The use of reflection has become a routine part of many professions such as teaching and nursing. In dentistry we have been slower to adopt it as way of highlighting development needs.
You might think, how can reflection help me, either to learn things or highlight an area that I need to develop further. How can reflection help to develop my own personal development plan?
There is evidence that engaging in Reflective Practice is associated with the improvement of the quality of care, stimulating personal and professional growth and closing the gap between theory and practice. There is a lot of literature on Reflective Practice. Davies (2012) has summarised a lot this and identifies that there are both benefits as well as limitations to reflective practice:
Benefits to Reflective Practice
- Increased learning from an experience or situation
- Promotion of deep learning
- Identification of personal and professional strengths and areas for improvement
- Identification of educational needs
- Acquisition of new knowledge and skills
- Further understanding of own beliefs, attitudes and values
- Encouragