Gaudin, C., & Chaliès, S. (2015). Video viewing in teacher education and professional development: A literature review. Educational Research Review, 16, 41–67.

Ghaye, T. (2000). Into the reflective mode: Bridging the stagnant moat. Reflective Practice, 1 (1), 5–9.

Greene, M. (1978). Landscapes of learning . New York, NY: Teachers College Press.

Kim, H.-K. (2003). Critical thinking, learning and Confucius: A positive assessment. Journal of Philosophy of Education, 37 (1), 71–87.

Kong, F. (1979). The Analects . London, England: Penguin Classics.

Mann, S., & Walsh, S. (2017). Reflective practice in English language teaching: Research-based principles and practices . New York, NY: Routledge.

Marsh, B., & Mitchell, N. (2014). The role of video in teacher professional development. Teacher Development: An International Journal of Teachers’ Professional Development, 18 (3), 403–417.

McMillan, J. H. (2003). Understanding and improving teachers’ classroom assessment decision making: Implications for theory and practice. Educational Measurement: Issues and Practices, 22 (4), 34–43.

McMillan, D. J., McConnell, B., & O’Sullivan, H. (2016). Continuing professional development—Why bother? Perceptions and motivations of teachers in Ireland. Professional Development in Education, 42 (1), 150–167.

Newman, S. (1999). Constructing and critiquing reflective practice. Educational Action Research, 7 (1), 145–163.

Richards, J. C., & Lockhart, C. (1994). Reflective teaching in second language classrooms . New York, NY: Cambridge University Press.

Ripamonti, S., Galuppo, L., Gorli, M., Scaratti, G., & Cunliffe, A. L. (2015). Pushing action research toward reflexive practice. Journal of Management Inquiry, 25 (1), 55–68.

Rodgers, C. (1998). Reflection in second language teacher education. TESOL Quarterly, 32 (3), 610–613.

Sawyer, R. D. (2001). Teacher decision-making as a fulcrum for teacher development: Exploring structures of growth. Teacher Development: An International Journal of Teachers’ Professional Development, 5 (1), 39–58.

Schön, D. (1983). The reflective practitioner: How professionals think in action . New York, NY: Basic Books.

Skaalvik, E. M., & Skaalvik, S. (2010). Teacher self-efficacy and teacher burnout: A study of relations. Teaching and Teacher Education, 26 (4), 1059–1069.

Stanley, C. (1998). A framework for teacher reflectivity. TESOL Quarterly, 32 (3), 584–591.

Trif, L. & Popescu, T. (2013). The reflective diary: An effective professional training instrument for future teachers. Procedia: Social and Behavioral Sciences , 93 , 1070–1074.

Zimmerman, L. (2009). Reflective teaching practice: Engaging in praxis. Journal of Theory Construction & Testing, 13 (2), 46–50.

Download references

Author information

Authors and affiliations.

Anaheim University, California, USA

Andy Curtis

You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andy Curtis .

Editor information

Editors and affiliations.

Dubai Men's College, Higher Colleges of Technology, Dubai, United Arab Emirates

Christine Coombe

English Language Teaching and Learning, Brigham Young University–Hawaii, Laie, HI, USA

Neil J Anderson

School of Education, The University of Notre Dame Australia, Sydney, Chippendale, NSW, Australia

Lauren Stephenson

Rights and permissions

Reprints and permissions

Copyright information

About this chapter

Curtis, A. (2020). Engaging in Reflective Practice: A Practical Guide. In: Coombe, C., Anderson, N.J., Stephenson, L. (eds) Professionalizing Your English Language Teaching. Second Language Learning and Teaching. Springer, Cham. https://doi.org/10.1007/978-3-030-34762-8_20

Download citation

DOI : https://doi.org/10.1007/978-3-030-34762-8_20

Published : 23 October 2020

Publisher Name : Springer, Cham

Print ISBN : 978-3-030-34761-1

Online ISBN : 978-3-030-34762-8

eBook Packages : Education Education (R0)

Share this chapter

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

Publish with us

Policies and ethics

Find a journal
Track your research

Getting started with Reflective Practice

Cambridge International Education Teaching and Learning Team

What is reflective practice?

The process of reflection is a cycle which needs to be repeated. • Teach • Self-assess the effect your teaching has had on learning • Consider new ways of teaching which can improve the quality of learning • Try these ideas in practice • Repeat the process Reflective practice is ‘learning through and from experience towards gaining new insights of self and practice’ (Finlay, 2008). Reflection is a systematic reviewing process for all teachers which allows you to make links from one experience to the next, making sure your students make maximum progress. Reflection is a basic part of teaching and learning. It aims to make you more aware of your own professional knowledge and action by ‘challenging assumptions of everyday practice and critically evaluating practitioners’ own responses to practice situations’ (Finlay, 2008). The reflective process encourages you to work with others as you can share best practice and draw on others for support. Ultimately, reflection makes sure all students learn more effectively as learning can be tailored to them. In the rest of this unit, we will look at the basics of reflective practice in more detail. We will look at the research behind reflective practice, discuss the benefits and explore some practical examples. Throughout the unit, we will encourage you to think about how you can include reflective practice in your own classroom practice. Listen to these educators discussing what reflective practice means for them. How do their ideas about reflective practice compare with yours?

Diagram showing the reflective cycle from Teach to Self-assess to Consider to Practise and back to Teach.

What are the benefits of reflective practice?

Reflective practice helps create confident teachers Reflective practice develops your ability to understand how your students learn and the best ways to teach them. By reflecting on your teaching, you identify any barriers to learning that your students have. You then create lessons which reteach any content which your students have not been able to access to allow them to overcome any obstacles and develop. Being reflective will also make sure you have a wider range of skills as you find new ways to teach. This will develop your confidence in the classroom as you find the best ways to deliver your knowledge of a subject. By reflecting, you will develop abilities to solve problems. Through questioning and changing the way you deliver your lessons, you will find new solutions and become more flexible with your teaching. It allows you to take time to assess and appreciate your own teaching. Reflective practice also helps create confident students. As a result of reflecting, students are challenged as you use new methods in the classroom. From reflection, you should encourage your students to take new challenges in learning, developing a secure and confident knowledge base. Reflective practice makes sure you are responsible for yourself and your students Reflecting on your teaching will help you to understand how your students best learn and will allow you to be accountable for their progress. By assessing the strengths and weaknesses in your own teaching, you will develop an awareness of the factors that control and prevent learning. The reflection process will also help you to understand yourself and the way you teach. By asking yourself questions and self-assessing, you will understand what your strengths are and any areas where development might be needed. Reflecting allows you to understand how you have helped others to achieve and what this looks like in a practical learning environment. By asking your students for their thoughts and feelings on the learning, they play an active part in the learning cycle. This allows them to take ownership of their learning and also work with you and give feedback, which creates self-aware and responsible students. Once the student starts to play an active part in the learning cycle, they become more aware of different learning styles and tasks. They become more aware of how they learn and they develop key skills and strategies to become lifelong learners. Reflective practice encourages innovation Reflective practice allows you to adapt lessons to suit your classes. You can create and experiment with new ideas and approaches to your teaching to gain maximum success. By varying learning and experimenting with new approaches, students have a richer learning experience. They will think more creatively, imaginatively and resourcefully, and be ready to adapt to new ways and methods of thinking. Reflective practice encourages engagement Being reflective helps you challenge your own practice as you will justify decisions and rationalise choices you have made. It encourages you to develop an understanding of different perspectives and viewpoints. These viewpoints might be those of students, focusing on their strengths, preferences and developments, or those of other colleagues, sharing best practice and different strategies. When you become more aware of your students’ preferences and strengths, learning becomes more tailored to their needs and so they are more curious and are equipped to explore more deeply. Reflective practice benefits all By reflecting, you create an environment which centres on the learner. This environment will support students and teachers all around you to become innovative, confident, engaged and responsible. Once you start the reflective process, your quality of teaching and learning will improve. You will take account of students’ various learning styles and individual needs, and plan new lessons based on these. Reflection helps focus on the learning process, so learning outcomes and results will improve as you reflect on how your learners are learning. By getting involved in the reflective process, you will create an environment of partnership-working as you question and adapt both your own practice and that of your students and other colleagues. The learning process then becomes an active one as you are more aware of what you want your students to achieve, delivering results which can be shared throughout the institution. By working with other colleagues and students, relationships become positive and demonstrate mutual respect. Students feel part of the learning cycle and are more self-aware. Colleagues can ‘team up’, drawing on expertise and support. This will develop the whole institution’s best practice. All of these things together result in a productive working environment. Listen to these educators giving their views on the benefits of reflective practice. Which of the benefits are most relevant to you and your colleagues?

Image captions

Woman sharing her thoughts to some friendly colleagues.

What is the research behind reflective practice?

Educational researchers have long promoted the importance of reflecting on practice to support student learning and staff development. There are many different models of reflective practice. However, they all share the same basic aim: to get the best results from the learning, for both the teacher and students. Each model of reflection aims to unpick learning to make links between the ‘doing’ and the ‘thinking’. Kolb's learning cycle David Kolb, educational researcher, developed a four-stage reflective model. Kolb’s Learning Cycle (1984) highlights reflective practice as a tool to gain conclusions and ideas from an experience. The aim is to take the learning into new experiences, completing the cycle. Kolb's cycle follows four stages. First, practitioners have a concrete experience. This means experiencing something new for the first time in the classroom. The experience should be an active one, used to test out new ideas and teaching methods. This is followed by… Observation of the concrete experience, then reflecting on the experience. Here practitioners should consider the strengths of the experience and areas of development. Practitioners need to form an understanding of what helped students’ learning and what hindered it. This should lead to… The formation of abstract concepts. The practitioner needs to make sense of what has happened. They should do this through making links between what they have done, what they already know and what they need to learn. The practitioner should draw on ideas from research and textbooks to help support development and understanding. They could also draw on support from other colleagues and their previous knowledge. Practitioners should modify their ideas or devise new approaches, based on what they have learnt from their observations and wider research. The final stage of this cycle is when… The practitioner considers how they are going to put what they have learnt into practice. The practitioner’s abstract concepts are made concrete as they use these to test ideas in future situations, resulting in new experiences. The ideas from the observations and conceptualisations are made into active experimentation as they are implemented into future teaching. The cycle is then repeated on this new method. Kolb’s model aims to draw on the importance of using both our own everyday experiences and educational research to help us improve. It is not simply enough for you to reflect. This reflection must drive a change which is rooted in educational research. Gibbs' reflective cycle The theoretical approach of reflection as a cyclical model was further developed by Gibbs (1998). This model is based on a six-stage approach, leading from a description of the experience through to conclusions and considerations for future events. While most of the core principles are similar to Kolb’s, Gibbs' model is broken down further to encourage the teacher to reflect on their own thoughts and feelings. Gibbs' model is an effective tool to help you reflect after the experience, and is a useful model if you are new to reflection as it is broken down into clearly defined sections. Description In this section, the practitioner should clearly outline the experience. This needs to be a factual account of what happened in the classroom. It should not be analytical at this stage. Feelings This section encourages the practitioner to explore any thoughts or feelings they had at the time of the event. Here the practitioner should explain feelings and give examples which directly reference the teaching experience. It is important the practitioner is honest with how they feel, even if these feelings might be negative. Only once the feelings have been identified can the practitioner implement strategies to overcome these barriers. Evaluation The evaluation section gives the opportunity for the practitioner to discuss what went well and analyse practice. It is also important to consider areas needed for development and things that did not work out as initially planned. This evaluation should consider both the practitioner’s learning and the students’ learning. Analysis This section is where the practitioner makes sense of the experience. They consider what might have helped the learning or hindered it. It is in this stage that the practitioner refers to any relevant literature or research to help make sense of the experience. For example, if you felt the instructions you gave were not clear, you could consult educational research on how to communicate effectively. Conclusion At this stage, the practitioner draws all the ideas together. They should now understand what they need to improve on and have some ideas on how to do this based on their wider research. Action plan During this final stage, the practitioner sums up all previous elements of this cycle. They create a step-by-step plan for the new learning experience. The practitioner identifies what they will keep, what they will develop and what they will do differently. The action plan might also outline the next steps needed to overcome any barriers, for example enrolling on a course or observing another colleague. In Gibbs' model the first three sections are concerned with what happened. The final three sections relate to making sense of the experience and how you, as the teacher, can improve on the situation. 'Reflection-in-action' and 'reflection-on-action' Another approach to reflection is the work by Schön. Schön (1991) distinguishes between reflection-in-action and reflection-on-action. Reflection-in-action is reflection during the ‘doing’ stage (that is, reflecting on the incident while it can still benefit the learning). This is carried out during the lesson rather than reflecting on how you would do things differently in the future. This is an extremely efficient method of reflection as it allows you to react and change an event at the time it happens. For example, in the classroom you may be teaching a topic which you can see the students are not understanding. Your reflection-in-action allows you to understand why this has happened and how to respond to overcome this situation. Reflection-in-action allows you to deal with surprising incidents that may happen in a learning environment. It allows you to be responsible and resourceful, drawing on your own knowledge and allowing you to apply it to new experiences. It also allows for personalised learning as, rather than using preconceived ideas about what you should do in a particular situation, you decide what works best at that time for that unique experience and student. Reflection-on-action , on the other hand, involves reflecting on how practice can be developed after the lesson has been taught. Schön recognises the importance of reflecting back ‘in order to discover how our knowing-in-action may have contributed to an unexpected outcome’ (Schön, 1983). Reflection-on-action means you reflect after the event on how your knowledge of previous teaching may have directed you to the experience you had. Reflection-on-action should encourage ideas on what you need to change for the future. You carry out reflection-on-action outside the classroom, where you consider the situation again. This requires deeper thought, for example, as to why the students did not understand the topic. It encourages you to consider causes and options, which should be informed by a wider network of understanding from research. By following any of the above models of reflection, you will have a questioning approach to teaching. You will consider why things are as they are, and how they could be. You will consider the strengths and areas of development in your own practice, questioning why learning experiences might be this way and considering how to develop them. As a result, what you do in the classroom will be carefully planned, informed by research and previous experience, and focused, with logical reasons. All of these models stress the importance of repeating the cycle to make sure knowledge is secure and progression is continued.

Diagram of Kolb's learning cycle. Concrete Experience followed by Reflective observation followed by Abstract conceptualisation followed by Active Experimentation then back to Concrete Experience.

Common misconceptions about reflective practice

‘It doesn’t directly impact my teaching if I think about things after I have done them’ Reflection is a cyclical process: do, analyse, adapt and repeat. The reflections you make will directly affect the next lesson or block of teaching as you plan to rework and reteach ideas. Ask yourself: What did not work? How can I adapt this idea for next time? This might mean redesigning a task, changing from group to paired work or reordering the lesson. ‘Reflection takes too long; I do not have the time’ Reflection can be done on the spot (Schön: reflection-in-action). You should be reflecting on things as they happen in the classroom. Ask yourself: What is working well? How? Why? What are the students struggling with? Why? Do the students fully understand my instructions? If not, why not? Do the students fully understand the task? If not, why not? Do your students ultimately understand what success looks like in the task or activity? Can they express this for themselves? ‘Reflection is only focused on me, it does not directly affect my students’ Reflecting and responding to your reflections will directly affect your students as you change and adapt your teaching. You will reteach and reassess the lessons you have taught, and this will allow students the chance to gain new skills and strengthen learning. Creating evaluation models will help you to know whether the actions you have taken have had the intended effect. ‘Reflection is a negative process’ Reflection is a cyclical process, meaning you grow and adapt. You should plan to draw on your own strengths and the best practice of colleagues, which you then apply to your own teaching. Try any of the reflection models listed in this unit to help you progress. By getting involved in a supportive network everyone will develop. 'Reflection is a solo process, so how will I know I’ve improved?’ Reflection is best carried out when part of a supportive network. You can draw on the support of colleagues by asking them to observe and give feedback. You can also draw on student feedback. Reflection should trigger discussion and co-operation.

Older students studying together in a library.

Reflective practice in practice

As a reflective practitioner you will continuously review the learning process to make sure all students make maximum progress. While working through this document you may have identified a model which appeals to you. As well as using a model of reflection, you can carry out other reflective activities to develop your practice. These can include the following. Self-questioning Asking yourself questions can help you understand the effect and efficiency of your teaching. Experimenting with new ideas Trying out new methods or approaches in the classroom can create new learning opportunities. These changes can be as simple as varying a small activity or as adventurous as changing your whole approach or plan. Discussing with other colleagues Drawing on support from colleagues will allow you to cement understanding and get involved with others’ ideas and best practice. Discussing with students Drawing on student feedback will make sure your reflections are focused on your students. By reflecting with students, you allow them to play an active part in their learning and gain insight into what needs to improve to support student development. Observations and feedback Being observed by colleagues will allow you to gain others’ perspectives into your practice and provide feedback and ideas on how to improve. Observing your colleagues can also provide new ideas and approaches which you can try in your own practice. All these approaches are explained in the ‘Next steps’ section and provide a guide of how to carry out reflective practice, using the following. • Learning journal • Lesson evaluations • Observations • Student dialogue • Shared planning Listen to these educators talking about how they reflect. How could you use their techniques in your practice?

There are five main principles that will make sure you get the most out of your reflections − reacting, recording, reviewing, revising, reworking and reassessing. These are sometimes referred to as the five Rs.

5 main principles of reflection. See above.

If you are new to reflective practice, it will help to ask yourself the following questions. Reacting How will I decide what area of my practice I need to focus on? Will this be decided by looking at data, each learner’s performance or an aspect of the curriculum? Recording (logging your reflections) How will I assess my performance? Will this take the form of an observation, discussion or shared planning? How will I record this? Will this be recorded by yourself, a peer or a student? How will I log this? What documents will you use to record your reflections? For example, a journal, notebook or form provided by your school or institution. When will I log this? Will your reflections be logged straight after the lesson, during or before the lesson? How often will you record these reflections? Reviewing (understanding your current teaching methods) What worked well and how do I know this? Consider what the students really understood and enjoyed about the lesson, and why. How do you know improvements have been made? What did not work as planned? Consider what the students did not get involved with or find challenging, and why. What could I try next time? How could you adapt the activity? Some practical ideas include introducing a different task, clearer instructions, time-based activities and activities which appeal to different learning styles. Revising (adapting your teaching by trying new strategies) What will I change or adapt? This could be a whole task or something specific about a task. Some practical ideas include changing the task from independent work to paired work, adding a scaffold to a challenging task, providing instructions step by step, and making activities time based. Reworking (action plan of how you can put these ideas in place in a practical way) How will I put this in place? Consider what will you need to do before and during the lesson to make sure your changes happen. What will the students be doing differently to make sure they make progress? What materials do I need? What things will you need to put your revised ideas into practice? Some practical examples include coloured pens, larger paper, handouts, cut-up activities, specialised equipment. Reassessing (understanding how these new strategies affected learning) How successful were the new strategies? Once you have redelivered the lesson, consider how engaged the students were. How well did they understand this time? What changed? Consider the following areas of potential change: delivery, planning and assessment.

Here are some activities to help you to further explore reflective practice. Learning journal What is it? A learning journal is a collection of notes, observations, thoughts and other relevant materials built up over a period of time and recorded together. What happens? After each lesson you record your thoughts and feelings regarding the lesson. Use the five Rs in the Checklist section to help focus your journal. Lesson evaluations What are they? Evaluations require you to think back on the lesson, assessing its strengths, weaknesses and opportunities for development. To help focus your evaluation, consider the following questions: • What went well in this lesson? Why? • What problems did I experience? Why? • How engaged and active were the students? • How much learning took place? How do I know? • What could I have done differently? • What did I learn from this experience that will help me in future lessons? What happens? Once you have taught your lesson, record your reflections on the lesson as soon as possible. This will help you keep track of your progress as a developing reflective practitioner and also help you track your students’ progress. Observations What are they? Observations are when someone assesses your practice through watching it in action. These observations should have a very specific focus, for example the quality of questioning or the quality of student-led activities. This focus can then be specific, measured, reflected upon and revised to make sure your students make progress. What happens? Once you have set the specific focus or target area, a colleague will watch you deliver the lesson and give feedback on the strengths of your practice or some possible ideas for development. These observations could also be carried out over a block of lessons to show progression. Student dialogue What is it? This is where you make sure students play an active part in their learning. You will ask them to carry out a short reflection on how well they felt the lesson went and to assess the lesson’s strengths and possible ideas for development. What happens? Ask a student to keep a learning journal of their lessons. This journal could include what they enjoyed, how they felt in the lesson, what they understood and engaged with, what they still need more help with, what they liked about the lesson and things they thought could have been better. Shared planning What is it? Shared planning is where you draw on support from colleagues to plan lessons together. You draw on each other’s best practice to help create innovative and improved lessons. What happens? Shared planning can take many forms: • Planning a lesson with another colleague together from start to finish. • Using a lesson a colleague has produced and adapting it to suit your style and class. • Planning a lesson and asking another colleague to review it. The shared-planning process should encourage talking and co-operation. You should draw on support from colleagues to help develop practice and share ideas. Want to know more? Here is a printable list of interesting books, articles and websites on the topics that we have looked at.

Signposts directing you to Observe, Research and Plan.

13 Self Reflection Worksheets & Templates to Use in Therapy

While valuable for clients and students, it is equally vital for therapists, coaches, and mental health professionals.

Literature across multiple disciplines confirms that reflection serves therapists by improving “learning and performance in essential competencies” (Aronson, 2011, p. 200). In therapy, it helps the client “manage personal feelings, such as anxiety and inadequacy, and their impact on others” (Fisher, Chew, & Leow, 2015, p. 736).

This article introduces the basics behind reflection along with questions and worksheets that encourage and support the reflective process and maximize the benefits for therapists, clients, and students.

Before you continue, you might like to download our three Meaning and Valued Living Exercises for free . These creative, science-based exercises will help you learn more about your values, motivations, and goals and will give you the tools to inspire a sense of meaning in the lives of your clients, students, or employees.

This Article Contains:

Fostering reflection skills: the basics, 50+ questions to ask your clients or students, 5 helpful reflection worksheets & tools, journaling & diaries: 2 useful templates, top 3 activities for practicing reflection, 3 fun games to inspire clients, positivepsychology.com’s reflection resources, a take-home message.

While reflection has no single, universal definition, Aronson (2011, p. 200) frames it as the “process of analyzing, questioning, and reframing an experience in order to make an assessment of it for the purposes of learning (reflective learning) and/or improve practice (reflective practice).” It has multiple uses in various contexts.

Reflection is central to most therapies. Indeed, Socratic questioning (using open yet focused questions) is widely used in Cognitive-Behavioral Therapy (CBT) to encourage reflection and unpack deeply held beliefs (Bennett-Levy, Thwaites, Chaddock, & Davis, 2009).

Within therapy , Bennett-Levy et al. (2009) recognized that reflection can be beneficial for both the therapist and the client, and can be considered from several perspectives.

Reflective practices Reflection as part of the clinical experience, using journals, video, and group activities.
Reflective skills The ability to reflect on oneself through therapeutic interaction and self-awareness of feelings and thoughts.
Reflective systems Reflection results from the interaction of several processes, including the individual’s memory, skills, and reflective system.
Reflective processes Reflection involves the ability to observe (possibly via visualization) and then reflect or conceptualize to engage in further processing, including elaboration, problem solving, and self-questioning.

Bennett-Levy et al. (2009, p. 121) offer the following helpful definition of reflection:

“Reflection is the process of intentionally focusing one’s attention on a particular content; observing and clarifying this focus; and using other knowledge and cognitive processes (such as self-questioning, logical analysis and problem-solving) to make meaningful links.”

The benefits of reflection carry across to the learning process found within educational environments. It forms the second of the following four-stage model used by coaches engaging with students to understand the learning process (Adams, 2016):

Attending to and focusing on the relevant features of their experience
Actively reflecting on their experience
Extracting learning from that experience
Planning how to create new ways of behaving in response to the learning

Reflection and learning are also highly applicable outside of school.

While reflection is vital to self-awareness and healing for clients, it is also a powerful and insightful tool for therapists.

Mental health professionals must be self-aware and cognizant of the skills they are using, because “in no other profession does the personality and behavior of the professional make such difference as it does in counseling” (Meier & Davis, 1997).

The following questions can be helpful for new and existing counselors and their clients to increase self-awareness and knowledge of counseling techniques (modified from Bennett-Levy et al., 2009):

Observe the experience (such as the session or intervention). How did I feel? What did I notice?
Clarify the experience. What did I learn? Was it helpful? What did not change?

The following two points are more applicable for therapists:

Implications of the experience for clinical practice What are the implications for and impacts on one-to-one therapy, supervision, consultation, etc.?
Implications of the experience for how I see myself as a therapist What are the implications of this experience for my understanding of cognitive therapy and theory?

Considering each question in turn can provide insights that encourage greater knowledge of the therapeutic process and promote lessons to take forward to future sessions.

Asking appropriate questions is a crucial aspect of reflection and central to deeper, long-lasting learning (Aronson, 2011; Adams, 2016).

Reflection questions for students

The following three sets of questions promote reflection in students by considering academic performance (modified from ones used by the Colorado Department of Education ):

Reflective Questions for personal academic performance

These Reflective Questions prompt the student to think about what they are learning, why they are learning, and how they can improve the overall process.

The student answers the first question regarding what they have been learning and then selects a sample of other questions to prompt reflection.

They then complete the last column with their thoughts for later review by themselves or a therapist, coach, or counselor.

A sample of the questions includes:

What have you been learning about (today, this week, or this semester)? Why do you think these objectives and this subject are important? Did you give your best effort on your most recent assignment?

Reflective Metacognition Questions for students

Reflective Metacognition Questions help students reflect on how and what they think .

The questions are grouped under the following subsections and can be answered individually, in pairs, or as a group exercise, with a summary of the answers placed in the final column.

Reflection and collaboration
Self-reflection

Example questions include:

What are your thoughts about what was said? Are there any other similar answers or alternative answers? Why do you think this answer is true?

Reflection Questions in Therapy

Reflection is an essential part of therapy.

Using the Reflective Questions in Therapy worksheet, the therapist can encourage and facilitate the process of reflection in the client, such as (Bennett-Levy et al., 2009):

What do I wish people better understood about me? What behaviors and beliefs do I want to let go of? Have I been receiving enough support this year?

Download 3 Meaning & Valued Living Exercises (PDF)

These detailed, science-based exercises will equip you or your clients with tools to find meaning in life help and pursue directions that are in alignment with values.

Download 3 Free Meaning Tools Pack (PDF)

By filling out your name and email address below.

During CBT and other therapies, the client is often given a workbook or journal to capture reflections on the practice or skills they develop as they progress through treatment.

Reflection reinforces learning within the sessions and, more importantly, leads to deeper insights between sessions (Bennett-Levy et al., 2009).

Learning From My Past

The Reflections on Learning From My Past worksheet helps the client capture and reflect on an event from their past and consider how different behavior may have led to an alternate outcome.

The client is asked a series of questions about the incident, such as:

What happened or what was the event? How did it make you feel? How did you handle it?

Self-Reflection Behavior Review

At the end of the year or looking back on the client’s life, it can help to look for patterns in behavior.

The Self-Reflection Behavior Review worksheet is a valuable way to summarize events and see the recurring traps into which the client falls.

The summary provides a valuable talking point during therapy sessions and can be referred to later in order to assess how behavior has changed and improved.

It asks the client to consider:

Do you see a pattern in your behavior? How could you act differently in the future? What situations should you try to avoid?

Who Am I Self-Reflection

In life, we are often so busy with everyday tasks that we forget to take stock of who we are, what we are good at, and what is important to us.

Clients or students can use the Who Am I Self-Reflection worksheet to think about what they are good at, what significant challenges they have been confronted with, and what inspires them.

Some questions to consider include:

Think of something significant that went wrong. What did I learn from it? What am I passionate about? What do I love most about myself?

Student Work Reflection

Students can help their existing and future learning by thinking about how they are approaching their work and using metacognitive skills to drive future improvements (Adams, 2016).

The Student Work Reflection is a set of simple repeating questions to consider how they approach each task in school.

It asks the student to consider:

How could I improve? What am I still working on? What am I most proud of?

Reflection on Group Activities

Reflection is equally important in group tasks as in individual tasks. The Reflection on Group Activities is for an educational or therapy setting to assess the success and learnings from a group activity.

Working individually or in groups, students can answer questions such as:

What went well? What did not go well? What could we try next time?

As an intervention, it is a creative way to engage clients in a therapeutic activity, increasing self-awareness and personal growth.

It can be helpful to capture some of the key events of the day. The act of writing what happened and reviewing it later can be insightful and help you recognize positive and negative patterns in your behavior.

Daily Reflection of Feelings

Use the Daily Reflection of Feelings journal with the client to record how their day went and capture the feelings they experienced.

Questions include:

What was the best part of the day? What would you change about the day if you could? What are you looking forward to tomorrow?

Daily Reflection of Behavior

Clients and therapists can benefit from reviewing significant events that occurred between sessions.

Use the Daily Reflection of Behavior journal with clients to capture daily behaviors that were unexpected or parts of habits that the client wishes to change.

What happened? How did I behave? Why did it happen?

How to start a creative journal – Johanna Clough

Several techniques can encourage the process of reflection in clients and students.

DARN The DARN acronym forms an important aspect of motivational interviewing . With the use of evocative change questions, the client is invited to engage in reflection to consider the change, including:

Desire questions – What I would like, wish, or want to do? Ability questions – Capturing the idea that change is possible. Reasons questions – Recognizing the reasons for change. Need questions – Identifying the urgency of the change.

OARS OARS is another acronym important to the process of motivational interviewing to elicit change talk through the use of the following:

Open questions encourage the client to talk. Affirmations include statements of understanding and offers of support. Reflections capture and rephrase what the client has said Summarizing provides a check-in with the client by summarizing what has been said.

OARS encourages reflection in both the therapist and the client.

Socratic questioning Observing and taking part in Socratic questioning can be a valuable opportunity to learn about the process of encouraging reflection in others and in oneself.

Consider the five questions:

What happened? When did it happen? Where did it happen? Why did it happen? How did it happen?

Try out the following three activities with clients or students.

Your life as a play

You can carry out this reflective exercise in small groups of three or four people.

Ask each person to describe their ideal life in three acts, as though it were a play.

What past dreams were achieved? What is the present (good and bad)? What is your ideal future?

Share with the group, discussing each of the acts, adding humorous insights along the way. End with your positive view of how the future might look.

Shield of honor

This activity is ideal for reflection in multiple small groups.

Ask each group to create a shield out of a large piece of paper.

Divide the paper into four equal rectangles, representing:

Skills and abilities they offer
Skills and abilities they need to improve
Frustrations
What they are proud of

Tell the group they are only allowed to use drawings and pictures – no words.

After 20 minutes, ask each group to share what they have created.

Reflection on communication

Individuals are grouped into pairs and asked to sit back-to-back.

One person is given either a pen and paper or building blocks and asked to create a novel design.

Ask them to describe what it looks like, while the other person attempts to recreate the design on their side.

Once finished, the two can compare what they have created and discuss the communication process.

17 Tools To Encourage Meaningful, Value-Aligned Living

This 17 Meaning & Valued Living Exercises [PDF] pack contains our best exercises for helping others discover their purpose and live more fulfilling, value-aligned lives.

Created by Experts. 100% Science-based.

Throughout this post, we’ve discussed the importance of clarifying wants, behavior patterns, and forces of motivation to better understand what brings meaning throughout one’s life. To this end, we invite you to check out our free Meaning & Valued Living Exercises Pack .

This pack features three of our top tools from the Positive Psychology Toolkit©, all of which center on the theme of values-based living:

The Top 5 Values This exercise draws on key principles of Acceptance and Commitment Therapy to help clients begin brainstorming their values. Following this, clients will then prioritize these values in a list to identify those most central to who they are.
Self-Eulogy This exercise invites clients to consider how they’d like to be remembered at their funeral as a means to identify and clarify values. Based on this, they can then consider how well they are living in alignment with these values.
The Scoreboard Metaphor This exercise helps clients recognize how to enact their values through goal-setting. In particular, it draws on the metaphor of a basketball game to illustrate how living into one’s values is an ongoing process and that the paths by which we pursue our goals are opportunities to enact our values in daily life.

You can access all three exercises for free by downloading our Meaning & Valued Living Exercises Pack .

Additionally, if you’re looking for further reading on the topic of self-reflection, be sure to check out our blog post featuring ten book recommendations .

If you’re looking for more science-based ways to help others discover meaning, this collection contains 17 validated meaning tools for practitioners. Use them to help others choose directions for their lives in alignment with what is truly important to them.

Reflection engages clients and students in the process of analyzing, questioning, and reframing an experience. It encourages individuals or groups to learn and improve, and promotes deeper, longer lasting learning (Aronson, 2011).

Within therapy and coaching, reflection can help individuals manage their feelings (such as anxiety or self-doubt) and recognize how their behavior affects others (Fisher et al., 2015).

In an educational setting, research shows that questions and exercises prompt learners to improve core competencies (Aronson, 2011).

In any environment, reflection involves metacognition. Individuals must step outside of their existing cognition to think about their thinking . It is a skill that is best learned through practice.

Therapists, coaches, counselors, and teachers can help by prompting the client or class to consider what they have learned, what has gone well (and hasn’t), and what they could have done differently.

The takeaways from reflection can change a person’s view of what has already happened and influence how they behave in the future.

The exercises and questions within this article will engage others, promoting the reflective process and offering deeper understanding and tools for future learning.

We hope you enjoyed reading this article. Don’t forget to download our three Meaning and Valued Living Exercises for free .

Adams, M. (2016). Coaching psychology in schools: Enhancing performance, development and wellbeing . Routledge.
Aronson, L. (2011). Twelve tips for teaching reflection at all levels of medical education. Medical Teacher , 33 (3), 200–205.
Bennett-Levy, J., Thwaites, R., Chaddock, A., & Davis, M. (2009). Reflective practice in cognitive behavioural therapy: The engine of lifelong learning. In J. Stedmon & R. Dallos (Eds.), Reflective practice in psychotherapy and counselling (pp. 115–35). Open University Press.
Fisher, P., Chew, K., & Leow, Y. J. (2015). Clinical psychologists’ use of reflection and reflective practice within clinical work. Reflective Practice , 16 (6), 731–743.
Hayman, B., Wilkes, L., & Jackson, D. (2012). Journaling: Identification of challenges and reflection on strategies. Nurse Researcher , 19 (3), 27–31.
Meier, S., & Davis, S. (1997). The Elements of Counselling . Brooks/Cole.

Share this article:

Article feedback

What our readers think.

Thank you for this amazing article. Very useful and informative. Heartfelt gratitude for sharing such wonderful information. Your touching and empowering many lives silently. Thank you

Let us know your thoughts Cancel reply

Your email address will not be published.

Save my name, email, and website in this browser for the next time I comment.

Reparenting: Seeking Healing for Your Inner Child

In our work as therapists, we often encounter the undeniable truth: we never truly outgrow our inner child. A youthful part within us persists, sometimes [...]

30 Best Self-Exploration Questions, Journal Prompts, & Tools

Life is constantly in flux – our environment and ‘self’ change continually. Self-exploration helps us make sense of who we are, where we are, and [...]

Inner Child Healing: 35 Practical Tools for Growing Beyond Your Past

Many clients enter therapy because they have relationship patterns that they are tired of repeating (Jackman, 2020). They may arrive at the first session asking, [...]

My presentations

Auth with social network:

Download presentation

We think you have liked this presentation. If you wish to download it, please recommend it to your friends in any social system. Share buttons are a little bit lower. Thank you!

Presentation is loading. Please wait.

To view this video please enable JavaScript, and consider upgrading to a web browser that supports HTML5 video

Reflective Practice-The Frameworks

Published by Katrina Nichols Modified over 8 years ago

Presentation on theme: "Reflective Practice-The Frameworks"— Presentation transcript:

Developing a Positive Identity

Carper (1978) Fundamental patterns of knowing

How can we teach effectively?

Learning What do we want to learn…. ….and how do we do it?

Learning strategies How do we learn and how can we learn more effectively.

Curriculum Development and Course Design

Reflective Practice: What, Who, When, Where, & How

Foundation of Nursing Studies in partnership with the Burdett Trust for Nursing Patients First: Supporting nurse led innovation in practice Workshop 1.

Reflective learning Tutors’ Conference 17/05/12.

Simulation in the Undergraduate Nursing Curriculum at Queen’s University Belfast: Clinical Skills, OSCE, ILS, High Fidelity Simulation.

The role of Reflective Practice in CPD.

Becoming a Reflective Practitioner

Critical Thinking and Reflective Learning

Experiential Learning Cycle

CRAMLAP Reflective Practice Steve Walsh. Learning Outcomes To provide participants with an overview of the main principles of RP; To consider the advantages.

How to write reflectively Academic Development Tutors

Why the rise of reflection now? Perspectives from Nurse Education Chris Bulman School of Health and Social Care Oxford Brookes University.

How to develop your learning skills

Reflection in Nursing Practice Rebecca Taylor (3 rd year student nurse)

Becoming a GP. Aims of this morning Encourage reflective learning Develop greater understanding of the curriculum and competency framework Value the importance.

About project

Reflective Practice

May 18, 2012

950 likes | 3.76k Views

Reflective Practice. Definitions, Models & Methods Certificate in Education Year 2 2008-9. Reflection: A Definition (1).

Share Presentation

a reflective journal
professional knowledge base
learning goals
past mistakes

Presentation Transcript

Reflective Practice Definitions, Models & Methods Certificate in Education Year 2 2008-9

Reflection: A Definition (1) ‘Reflection is an important human activity in which people recapture their experience, think about it, mull over & evaluate it. It is this working with experience that is important in learning’. Boud, D., Keogh, R. & Walker, D. (1985) p 43 Reflection: Turning Experience into Learning. London: Kogan Page.

Reflection: A Definition (2) ‘We learn through critical reflection by putting ourselves into the experience & exploring personal & theoretical knowledge to understand it & view it in different ways. Tate, S. & Sills, M. (eds) (2004) p 126 The Development of Critical Reflection in the Health Professions. London; Higher Education Authority.

Reflection: Informal & informal Informal Reflection • Involves self- questioning • Develops our awareness of our own assumptions Formal Reflection • Draws on research & theory • Provides guidance & frameworks for practice.

Models of ReflectionDewey’s (1938) 5 Stage Model 1. We identify a problem that is perplexing & ‘felt’ 2. We observe & refine the identified problem to create a fuller understanding 3. We develop a hypothesis or an understanding about the problem, its origins & possible solutions 4. We subject the hypothesis to scrutiny & reasoning 5. We test the hypothesis or understanding in practice Dewey, J. (1938) Logic: The Theory of Inquiry. Troy, MN: Rinehart & Winston.

Models of ReflectionSchon’s (1983) ‘Reflection in Action’ Reflection in action concerns thinking about something whilst engaged in doing it, having a feeling about something & practicing according to that feeling. This model celebrates the intuitive & artistic approaches that can be brought to uncertain situations. Schon, D. (1983) The Reflective Practitioner. London: Temple Smith

Models of ReflectionKolb’s (1984) Learning Cycle 1. Concrete Experience: The event 2. Reflective observation: Consider what has happened from a variety of perspectives e.g. own feelings, the group’s, an individual student’s view 3. Abstract conceptualisation: Re-package & process your reflections into a theoretical understanding (use theory to analyse the event) 4. Active Experimentation: Armed with this new understanding, you do it again, differently this time. Kolb, D. (1984) Experiential Learning. New Jersey; Prentice Hall

Models of ReflectionBoud’s (1985) Experiential Learning 1. Return to an event, incident or experience & record it 2. Consider it in detail at an emotional and cognitive level 3. Re-evaluate the event in the light of experience, knowledge & experimentation. Seek to understand the meaning of the experience 4. Plan for what you might change. Boud, D., Keogh, R. & Walker, D. (1985) Reflection: Turning Experience into Learning. London: Kogan Page.

Models of ReflectionJohn’s Ten C’s of Reflection (2000) • Commitment Accept responsibility & be open to change • Contradiction Note tension between actual & desired practice • Conflict Harness this energy to take appropriate action • Challenge Confront your own typical actions, beliefs & attitudes in a non-threatening way • Catharsis Work through negative feelings • Creation Move beyond old self to novel alternatives • Connection Connect new insights in the world of practice • Caring Realise desirable practice • Congruence Reflection as a mirror for caring • Constructing Building personal knowledge in practice Johns, C. (2000). Becoming a Reflective Practitioner. Oxford; Blackwell

Barriers to Reflection Practical Barriers Kolb (1984) sees that to reflect effectively on your experience, you should actively set aside part of your working day to reflect & analyse. Kolb, D. (1984) Experiential Learning. New Jersey; Prentice Hall

Barriers to Reflection Psychological Barriers Fear of judgement, fear of criticism, being closed to feedback, defensiveness, professional arrogance.

Bridges to Reflection • Non-judgemental support, e.g. mentor, manager • Feeling ‘safe’ enough – or we may use ‘expedient’ learning & do what we expect will get us through • A role model, e.g. a mentor who reflects on their own practice • Knowledge of as many methods as possible • As many opportunities as possible for engaging in reflection, e.g. pairs, groups • Time & Energy. Ixer, G. (2003) Developing the relationship between reflective practice & social work values. Journal of Practice Teaching, 5, 1, pp 7-22.

Methods of ReflectionNarratives A Narrative is a story of an experience or event: • Written in the first person, i.e. I felt… I thought … • Learner-centred in that it allows the learner’s voice to be heard • Enables links to be made between personal & professional development • Can be shared to allow deeper reflection & comparison.

Methods of ReflectionReflective Journal A Reflective Journal focuses on: • Your reaction to the event or experience • Different ways that you might look at it • How the experience links with other experiences • How you can understand the experience in the light of theory • What you have learned in the situation • What you need to learn • How you might achieve your identified learning goals

Methods of ReflectionCritical Incident A critical incident is an incident that is in some way significant to the individual recounting it. You should record: • What the situation was • What you did in it • What happened as a result of your actions • A reflection on the situation or event & the process by which it unfolded.

The Importance of Reflection Reflection enables us to: • Be conscious of our potential for bias & discrimination. • Make the best use of the knowledge available. • Challenge & develop the existing professional knowledge base • Avoid past mistakes • Maximise our own opportunities for learning.

The Importance of Reflection Unless we make conscious & systematic efforts to critique our own practice: • We will be unaware of how & when we are being discriminatory • We will not make use of the knowledge base developed by our own profession • We will continue to repeat the same mistakes • Our skills will stagnate rather then develop.

References Boud, D., Keogh, R. & Walker, D. (1985) Reflection: Turning Experience into Learning. London: Kogan Page. Dewey, J. (1938) Logic: The Theory of Inquiry. MN: Rinehart & Winston Ixer, G. (2003) Developing the relationship between reflective practice & social work values. Journal of Practice Teaching, 5, 1, pp 7-22. Johns, C. (2000). Becoming a Reflective Practitioner. Oxford; Blackwell Kolb, D. (1984) Experiential Learning. New Jersey Schon, D. (1983) The Reflective Practitioner. London: Temple Smith Tate, S. & Sills, M. (eds) (2004) p 126 The Development of Critical Reflection in the Health Professions. London; Higher Education Authority

PDJ Entry 1 • What are your hopes & aspirations at the start of Year 2? • Do you foresee any potential problems in fulfilling the course requirements? • What support would help to overcome these problems?

More by User

Reflective practice

Reflective practice. Session 4 – Working together. Welcome to the fourth and final session on reflective practice. In this session we are going to be exploring reflective practice as a collaborative activity and planning for a shared approach.

917 views • 18 slides

8 Reflective Practice

8 Reflective Practice. What is reflective practice?. An ongoing, dynamic process of thinking honestly, deeply and critically about all aspects of professional practice with children and families It occurs spontaneously as well as in essential planned reflection time

650 views • 34 slides

Reflective Practice . reflective practice. Reflection is what allows us to learn from our experiences: it is an assessment of where we have been and where we want to go next. ~ Kenneth Wolf. Definition.

467 views • 24 slides

Reflective Practice Workshop

Reflective Practice Workshop. RCSLT: Sharon Woolf Head of Professional Development Dominique Lowenthal Professional Development Services Manager. Reflective Writing. Introduction to writing reflectively Why do reflective writing? What does good reflective writing look like?

910 views • 45 slides

What is Reflection? . ?? A process of reviewing an experience of practice in order to describe, analyse and evaluate and so inform learning on practice"(Reid, 1993 ? cited in Burns

597 views • 20 slides

Reflective Teaching Practice

Powerpoint for Teaching and Managing Learning Environments

807 views • 15 slides

Stimulating Reflective practice

In your personal, professional, and academic life. Stimulating Reflective practice. Current environment. Reflection is recognized as a valuable and necessary component of medical practice – now incorporated into competencies Increasing presence of reflection in top medical journals

269 views • 15 slides

Reflective Practice . By Paula Marty. Questions. What brought me here? What have I learned? How did I learn from my experiences? What do I see in my future?. What brought me here?. I want to like what I see when I look reflectively at me…. Nanny. Walking down the aisle.

270 views • 14 slides

Intentional Reflective Practice

Intentional Reflective Practice. Dr. Steve Mills and Jillian White DSA Professional Development Conference 1.20.12. Reflection. Process of deriving meaning from experience Engages participants in conscious, intentional, critical thinking for the examination of an experience

324 views • 20 slides

Teaching as Reflective Practice

Teaching as Reflective Practice. September 12, 2013 Class 2. Housekeeping. Please sign in ERC, if you missed it please go to the basement of Winters College and the IT people will sort out your York email accounts

304 views • 15 slides

Reflective Practice. Aims & Outcomes. Clarify what is meant by reflection Identify & discuss strategies & techniques of reflective practice Recognise how this leads to evidence of output / impact. Common-sense views of reflection. Links between reflection and learning

458 views • 12 slides

354 views • 19 slides

Reflective Practice. Leadership Development Tool. Context. recognised that a key differentiator between places where people wanted to work and places where people did not want to work was “Leadership” staff with varying degrees of training ie short courses to Masters

382 views • 15 slides

Reflective Practice. Keeping a journal. Why reflective practice. To create distance between the events and yourself So that you can analyse the events from a neutral perspective To move through the world in conscious ways rather than unconscious ways

424 views • 16 slides

Reflective Practice. Postgraduate certificate in Education Mini teach. Aims and Objectives. Aim Introduction to the concept of reflective practice to encourage personal and professional growth. Objectives Identify the purpose of reflection

527 views • 10 slides

Reflective Practice. Reflective Practice -Aims. To build a shared understanding of what the term ‘reflective practice’ means. To decide what we might do to help each other become more reflective. Reflective Practice -Objectives. By the end of the session participants will be able to:

1.16k views • 18 slides

Reflective Practice. In our community of practice. Something to start us thinking!. IQ is a reliable indicator of learning ability Reflectiveness is a critical element in learning Teaching adults is the same as teaching children Learning on-the-job is the best way of learning.

448 views • 19 slides

Reflective Practice. reflective practice. Reflection is what allows us to learn from our experiences: it is an assessment of where we have been and where we want to go next. ~ Kenneth Wolf. Definition.

284 views • 24 slides

Reflective Practice . Dr Caroline Whelan GP Registrar August 2012. Why do we need it?. We have to do it to pass To find gaps in our knowledge so we can address them & then apply what we learn To widen our professional boundaries To benchmark our performance against our peers & supervisors

171 views • 14 slides

Developing Reflective Practice

Developing Reflective Practice. February 3rd 2007 Johannesburg. Donald Schon. Reflexive practice for practitioners Reflection – in – action Generative metaphor ..’urban blight.’ Worked extensively with Argyris on organisation learning Interested in how professions introduce artistry

298 views • 28 slides

Critical Reflective Practice

Critical Reflective Practice. TTP Class 2. Session Overview. The purpose of this class is to: Examine how critical reflective practice supports personal & professional growth

402 views • 22 slides

7 Free Reflection Activities and Revision Exercises for Freelance Trainers & Teachers

When providing training, reflection activities are a great idea in order to give participants a chance to revise the ideas and concepts that have been covered in the class. Such activities help to re-enforce learning and in a fun way.

So coming up below are 7 reflection activities and games that also can be used in your workshops and classes as a freelance trainer or teacher.

Reflection exercises and activities for teaching

Page Contents

The ‘Matching Games’ Icebreaker

Activity time-frame.

Allowing 20 to 30 minutes is the perfect amount of time for this activity.

Number of Participants

Divide participants into groups of 4 to 6 people.

Activity Purpose and Goal

For revisions and reflection, this is a good activity to either get the participants to revise concepts covered during the training or to reflect and find solutions on a topic.

Each group receives a set of cards, which have information on them such as sentences, questions, pictures, scenarios. Basically, almost anything that is significant for the topic.

They are then asked to rank the cards in a particular order, sort them into categories or to use them as labels on a mind map, chart or picture.

Alternatively, they can match each card (which contains a question, for example) with a corresponding card from a different set (which contains the answers).

Reflection Activity Instructions

1. Divide participants into small groups of 3 to 6 people each, depending on the class size.

2. Give each group of participants a set of cards, 20 for instance, with words, pictures, or statements. If relevant, also give them the items that they need to match these cards with (another set of cards, a map, etc.)

3. Explain to them whether they need to sort the cards into groups of concepts, rank them, or match them with other items.

Give participants 10 minutes (or a bit more, depending on the complexity of the concepts).

Ask each group to discuss with the rest of the class how they have matched or ranked the concepts.

Benefits of this Classroom Reflection Exercise

This activity helps students to ‘construct’ their own knowledge.
It is very good to help participants take ownership of their own learning by giving them time to reflect and make associations.
This is an activity that participants can do on their own but, if they do it in groups, they will develop communication and team-building skills .

The ‘Elements of Success’ Reflection Activity Exercise

15 to 20 minutes is the perfect time frame for this reflection exercise, but you can easily adapt it to be shorter or longer, depending on available time.

This activity is best done in groups of 3 or 4 people.

Purpose (Reflection and discussion)

The topic of this game is ‘success’, so participants will share their ideas on what makes something or someone successful.

It’s very useful in particular for soft skills and life planning training sessions .

Activity Instructions

1. Split participants into groups of 3 or 4.

2. Ask each of them to think of a peak experience of whatever the topic is (e.g., the best work meeting you ever had; the best-organized conference you attended; the most engaging speaker you ever heard; the most interesting presentation you remember; the best piece of work you did, etc.).

3. Ask each participant to think about what made the experience so successful.

4. Ask participants to share their story with the rest of their small group.

5. Get the group to discuss what they think the elements of success are.

6. Get each group to share the outcome of their conversation with the rest of the class. You can write down the elements of success on a flip chart yourself or ask each group to write on their own sheet of A1 paper and present it.

Benefits of this Reflection and Revision Exercise

This exercise promotes a positive mindset as it focuses on success.
By promoting discussion, this exercise stimulates deep learning.

The ‘Snowballs Revision & Reflection’ Activity

The snowball reflection and revision exercise and activity

15 to 20 minutes is the perfect amount of time for the Snowball activity exercise.

This activity is ideal for 6 people or more.

Purpose of this Revision and Reflection Exercise

This is a fun and active way to review a topic.

1. Supply each participant with a pen and paper.

2. Ask a relevant question and ask participants to write their answers on a piece of paper.

3. Form a circle, away from any obstacles such as tables and chairs.

4. Ask participants to scrunch up their sheet of paper to make a ‘snowball’.

5. Say ‘Let’s start a snowball fight’ and allow participants 30 seconds to throw, catch and throw as many snowballs as they can.

6. At the end of the 30 seconds, stop the fight by blowing a whistle.

7. Ask each participant to pick up a snowball and open it.

8. Ask participants to take turns in reading aloud the response on their piece of paper.

9. Repeat the process with another question, playing as many rounds as the number of questions you want to ask.

Benefits of this Activity

Through this activity, participants can give their input anonymously.
As a trainer, this activity can help you evaluate what the participants have learned or want to learn.

The ‘Your Ideal Life in Three Acts’ Revision & Planning Exercise

Ideal life revision exercise activity for freelance trainers

Allow 15 to 20 minutes for this reflection and planning exercise

This exercise can be carried out individually or in small groups of 3 to 4 people.

Purpose of this Reflection and Planning Exercise

This is a good exercise for a training session on focus and life planning, happiness, or mindfulness . It could also be a useful exercise for talking about the importance of prioritizing, during a session on time management .

Instructions to Run this Activity

1. Ask participants to write the story of their ideal life in three acts, as though it was a play:

Past dreams achieved.
Present situation (good and bad parts)
Their ideal future

2. You can ask participants to share this exercise with a small group and discuss it, or it can be used as an individual reflection. Some discussion with the rest of the class after the activity is always useful though, even if participants carry out the exercise individually.

The Benefits

By asking participants to focus on their ideal life and finishing with their ideal future, it gives them a positive perspective about what they can still achieve.

The ‘Response Cards Activity’

From 15 to 30 minutes, depending on the number of questions you want to ask.

Any number, in groups of 4 to 6 people.

Activity Purpose

This is a revision, reflection, and discovery activity. It’s an interesting alternative to asking questions to participants with the trainer writing the answers on a flip chart.

Unlike the flip-chart activity, this activity gives everyone the chance to give an answer.

1. Ask an open-ended question and ask each participant to write their answer on a card. Give them a suitable time limit.

2. Separate the participants into small groups of 4 to 6 people per group.

3. Collect the responses from each team and give them to another team.

4. Ask each group to select two responses: the ‘best’ one and the response that is the most different from the others. Give them a suitable time limit.

5. Ask each team to read the responses they selected.

6. Comment and discuss on each response.

The Benefits of this activity

This activity gives participants time for reflection.
It is a good way to involve even the shyest participants , who would not answer in front of the whole class otherwise.

Personal Shield of Honour

15 to 20 minutes.

Put participants into groups of 4 to 8 people.

Purpose of this activity

This activity is perfect for Reflection and discussion.

The aim is to focus on what is done well at their workplace, as well as on what it could be improved.

You will need:

A1 pieces of paper
Writing implements such as pen, markers, and crayons
Possibly even a magazine and scissors

1. Explain that each group will create a ‘shield’ out of a big piece of paper.

2. Each group will need to divide their shield into 4 quadrants, each containing the following elements:

Quadrant 1: What skills and abilities do you bring to the workplace
Quadrant 2: What skills and abilities do you need to improve upon in the workplace
Quadrant 3: What frustrates you about our workplace
Quadrant 4: What is a source of pride at your workplace

3. Ask the groups to use only images, photos, drawings, and graphics. No words are allowed.

4. Give them 10 minutes to create their shield.

5. Give every group the chance to share their results by asking them to present their shield to the rest of the class. Allow 1 to 2 minutes for each presentation.

This activity engages visual and kinaesthetic learning styles.

Personal Brand Tagline

5 to 10 minutes

Participants

Any number of participants. This activity is done individually and the results can then be shared with the rest of the class.

Purpose of the Exercise

This is a great marketing, creativity, or self-reflection exercise. This activity can be used for training sessions on copywriting, marketing (including digital marketing ), soft skills, writing CVs. It can be quite a versatile tool.

1. Provide participants with pen and paper if they do not already have them.

2. Ask participants to write a tagline as a tweet, using only 140 characters to promote themselves.

3. Share with the rest of the class and discuss.

This is a good exercise to help participants focus on the essentials and on what is important.
The results can be funny, so this may be a useful activity to lighten the mood.

Recent Posts

Growth Mindset Training Course Materials - May 12, 2024
8 Ways to Develop a Growth Mindset at Work - May 12, 2024
12 Workplace Wellness Trends for 2025 - May 10, 2024

Positive team building training activity

Thank you so much for sharing these.

As mother of two preteens I struggle to “manage” them. I think I could use these exercises to help teach them some valuable life skills in entertaining way.

I have utilized similar activities through my 20 years in upper retail management. I wrote similar activities during my second career as an Instructional Designer. One day I just realized these techniques could be utilized to help me teach me kids. Maybe we don’t need to separate work and home as much as we think we do.

It is nice to be able to utilize these activities without having to create them. Thank you for sharing.

Submit a Comment Cancel reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed .

>> View All Training Course Materials

Training Materials Catalogue & Prices

Training materials price list and courses list

Payment Options

Bulk Discounts

What Is Included in Our Training Packages?

What's included in the training course materials

Open access
Published: 02 May 2024

Use of the International IFOMPT Cervical Framework to inform clinical reasoning in postgraduate level physiotherapy students: a qualitative study using think aloud methodology

Katie L. Kowalski 1 ,
Heather Gillis 1 ,
Katherine Henning 1 ,
Paul Parikh 1 ,
Jackie Sadi 1 &
Alison Rushton 1

BMC Medical Education volume 24 , Article number: 486 ( 2024 ) Cite this article

240 Accesses

Metrics details

Vascular pathologies of the head and neck are rare but can present as musculoskeletal problems. The International Federation of Orthopedic Manipulative Physical Therapists (IFOMPT) Cervical Framework (Framework) aims to assist evidence-based clinical reasoning for safe assessment and management of the cervical spine considering potential for vascular pathology. Clinical reasoning is critical to physiotherapy, and developing high-level clinical reasoning is a priority for postgraduate (post-licensure) educational programs.

To explore the influence of the Framework on clinical reasoning processes in postgraduate physiotherapy students.

Qualitative case study design using think aloud methodology and interpretive description, informed by COnsolidated criteria for REporting Qualitative research. Participants were postgraduate musculoskeletal physiotherapy students who learned about the Framework through standardized delivery. Two cervical spine cases explored clinical reasoning processes. Coding and analysis of transcripts were guided by Elstein’s diagnostic reasoning components and the Postgraduate Musculoskeletal Physiotherapy Practice model. Data were analyzed using thematic analysis (inductive and deductive) for individuals and then across participants, enabling analysis of key steps in clinical reasoning processes and use of the Framework. Trustworthiness was enhanced with multiple strategies (e.g., second researcher challenged codes).

For all participants ( n = 8), the Framework supported clinical reasoning using primarily hypothetico-deductive processes. It informed vascular hypothesis generation in the patient history and testing the vascular hypothesis through patient history questions and selection of physical examination tests, to inform clarity and support for diagnosis and management. Most participant’s clinical reasoning processes were characterized by high-level features (e.g., prioritization), however there was a continuum of proficiency. Clinical reasoning processes were informed by deep knowledge of the Framework integrated with a breadth of wider knowledge and supported by a range of personal characteristics (e.g., reflection).

Conclusions

Findings support use of the Framework as an educational resource in postgraduate physiotherapy programs to inform clinical reasoning processes for safe and effective assessment and management of cervical spine presentations considering potential for vascular pathology. Individualized approaches may be required to support students, owing to a continuum of clinical reasoning proficiency. Future research is required to explore use of the Framework to inform clinical reasoning processes in learners at different levels.

Peer Review reports

Introduction

Musculoskeletal neck pain and headache are highly prevalent and among the most disabling conditions globally that require effective rehabilitation [ 1 , 2 , 3 , 4 ]. A range of rehabilitation professionals, including physiotherapists, assess and manage musculoskeletal neck pain and headache. Assessment of the cervical spine can be a complex process. Patients can present to physiotherapy with vascular pathology masquerading as musculoskeletal pain and dysfunction, as neck pain and/or headache as a common first symptom [ 5 ]. While vascular pathologies of the head and neck are rare [ 6 ], they are important considerations within a cervical spine assessment to facilitate the best possible patient outcomes [ 7 ]. The International IFOMPT (International Federation of Orthopedic Manipulative Physical Therapists) Cervical Framework (Framework) provides guidance in the assessment and management of the cervical spine region, considering the potential for vascular pathologies of the neck and head [ 8 ]. Two separate, but related, risks are considered: risk of misdiagnosis of an existing vascular pathology and risk of serious adverse event following musculoskeletal interventions [ 8 ].

The Framework is a consensus document iteratively developed through rigorous methods and the best contemporary evidence [ 8 ], and is also published as a Position Statement [ 7 ]. Central to the Framework are clinical reasoning and evidence-based practice, providing guidance in the assessment of the cervical spine region, considering the potential for vascular pathologies in advance of planned interventions [ 7 , 8 ]. The Framework was developed and published to be a resource for practicing musculoskeletal clinicians and educators. It has been implemented widely within IFOMPT postgraduate (post-licensure) educational programs, influencing curricula by enabling a comprehensive and systemic approach when considering the potential for vascular pathology [ 9 ]. Frequently reported curricula changes include an emphasis on the patient history and incorporating Framework recommended physical examination tests to evaluate a vascular hypothesis [ 9 ]. The Framework aims to assist musculoskeletal clinicians in their clinical reasoning processes, however no study has investigated students’ use of the Framework to inform their clinical reasoning.

Clinical reasoning is a critical component to physiotherapy practice as it is fundamental to assessment and diagnosis, enabling physiotherapists to provide safe and effective patient-centered care [ 10 ]. This is particularly important for postgraduate physiotherapy educational programs, where developing a high level of clinical reasoning is a priority for educational curricula [ 11 ] and critical for achieving advanced practice physiotherapy competency [ 12 , 13 , 14 , 15 ]. At this level of physiotherapy, diagnostic reasoning is emphasized as an important component of a high level of clinical reasoning, informed by advanced use of domain-specific knowledge (e.g., propositional, experiential) and supported by a range of personal characteristics (e.g., adaptability, reflective) [ 12 ]. Facilitating the development of clinical reasoning improves physiotherapist’s performance and patient outcomes [ 16 ], underscoring the importance of clinical reasoning to physiotherapy practice. Understanding students’ use of the Framework to inform their clinical reasoning can support optimal implementation of the Framework within educational programs to facilitate safe and effective assessment and management of the cervical spine for patients.

To explore the influence of the Framework on the clinical reasoning processes in postgraduate level physiotherapy students.

Using a qualitative case study design, think aloud case analyses enabled exploration of clinical reasoning processes in postgraduate physiotherapy students. Case study design allows evaluation of experiences in practice, providing knowledge and accounts of practical actions in a specific context [ 17 ]. Case studies offer opportunity to generate situationally dependent understandings of accounts of clinical practice, highlighting the action and interaction that underscore the complexity of clinical decision-making in practice [ 17 ]. This study was informed by an interpretive description methodological approach with thematic analysis [ 18 , 19 ]. Interpretive description is coherent with mixed methods research and pragmatic orientations [ 20 , 21 ], and enables generation of evidence-based disciplinary knowledge and clinical understanding to inform practice [ 18 , 19 , 22 ]. Interpretive description has evolved for use in educational research to generate knowledge of educational experiences and the complexities of health care education to support achievement of educational objectives and professional practice standards [ 23 ]. The COnsolidated criteria for REporting Qualitative research (COREQ) informed the design and reporting of this study [ 24 ].

Research team

All research team members hold physiotherapy qualifications, and most hold advanced qualifications specializing in musculoskeletal physiotherapy. The research team is based in Canada and has varying levels of academic credentials (ranging from Clinical Masters to PhD or equivalent) and occupations (ranging from PhD student to Director of Physical Therapy). The final author (AR) is also an author of the Framework, which represents international and multiprofessional consensus. Authors HG and JS are lecturers on one of the postgraduate programs which students were recruited from. The primary researcher and first author (KK) is a US-trained Physical Therapist and Postdoctoral Research Associate investigating spinal pain and clinical reasoning in the School of Physical Therapy at Western University. Authors KK, KH and PP had no prior relationship with the postgraduate educational programs, students, or the Framework.

Study setting

Western University in London, Ontario, Canada offers a one-year Advanced Health Care Practice (AHCP) postgraduate IFOMPT-approved Comprehensive Musculoskeletal Physiotherapy program (CMP) and a postgraduate Sport and Exercise Medicine (SEM) program. Think aloud case analyses interviews were conducted using Zoom, a viable option for qualitative data collection and audio-video recording of interviews that enables participation for students who live in geographically dispersed areas across Canada [ 25 ]. Interviews with individual participants were conducted by one researcher (KK or KH) in a calm and quiet environment to minimize disruption to the process of thinking aloud [ 26 ].

Participants

AHCP postgraduate musculoskeletal physiotherapy students ≥ 18 years of age in the CMP and SEM programs were recruited via email and an introduction to the research study during class by KK, using purposive sampling to ensure theoretical representation. The purposive sample ensured key characteristics of participants were included, specifically gender, ethnicity, and physiotherapy experience (years, type). AHCP students must have attended standardized teaching about the Framework to be eligible to participate. Exclusion criteria included inability to communicate fluently in English. As think-aloud methodology seeks rich, in-depth data from a small sample [ 27 ], this study sought to recruit 8–10 AHCP students. This range was informed by prior think aloud literature and anticipated to balance diversity of participant characteristics, similarities in musculoskeletal physiotherapy domain knowledge and rich data supporting individual clinical reasoning processes [ 27 , 28 ].

Learning about the IFOMPT Cervical Framework

CMP and SEM programs included standardized teaching of the Framework to inform AHCP students’ clinical reasoning in practice. Delivery included a presentation explaining the Framework, access to the full Framework document [ 8 ], and discussion of its role to inform practice, including a case analysis of a cervical spine clinical presentation, by research team members AR and JS. The full Framework document that is publicly available through IFOMPT [ 8 ] was provided to AHCP students as the Framework Position Statement [ 7 ] was not yet published. Discussion and case analysis was led by AHCP program leads in November 2021 (CMP, including research team member JS) and January 2022 (SEM).

Think aloud case analyses data collection

Using think aloud methodology, the analytical processes of how participants use the Framework to inform clinical reasoning were explored in an interview with one research team member not involved in AHCP educational programs (KK or KH). The think aloud method enables description and explanation of complex information paralleling the clinical reasoning process and has been used previously in musculoskeletal physiotherapy [ 29 , 30 ]. It facilitates the generation of rich verbal [ 27 ]as participants verbalize their clinical reasoning protocols [ 27 , 31 ]. Participants were aware of the aim of the research study and the research team’s clinical and research backgrounds, supporting an open environment for depth of data collection [ 32 ]. There was no prior relationship between participants and research team members conducting interviews.

Participants were instructed to think aloud their analysis of two clinical cases, presented in random order (Supplementary 1 ). Case information was provided in stages to reflect the chronology of assessment of patients in practice (patient history, planning the physical examination, physical examination, treatment). Use of the Framework to inform clinical reasoning was discussed at each stage. The cases enabled participants to identify and discuss features of possible vascular pathology, treatment indications and contraindications/precautions, etc. Two research study team members (HG, PP) developed cases designed to facilitate and elicit clinical reasoning processes in neck and head pain presentations. Cases were tested against the research team to ensure face validity. Cases and think aloud prompts were piloted prior to use with three physiotherapists at varying levels of practice to ensure they were fit for purpose.

Data collection took place from March 30-August 15, 2022, during the final terms of the AHCP programs and an average of 5 months after standardized teaching about the Framework. During case analysis interviews, participants were instructed to constantly think aloud, and if a pause in verbalizations was sustained, they were reminded to “keep thinking aloud” [ 27 ]. As needed, prompts were given to elicit verbalization of participants’ reasoning processes, including use of the Framework to inform their clinical reasoning at each stage of case analysis (Supplementary 2 ). Aside from this, all interactions between participants and researchers minimized to not interfere with the participant’s thought processes [ 27 , 31 ]. When analysis of the first case was complete, the researcher provided the second case, each lasting 35–45 min. A break between cases was offered. During and after interviews, field notes were recorded about initial impressions of the data collection session and potential patterns appearing to emerge [ 33 ].

Data analysis

Data from think aloud interviews were analyzed using thematic analysis [ 30 , 34 ], facilitating identification and analysis of patterns in data and key steps in the clinical reasoning process, including use of the Framework to enable its characterization (Fig. 1 ). As established models of clinical reasoning exist, a hybrid approach to thematic analysis was employed, incorporating inductive and deductive processes [ 35 ], which proceeded according to 5 iterative steps: [ 34 ]

Data analysis steps

Familiarize with data: Audio-visual recordings were transcribed verbatim by a physiotherapist external to the research team. All transcripts were read and re-read several times by one researcher (KK), checking for accuracy by reviewing recordings as required. Field notes supported depth of familiarization with data.

Generate initial codes: Line-by-line coding of transcripts by one researcher (KK) supported generation of initial codes that represented components, patterns and meaning in clinical reasoning processes and use of the Framework. Established preliminary coding models were used as a guide. Elstein’s diagnostic reasoning model [ 36 ] guided generating initial codes of key steps in clinical reasoning processes (Table 1 a) [ 29 , 36 ]. Leveraging richness of data, further codes were generated guided by the Postgraduate Musculoskeletal Physiotherapy Practice model, which describes masters level clinical practice (Table 1 b) [ 12 ]. Codes were refined as data analysis proceeded. All codes were collated within participants along with supporting data.

Generate initial themes within participants: Coded data was inductively grouped into initial themes within each participant, reflecting individual clinical reasoning processes and use of the Framework. This inductive stage enabled a systematic, flexible approach to describe each participant’s unique thinking path, offering insight into the complexities of their clinical reasoning processes. It also provided a comprehensive understanding of the Framework informing clinical reasoning and a rich characterization of its components, aiding the development of robust, nuanced insights [ 35 , 37 , 38 ]. Initial themes were repeatedly revised to ensure they were grounded in and reflected raw data.

Develop, review and refine themes across participants: Initial themes were synthesized across participants to develop themes that represented all participants. Themes were reviewed and refined, returning to initial themes and codes at the individual participant level as needed.

Organize themes into established models: Themes were deductively organized into established clinical reasoning models; first into Elstein’s diagnostic reasoning model, second into the Postgraduate Musculoskeletal Physiotherapy Practice model to characterize themes within each diagnostic reasoning component [ 12 , 36 ].

Trustworthiness of findings

The research study was conducted according to an a priori protocol and additional steps were taken to establish trustworthiness of findings [ 39 ]. Field notes supported deep familiarization with data and served as a means of data source triangulation during analysis [ 40 ]. One researcher coded transcripts and a second researcher challenged codes, with codes and themes rigorously and iteratively reviewed and refined. Frequent debriefing sessions with the research team, reflexive discussions with other researchers and peer scrutiny of initial findings enabled wider perspectives and experiences to shape analysis and interpretation of findings. Several strategies were implemented to minimize the influence of prior relationships between participants and researchers, including author KK recruiting participants, KK and KH collecting/analyzing data, and AR, JS, HG and PP providing input on de-identified data at the stage of synthesis and interpretation.

Nine AHCP postgraduate level students were recruited and participated in data collection. One participant was withdrawn because of unfamiliarity with the standardized teaching session about use of the Framework (no recall of session), despite confirmation of attendance. Data from eight participants were used for analysis (CMP: n = 6; SEM: n = 2; Table 2 ), which achieved sample size requirements for think aloud methodology of rich and in-depth data [ 27 , 28 ].

Diagnostic reasoning components

Informed by the Framework, all components of Elstein’s diagnostic reasoning processes [ 36 ] were used by participants, including use of treatment with physiotherapy interventions to aid diagnostic reasoning. An illustrative example is presented in Supplement 3 . Clinical reasoning used primarily hypothetico-deductive processes reflecting a continuum of proficiency, was informed by deep Framework knowledge and breadth of prior knowledge (e.g., experiential), and supported by a range of personal characteristics (e.g., justification for decisions).

Cue acquisition

All participants sought to acquire additional cues early in the patient history, and for some this persisted into the medical history and physical examination. Cue acquisition enabled depth and breadth of understanding patient history information to generate hypotheses and factors contributing to the patient’s pain experience (Table 3 ). All participants asked further questions to understand details of the patients’ pain and their presentation, while some also explored the impact of pain on patient functioning and treatments received to date. There was a high degree of specificity to questions for most participants. Ongoing clinical reasoning processes through a thorough and complete assessment, even if the patient had previously received treatment for similar symptoms, was important for some participants. Cue acquisition was supported by personal characteristics including a patient-centered approach (e.g., understanding the patient’s beliefs about pain) and one participant reflected on their approach to acquiring patient history cues.

Hypothesis generation

Participants generated an average of 4.5 hypotheses per case (range: 2–8) and most hypotheses (77%) were generated rapidly early in the patient history. Knowledge from the Framework about patient history features of vascular pathology informed vascular hypothesis generation in the patient history for all participants in both cases (Table 4 ). Vascular hypotheses were also generated during the past medical history, where risk factors for vascular pathology were identified and interpreted by some participants who had high levels of suspicion for cervical articular involvement. Non-vascular hypotheses were generated during the physical examination by some participants to explain individual physical examination or patient history cues. Deep knowledge of the patient history section in the Framework supported high level of cue identification and interpretation for generating vascular hypotheses. Initial hypotheses were prioritized by some participants, however the level of specificity of hypotheses varied.

Cue evaluation

All participants evaluated cues throughout the patient history and physical examination in relationship to hypotheses generated, indicating use of hypothetico-deductive reasoning processes (Table 5 ). Framework knowledge of patient history features of vascular pathology was used to test vascular hypotheses and aid differential diagnosis. The patient history section supported high level of cue identification and interpretation of patient history features for all but one participant, and generation of further patient history questions for all participants. The level of specificity of these questions was high for all but one participant. Framework knowledge of recommended physical examination tests, including removal of positional testing, supported planning a focused and prioritized physical examination to further test vascular hypotheses for all participants. No participant indicated intention to use positional testing as part of their physical examination. Treatment with physiotherapy interventions served as a form of cue evaluation, and cues were evaluated to inform prognosis for some participants. At times during the physical examination, some participants demonstrated occasional errors or difficulty with cue evaluation by omitting key physical exam tests (e.g., no cranial nerve assessment despite concerns for trigeminal nerve involvement), selecting physical exam tests in advance of hypothesis generation (e.g., cervical spine instability testing), difficulty interpreting cues, or late selection of a physical examination test. Cue acquisition was supported by a range of personal characteristics. Most participants justified selection of physical examination tests, and some self-reflected on their ability to collect useful physical examination information to inform selection of tests. Precaution to the physical examination was identified by all participants but one, which contributed to an adaptable approach, prioritizing patient safety and comfort. Critical analysis of physical examination information aided interpretation within the context of the patient for most participants.

Hypothesis evaluation

All participants used the Framework to evaluate their hypotheses throughout the patient history and physical examination, continuously shifting their level of support for hypotheses (Table 6 , Supplement 4 ). This informed clarity in the overall level of suspicion for vascular pathology or musculoskeletal diagnoses, which were specific for most participants. Response to treatment with physiotherapy interventions served as a form of hypothesis evaluation for most participants who had low level suspicion for vascular pathology, highlighting ongoing reasoning processes. Hypotheses evaluated were prioritized by ranking according to level of suspicion by some participants. Difficulties weighing patient history and physical examination cues to inform judgement on overall level of suspicion for vascular pathology was demonstrated by some participants who reported that incomplete physical examination data and not being able to see the patient contributed to difficulties. Hypothesis evaluation was supported by the personal characteristic of reflection, where some students reflected on the Framework’s emphasis on the patient history to evaluate a vascular hypothesis.

The Framework supported all participants in clinical reasoning related to treatment (Table 7 ). Treatment decisions were always linked to the participant’s overall level of suspicion for vascular pathology or musculoskeletal diagnosis. Framework knowledge supported participants with high level of suspicion for vascular pathology to refer for further investigations. Participants with a musculoskeletal diagnosis kept the patient for physiotherapy interventions. The Framework patient history section supported patient education about symptoms of vascular pathology and safety netting for some participants. Framework knowledge influenced informed consent processes and risk-benefit analysis to support the selection of musculoskeletal physiotherapy interventions, which were specific and prioritized for some participants. Less Framework knowledge related to treatment was demonstrated by some students, generating unclear recommendations regarding the urgency of referral and use of the Framework to inform musculoskeletal physiotherapy interventions. Treatment was supported by a range of personal characteristics. An adaptable approach that prioritized patient safety and was supported by justification was demonstrated in all participants except one. Shared decision-making enabled the selection of physiotherapy interventions, which were patient-centered (individualized, considered whole person, identified future risk for vascular pathology). Communication with the patient’s family doctor facilitated collaborative patient-centered care for most participants.

This is the first study to explore the influence of the Framework on clinical reasoning processes in postgraduate physiotherapy students. The Framework supported clinical reasoning that used primarily hypothetico-deductive processes. The Framework informed vascular hypothesis generation in the patient history and testing the vascular hypothesis through patient history questions and selection of physical examination tests to inform clarity and support for diagnosis and management. Most postgraduate students’ clinical reasoning processes were characterized by high-level features (e.g. specificity, prioritization). However, some demonstrated occasional difficulties or errors, reflecting a continuum of clinical reasoning proficiency. Clinical reasoning processes were informed by deep knowledge of the Framework integrated with a breadth of wider knowledge and supported by a range of personal characteristics (e.g., justification for decisions, reflection).

Use of the Framework to inform clinical reasoning processes

The Framework provided a structured and comprehensive approach to support postgraduate students’ clinical reasoning processes in assessment and management of the cervical spine region, considering the potential for vascular pathology. Patient history and physical examination information was evaluated to inform clarity and support the decision to refer for further vascular investigations or proceed with musculoskeletal physiotherapy diagnosis/interventions. The Framework is not intended to lead to a vascular pathology diagnosis [ 7 , 8 ], and following the Framework does not guarantee vascular pathologies will be identified [ 41 ]. Rather, it aims to support a process of clinical reasoning to elicit and interpret appropriate patient history and physical examination information to estimate the probability of vascular pathology and inform judgement about the need to refer for further investigations [ 7 , 8 , 42 ]. Results of this study suggest the Framework has achieved this aim for postgraduate physiotherapy students.

The Framework supported postgraduate students in using primarily hypothetico-deductive diagnostic reasoning processes. This is expected given the diversity of vascular pathology clinical presentations precluding a definite clinical pattern and inherent complexity as a potential masquerader of a musculoskeletal problem [ 7 ]. It is also consistent with prior research investigating clinical reasoning processes in musculoskeletal physiotherapy postgraduate students [ 12 ] and clinical experts [ 29 ] where hypothetico-deductive and pattern recognition diagnostic reasoning are employed according to the demands of the clinical situation [ 10 ]. Diagnostic reasoning of most postgraduate students in this study demonstrated features suggestive of high-level clinical reasoning in musculoskeletal physiotherapy [ 12 ], including ongoing reasoning with high-level cue identification and interpretation, specificity and prioritization during assessment and treatment, use of physiotherapy interventions to aid diagnostic reasoning, and prognosis determination [ 12 , 29 , 43 ]. Expert physiotherapy practice has been further described as using a dialectical model of clinical reasoning with seamless transitions between clinical reasoning strategies [ 44 ]. While diagnostic reasoning was a focus in this study, postgraduate students considered a breadth of information as important to their reasoning (e.g., patient’s perspectives of the reason for their pain). This suggests wider reasoning strategies (e.g., narrative, collaborative) were employed to enable shared decision-making within the context of patient-centered care.

Study findings also highlighted a continuum of proficiency in use of the Framework to inform clinical reasoning processes. Not all students demonstrated all characteristics of high-level clinical reasoning and there are suggestions of incomplete reasoning processes, for example occasional errors in evaluating cues. Some students offered explanations such as incomplete case information as factors contributing to difficulties with clinical reasoning processes. However, the ability to critically evaluate incomplete and potentially conflicting clinical information is consistently identified as an advanced clinical practice competency [ 14 , 43 ]. A continuum of proficiency in clinical reasoning in musculoskeletal physiotherapy is supported by wider healthcare professions describing acquisition and application of clinical knowledge and skills as a developmental continuum of clinical competence progressing from novice to expert [ 45 , 46 ]. The range of years of clinical practice experience in this cohort of students (3–14 years) or prior completed postgraduate education may have contributed to the continuum of proficiency, as high-quality and diverse experiential learning is essential for the development of high-level clinical reasoning [ 14 , 47 ].

Deep knowledge of the Framework informs clinical reasoning processes

Postgraduate students demonstrated deep Framework knowledge to inform clinical reasoning processes. All students demonstrated knowledge of patient history features of vascular pathology, recommended physical examination tests to test a vascular hypothesis, and the need to refer if there is a high level of suspicion for vascular pathology. A key development in the recent Framework update is the removal of the recommendation to perform positional testing [ 8 ]. All students demonstrated knowledge of this development, and none wanted to test a vascular hypothesis with positional testing. Most also demonstrated Framework knowledge about considerations for planning treatment with physiotherapy interventions (e.g., risk-benefit analysis, informed consent), though not all, which underscores the continuum of proficiency in postgraduate students. Rich organization of multidimensional knowledge is a required component for high level clinical reasoning and is characteristic of expert physiotherapy practice [ 10 , 48 , 49 ]. Most postgraduate physiotherapy students displayed this expert practice characteristic through integration of deep Framework knowledge with a breadth of prior knowledge (e.g., experiential, propositional) to inform clinical reasoning processes. This highlights the utility of the Framework in postgraduate physiotherapy education to develop advanced level evidence-based knowledge informing clinical reasoning processes for safe assessment and management of the cervical spine, considering the potential for vascular pathology [ 9 , 8 , 50 , 51 , 52 ].

Framework supports personal characteristics to facilitate integration of knowledge and clinical reasoning

The Framework supported personal characteristics of postgraduate students, which are key drivers for the complex integration of advanced knowledge and high-level clinical reasoning [ 10 , 12 , 48 ]. For all students, the Framework supported justification for decisions and patient-centered care, emphasizing a whole-person approach and shared decision-making. Further demonstrating a continuum of proficiency, the Framework supported a wider breadth of personal characteristics for some students, including critical analysis, reflection, self-analysis, and adaptability. These personal characteristics illustrate the interwoven cognitive and metacognitive skills that influence and support a high level of clinical reasoning [ 10 , 12 ] and the development of clinical expertise [ 48 , 53 ]. For example [ 54 ], reflection is critical to developing high-level clinical reasoning and advanced level practice [ 12 , 55 ]. Postgraduate students reflected on prior knowledge, experiences, and action within the context of current Framework knowledge, emphasizing active engagement in cognitive processes to inform clinical reasoning processes. Reflection-in-action is highlighted by self-analysis and adaptability. These characteristics require continuous cognitive processing to consider personal strengths and limitations in the context of the patient and evidence-based practice, adapting the clinical encounter as required [ 53 , 55 ]. These findings highlight use of the Framework in postgraduate education to support development of personal characteristics that are indicative of an advanced level of clinical practice [ 12 ].

Synthesis of findings

Derived from synthesis of research study findings and informed by the Postgraduate Musculoskeletal Physiotherapy Practice model [ 12 ], use of the Framework to inform clinical reasoning processes in postgraduate students is illustrated in Fig. 2 . Overlapping clinical reasoning, knowledge and personal characteristic components emphasize the complex interaction of factors contributing to clinical reasoning processes. Personal characteristics of postgraduate students underpin clinical reasoning and knowledge, highlighting their role in facilitating the integration of these two components. Bolded subcomponents indicate convergence of results reflecting all postgraduate students and underscores the variability among postgraduate students contributing to a continuum of clinical reasoning proficiency. The relative weighting of the components is approximately equal to balance the breadth and convergence of subcomponents. Synthesis of findings align with the Postgraduate Musculoskeletal Physiotherapy Practice model [ 12 ], though some differences exist. Limited personal characteristics were identified in this study with little convergence across students, which may be due to the objective of this study and the case analysis approach.

Use of the Framework to inform clinical reasoning in postgraduate level musculoskeletal physiotherapy students. Adapted from the Postgraduate Musculoskeletal Physiotherapy Practice model [ 12 ].

Strengths and limitations

Think aloud case analyses enabled situationally dependent understanding of the Framework to inform clinical reasoning processes in postgraduate level students [ 17 ], considering the rare potential for vascular pathology. A limitation of this approach was the standardized nature of case information provided to students, which may have influenced clinical reasoning processes. Future research studies may consider patient case simulation to address this limitation [ 30 ]. Interviews were conducted during the second half of the postgraduate educational program, and this timing could have influenced clinical reasoning processes compared to if interviews were conducted at the end of the program. Future research can explore use of the Framework to inform clinical reasoning processes in established advanced practice physiotherapists. The sample size of this study aligns with recommendations for think aloud methodology [ 27 , 28 ], achieved rich data, and purposive sampling enabled wide representation of key characteristics (e.g., gender, ethnicity, country of training, physiotherapy experiences), which enhances transferability of findings. Students were aware of the study objective in advance of interviews which may have contributed to a heightened level of awareness of vascular pathology. The prior relationship between students and researchers may have also influenced results, however several strategies were implemented to minimize this influence.

Implications

The Framework is widely implemented within IFOMPT postgraduate educational programs and has led to important shifts in educational curricula [ 9 ]. Findings of this study support use of the Framework as an educational resource in postgraduate physiotherapy programs to inform clinical reasoning processes for safe and effective assessment and management of cervical spine presentations considering the potential for vascular pathology. Individualized approaches may be required to support each student, owing to a continuum of clinical reasoning proficiency. As the Framework was written for practicing musculoskeletal clinicians, future research is required to explore use of the Framework to inform clinical reasoning in learners at different levels, for example entry-level physiotherapy students.

The Framework supported clinical reasoning that used primarily hypothetico-deductive processes in postgraduate physiotherapy students. It informed vascular hypothesis generation in the patient history and testing the vascular hypothesis through patient history questions and selection of physical examination tests, to inform clarity and support for diagnosis and management. Most postgraduate students clinical reasoning processes were characterized as high-level, informed by deep Framework knowledge integrated with a breadth of wider knowledge, and supported by a range of personal characteristics to facilitate the integration of advanced knowledge and high-level clinical reasoning. Future research is required to explore use of the Framework to inform clinical reasoning in learners at different levels.

Data availability

The dataset used and analyzed during the current study are available from the corresponding author on reasonable request.

Safiri S, Kolahi AA, Hoy D, Buchbinder R, Mansournia MA, Bettampadi D et al. Global, regional, and national burden of neck pain in the general population, 1990–2017: systematic analysis of the global burden of Disease Study 2017. BMJ. 2020;368.

Stovner LJ, Nichols E, Steiner TJ, Abd-Allah F, Abdelalim A, Al-Raddadi RM, et al. Global, regional, and national burden of migraine and tension-type headache, 1990–2016: a systematic analysis for the global burden of Disease Study 2016. Lancet Neurol. 2018;17:954–76.

Article Google Scholar

Cieza A, Causey K, Kamenov K, Hanson SW, Chatterji S, Vos T. Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the global burden of Disease Study 2019. Lancet. 2020;396:2006–17.

Côté P, Yu H, Shearer HM, Randhawa K, Wong JJ, Mior S et al. Non-pharmacological management of persistent headaches associated with neck pain: A clinical practice guideline from the Ontario protocol for traffic injury management (OPTIMa) collaboration. European Journal of Pain (United Kingdom). 2019;23.

Diamanti S, Longoni M, Agostoni EC. Leading symptoms in cerebrovascular diseases: what about headache? Neurological Sciences. 2019.

Debette S, Compter A, Labeyrie MA, Uyttenboogaart M, Metso TM, Majersik JJ, et al. Epidemiology, pathophysiology, diagnosis, and management of intracranial artery dissection. Lancet Neurol. 2015;14:640–54.

Rushton A, Carlesso LC, Flynn T, Hing WA, Rubinstein SM, Vogel S, et al. International Framework for examination of the Cervical Region for potential of vascular pathologies of the Neck Prior to Musculoskeletal intervention: International IFOMPT Cervical Framework. J Orthop Sports Phys Therapy. 2023;53:7–22.

Rushton A, Carlesso LC, Flynn T, Hing WA, Kerry R, Rubinstein SM, et al. International framework for examination of the cervical region for potential of vascular pathologies of the neck prior to orthopaedic manual therapy (OMT) intervention: International IFOMPT Cervical Framework. International IFOMPT Cervical Framework; 2020.

Hutting N, Kranenburg R, Taylor A, Wilbrink W, Kerry R, Mourad F. Implementation of the International IFOMPT Cervical Framework: a survey among educational programmes. Musculoskelet Sci Pract. 2022;62:102619.

Jones MA, Jensen G, Edwards I. Clinical reasoning in physiotherapy. In: Campbell S, Watkins V, editors. Clinical reasoning in the health professions. Third. Philadelphia: Elsevier; 2008. pp. 245–56.

Google Scholar

Fennelly O, Desmeules F, O’Sullivan C, Heneghan NR, Cunningham C. Advanced musculoskeletal physiotherapy practice: informing education curricula. Musculoskelet Sci Pract. 2020;48:102174.

Rushton A, Lindsay G. Defining the construct of masters level clinical practice in manipulative physiotherapy. Man Ther. 2010;15.

Rushton A, Lindsay G. Defining the construct of masters level clinical practice in healthcare based on the UK experience. Med Teach. 2008;30:e100–7.

Noblet T, Heneghan NR, Hindle J, Rushton A. Accreditation of advanced clinical practice of musculoskeletal physiotherapy in England: a qualitative two-phase study to inform implementation. Physiotherapy (United Kingdom). 2021;113.

Tawiah AK, Stokes E, Wieler M, Desmeules F, Finucane L, Lewis J, et al. Developing an international competency and capability framework for advanced practice physiotherapy: a scoping review with narrative synthesis. Physiotherapy. 2023;122:3–16.

Williams A, Rushton A, Lewis JJ, Phillips C. Evaluation of the clinical effectiveness of a work-based mentoring programme to develop clinical reasoning on patient outcome: a stepped wedge cluster randomised controlled trial. PLoS ONE. 2019;14.

Miles R. Complexity, representation and practice: case study as method and methodology. Issues Educational Res. 2015;25.

Thorne S, Kirkham SR, MacDonald-Emes J. Interpretive description: a noncategorical qualitative alternative for developing nursing knowledge. Res Nurs Health. 1997;20.

Thorne S, Kirkham SR, O’Flynn-Magee K. The Analytic challenge in interpretive description. Int J Qual Methods. 2004;3.

Creswell JW. Research design: qualitative, quantitative, and mixed methods approaches. Sage; 2003.

Dolan S, Nowell L, Moules NJ. Interpretive description in applied mixed methods research: exploring issues of fit, purpose, process, context, and design. Nurs Inq. 2023;30.

Thorne S. Interpretive description. In: Routledge International Handbook of Qualitative Nursing Research. 2013. pp. 295–306.

Thompson Burdine J, Thorne S, Sandhu G. Interpretive description: a flexible qualitative methodology for medical education research. Med Educ. 2021;55.

Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus group. Int J Qual Health Care. 2007;19:349–57.

Archibald MM, Ambagtsheer RC, Casey MG, Lawless M. Using zoom videoconferencing for qualitative data Collection: perceptions and experiences of researchers and participants. Int J Qual Methods. 2019;18.

Van Someren M, Barnard YF, Sandberg J. The think aloud method: a practical approach to modelling cognitive. Volume 11. London: Academic; 1994.

Fonteyn ME, Kuipers B, Grobe SJ. A description of think aloud Method and Protocol Analysis. Qual Health Res. 1993;3:430–41.

Lundgrén-Laine H, Salanterä S. Think-Aloud technique and protocol analysis in clinical decision-making research. Qual Health Res. 2010;20:565–75.

Doody C, McAteer M. Clinical reasoning of expert and novice physiotherapists in an outpatient orthopaedic setting. Physiotherapy. 2002;88.

Gilliland S. Physical therapist students’ development of diagnostic reasoning: a longitudinal study. J Phys Therapy Educ. 2017;31.

Ericsson KA, Simon HA. How to study thinking in Everyday Life: contrasting think-aloud protocols with descriptions and explanations of thinking. Mind Cult Act. 1998;5:178–86.

Dwyer SC, Buckle JL. The space between: on being an insider-outsider in qualitative research. Int J Qual Methods. 2009;8.

Shenton AK. Strategies for ensuring trustworthiness in qualitative research projects. Educ Inform. 2004;22:63–75.

Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101.

Fereday J, Muir-Cochrane E. Demonstrating Rigor using thematic analysis: a Hybrid Approach of Inductive and deductive coding and theme development. Int J Qual Methods. 2006;5.

Elstein ASLSS. Medical problem solving: an analysis of clinical reasoning. Harvard University Press; 1978.

Proudfoot K. Inductive/Deductive Hybrid Thematic Analysis in mixed methods research. J Mix Methods Res. 2023;17.

Charters E. The use of think-aloud methods in qualitative research an introduction to think-aloud methods. Brock Educ J. 2003;12.

Nowell LS, Norris JM, White DE, Moules NJ. Thematic analysis: striving to meet the trustworthiness Criteria. Int J Qual Methods. 2017;16:1–13.

Thurmond VA. The point of triangulation. J Nurs Scholarsh. 2001;33.

Hutting N, Wilbrink W, Taylor A, Kerry R. Identifying vascular pathologies or flow limitations: important aspects in the clinical reasoning process. Musculoskelet Sci Pract. 2021;53:102343.

de Best RF, Coppieters MW, van Trijffel E, Compter A, Uyttenboogaart M, Bot JC, et al. Risk assessment of vascular complications following manual therapy and exercise for the cervical region: diagnostic accuracy of the International Federation of Orthopaedic Manipulative physical therapists framework (the Go4Safe project). J Physiother. 2023;69:260–6.

Petty NJ. Becoming an expert: a masterclass in developing clinical expertise. Int J Osteopath Med. 2015;18:207–18.

Edwards I, Jones M, Carr J, Braunack-Mayer A, Jensen GM. Clinical reasoning strategies in physical therapy. Phys Ther. 2004;84.

Carraccio CL, Benson BJ, Nixon LJ, Derstine PL. Clinical teaching from the Educational Bench to the clinical Bedside: Translating the Dreyfus Developmental Model to the Learning of Clinical Skills.

Benner P. Using the Dreyfus Model of Skill Acquisition to describe and interpret Skill Acquisition and Clinical Judgment in nursing practice and education. Bull Sci Technol Soc. 2004;24:188–99.

Benner P. From novice to expert: Excellence and power in clinical nursing practice. Upper Saddle River, New Jersey: Prentice Hall;: Commemorative Ed; 2001.

Jensen GM, Gwyer J, Shepard KF, Hack LM. Expert practice in physical therapy. Phys Ther. 2000;80.

Huhn K, Gilliland SJ, Black LL, Wainwright SF, Christensen N. Clinical reasoning in physical therapy: a Concept Analysis. Phys Ther. 2019;99.

Hutting N, Kranenburg HA, Rik KR. Yes, we should abandon pre-treatment positional testing of the cervical spine. Musculoskelet Sci Pract. 2020;49:102181.

Kranenburg HA, Tyer R, Schmitt M, Luijckx GJ, Schans C, Van Der, Hutting N, et al. Effects of head and neck positions on blood flow in the vertebral, internal carotid, and intracranial arteries: a systematic review. J Orthop Sports Phys Ther. 2019;49:688–97.

Hutting N, Kerry R, Coppieters MW, Scholten-Peeters GGM. Considerations to improve the safety of cervical spine manual therapy. Musculoskelet Sci Pract. 2018;33.

Wainwright SF, Shepard KF, Harman LB, Stephens J. Novice and experienced physical therapist clinicians: a comparison of how reflection is used to inform the clinical decision-making process. Phys Ther. 2010;90:75–88.

Dy SM, Purnell TS. Key concepts relevant to quality of complex and shared decision-making in health care: a literature review. Soc Sci Med. 2012;74:582–7.

Christensen N, Jones MA, Higgs J, Edwards I. Dimensions of clinical reasoning capability. In: Campbell S, Watkins V, editors. Clinical reasoning in the health professions. 3rd edition. Philadelphia: Elsevier; 2008. pp. 101–10.

Download references

Acknowledgements

The authors would like to acknowledge study participants and the transcriptionist for their time in completing and transcribing think aloud interviews.

No funding was received to conduct this research study.

Author information

Authors and affiliations.

School of Physical Therapy, Western University, London, Ontario, Canada

Katie L. Kowalski, Heather Gillis, Katherine Henning, Paul Parikh, Jackie Sadi & Alison Rushton

You can also search for this author in PubMed Google Scholar

Contributions

Katie Kowalski: Conceptualization, methodology, validation, formal analysis, investigation, data curation, writing– original draft, visualization, project administration. Heather Gillis: Validation, resources, writing– review & editing. Katherine Henning: Investigation, formal analysis, writing– review & editing. Paul Parikh: Validation, resources, writing– review & editing. Jackie Sadi: Validation, resources, writing– review & editing. Alison Rushton: Conceptualization, methodology, validation, writing– review & editing, supervision.

Corresponding author

Correspondence to Katie L. Kowalski .

Ethics declarations

Ethics approval and consent to participate.

Western University Health Science Research Ethics Board granted ethical approval (Project ID: 119934). Participants provided written informed consent prior to participating in think aloud interviews.

Consent for publication

Not applicable.

Competing interests

Author AR is an author of the IFOMPT Cervical Framework. Authors JS and HG are lecturers on the AHCP CMP program. AR and JS led standardized teaching of the Framework. Measures to reduce the influence of potential competing interests on the conduct and results of this study included: the Framework representing international and multiprofessional consensus, recruitment of participants by author KK, data collection and analysis completed by KK with input from AR, JS and HG at the stage of data synthesis and interpretation, and wider peer scrutiny of initial findings. KK, KH and PP have no potential competing interests.

Authors’ information

The lead author of this study (AR) is the first author of the International IFOMPT Cervical Framework.

Additional information

Publisher’s note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary Material 1

Supplementary material 2, supplementary material 3, supplementary material 4, rights and permissions.

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article.

Kowalski, K.L., Gillis, H., Henning, K. et al. Use of the International IFOMPT Cervical Framework to inform clinical reasoning in postgraduate level physiotherapy students: a qualitative study using think aloud methodology. BMC Med Educ 24 , 486 (2024). https://doi.org/10.1186/s12909-024-05399-x

Download citation

Received : 11 February 2024

Accepted : 08 April 2024

Published : 02 May 2024

DOI : https://doi.org/10.1186/s12909-024-05399-x

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

International IFOMPT Cervical Framework
Clinical reasoning
Postgraduate students
Physiotherapy
Educational research
Qualitative research
Think aloud methodology

BMC Medical Education

ISSN: 1472-6920

Submission enquiries: [email protected]
General enquiries: [email protected]

IMAGES

Reflective Practice
Reflective Practice
The positive impacts of reflective practice • Carve Consulting
PPT
Getting started with Reflective Practice
What? So What? and Now What?

VIDEO

Reflective Practice Through Performance Evaluation
Reflective Practice Review Meeting
Reflective Poster Presentation
How to add a reflective practice
Reflective Practice Video Presentation recorded
Reflective practice (Presentation Video of Group 14 )

COMMENTS

Reflective Practice
Reflective Practice. Oct 29, 2013 • Download as PPTX, PDF •. 63 likes • 79,874 views. Olivier Serrat. Reflective practice is a discipline that ensures we give adequate time and attention to reflection in the learning cycle. It is necessary for the development of wisdom, and wisdom is necessary for effective change. Read more.
What is reflective practice?
Reflective practice was something which developed in disciplines such as teaching, medicine and social work as a way to learn from real life experiences. People in these areas would think about encounters with their students, patients or clients, how these worked and what lessons they could take away. Over time many other areas have adopted the ...
PPT reflective practice
Learning from experience must involve links between the doing and the thinking How to become a reflective learner 1. Establish objectives 2. Recognise current level of performance 3. Plan how to meet targets 4. Use effective time management 5. Use feedback and support 6. Monitor and review progress 7.
PDF Reflection for learning: a scholarly practice guide for educators
7.2 Conference presentations (refereed abstracts) 123 7.3 List of videos 124 ... reflective practice that we enact in our educational and personal lives. Our outputs reflect this through co-authoring publications, running workshops, and sharing our open-access resources. We stay on course for this exciting river journey by knowing our ...
Reflective Practice
Reflective practice is, in its simplest form, thinking about or reflecting on what you do. It is closely linked to the concept of learning from experience, in that you think about what you did, and what happened, and decide from that what you would do differently next time. Thinking about what has happened is part of being human.
Critical reflection for assessments and practice
Reflective practice is the act of thinking about your experiences in order to learn from them to shape what you do in the future. It therefore includes all aspects of your practice (e.g. relationships, interactions, learning, assessments, behaviours, and environments). It also includes examining how your practice is influenced by your own world ...
Professional Practice
Multiple and contradictory understandings of reflective practice can even be found within the same discipline. Despite this, some consensus has been achieved amid the profusion of definitions. In general, reflective practice is understood as the process of learning through and from experience towards gaining new insights of self and/or practice ...
Reflective Practice: Thinking About the Way You Do Things
An example of reflective practice is an athlete who, after every practice, thinks about what they did well, what they did badly, why they did things the way they did, and what they can do in the future to improve their performance. In addition, examples of reflective practice appear in a variety of other domains. For instance:
LibGuides: Reflective Practice Toolkit: Introduction
This resource will guide you through the basics of what reflective practice is, its benefits, how to integrate it into your everyday life and the basics of reflective writing. This resource is designed to be flexible so you can use it in the best way for you. You can read the whole resource to guide you through from the basics to a selection of ...
The Ultimate Guide to Reflective Practice in Teaching
2. Remain relevant and innovative. Self reflection helps you to create and experiment with new ideas and approaches to ensure your teaching is relevant, fresh and impactful for your students. 3. Stay learner focused. Reflective practice will help you better understand your learners, their abilities and needs.
Reflective practice
Reflective practice involves regularly reflecting on experiences to improve nursing care and cope with job demands. It describes two scenarios where nurses should have reflected: when a gauze was left in a patient after delivery and when a distressed mother complained about unanswered call bells. Theories of reflective practice emphasize ...
Reflective practice in health care and how to reflect effectively
Introduction. Reflective practice is something most people first formally encounter at university. This may be reflecting on a patient case, or an elective, or other experience. However, what you may not have considered is that you have been subconsciously reflecting your whole life: thinking about and learning from past experiences to avoid ...
Engaging in Reflective Practice: A Practical Guide
That is a fundamental difference when distinguishing between reflection, which can be simply thinking about our teaching, and reflective practice, which is to do with change occurring as a result of those thoughts. The change can be observable, i.e., a change in what we do as teachers and TESOL professionals, or it can be a change in how we ...
Getting started with Reflective Practice
Reflective practice allows you to adapt lessons to suit your classes. You can create and experiment with new ideas and approaches to your teaching to gain maximum success. By varying learning and experimenting with new approaches, students have a richer learning experience. They will think more creatively, imaginatively and resourcefully, and ...
Reflective practice
Reflective practice. Mar 6, 2017 • Download as PPTX, PDF •. 13 likes • 16,560 views. Islamic Azad University (IAU)- دانشگاه آزاد اسلامی. [email protected]. Education. 1 of 34.
13 Self Reflection Worksheets & Templates to Use in Therapy
Fostering Reflection Skills: The Basics. While reflection has no single, universal definition, Aronson (2011, p. 200) frames it as the "process of analyzing, questioning, and reframing an experience in order to make an assessment of it for the purposes of learning (reflective learning) and/or improve practice (reflective practice)." It has multiple uses in various contexts.
Reflective Practice-The Frameworks
Download ppt "Reflective Practice-The Frameworks". Introduction Reflective practice is associated with learning from experience, and is viewed as an important strategy for health professionals who embrace life long learning The act of reflection is seen as a way of promoting the development of autonomous, qualified and self-directed ...
PDF Supporting information for reflection in nursing and midwifery practice
develop reflective practice and that this can be used as evidence in their assessments. 1.2 prioritise the wellbeing of people promoting critical self-reflection and safe practice in accordance with the Code 1.8 ensure mistakes and incidents are fully investigated and learning reflections and actions are recorded and disseminated
PPT
Presentation Transcript. Reflective Practice Definitions, Models & Methods Certificate in Education Year 2 2008-9. Reflection: A Definition (1) 'Reflection is an important human activity in which people recapture their experience, think about it, mull over & evaluate it. It is this working with experience that is important in learning'.
7 Free reflection activities and revision exercises for trainers and
1. Supply each participant with a pen and paper. 2. Ask a relevant question and ask participants to write their answers on a piece of paper. 3. Form a circle, away from any obstacles such as tables and chairs. 4. Ask participants to scrunch up their sheet of paper to make a 'snowball'. 5.
Use of the International IFOMPT Cervical Framework to inform clinical
For example , reflection is critical to developing high-level clinical reasoning and advanced level practice [12, 55]. Postgraduate students reflected on prior knowledge, experiences, and action within the context of current Framework knowledge, emphasizing active engagement in cognitive processes to inform clinical reasoning processes.
Reflective practice
4. Models of reflection:Models of reflection: Seem to be based around the one ideaSeem to be based around the one idea ofof looking at something,looking at something, thinking about why it is as it is, andthinking about why it is as it is, and deciding what to do next time.deciding what to do next time. The models oftenThe models often Have a ...

Reflective Practice

What is Reflective Practice?

Reflective Practice as a Skill

Developing and Using Reflective Practice

The Benefits of Reflective Practice

To Conclude

Critical reflection for assessments and practice

Critical reflection for assessments and practice: Reflective practice

What is reflective practice?

Thinking and doing

Why reflect?

When to critically reflect?

Reflective practice and critical reflection

Critical reflection and areas of your practice

Reflective practice and you

Professional Practice - The Process of Reflective Practice

Related Papers

RELATED PAPERS

RELATED TOPICS

Reflective Practice: Thinking About the Way You Do Things

Examples of reflective practice

The benefits of reflective practice

How to engage in reflective practice

The reflective cycle

Types of reflection

Levels of reflection

Using self-distancing to help reflection

Reflective practice as a shared activity

How to encourage reflective practice in others

Related concepts

Summary and conclusions

Other articles you may find interesting:

Study Skills

Who is this resource for?

Pathway 1: Beginners

Pathway 2: Intermediate

The Ultimate Guide to Reflective Practice in Teaching

What is reflective practice in teaching?

Using video for reflective practice: what the teachers say

Reflective practitioners can better ride the waves of change

Reflective cultures support excellence in teaching AND learning

1. Reflection is at the heart of effective professional development

2. Remain relevant and innovative

3. Stay learner focused

4. Developing reflective learners

5. Humility

How to reflect on teaching: getting started with reflective practice and tools to help

Step 1: Gather insights

Keep a teacher diary/journal

Invite a peer to observe

Record your lesson

Have reflective discussions

7 reflection activities for teachers:

Get blog notifications

Engaging in Reflective Practice: A Practical Guide

Cite this chapter

Access this chapter

Author information

Corresponding author

Editor information

Rights and permissions

Copyright information

About this chapter

Download citation

Share this chapter

Getting started with Reflective Practice

What is reflective practice?

What are the benefits of reflective practice?

Image captions

What is the research behind reflective practice?

Common misconceptions about reflective practice

Reflective practice in practice

13 Self Reflection Worksheets & Templates to Use in Therapy

This Article Contains:

Reflection questions for students

Reflective Questions for personal academic performance

Reflective Metacognition Questions for students

Reflection Questions in Therapy

Download 3 Meaning & Valued Living Exercises (PDF)

Download 3 Free Meaning Tools Pack (PDF)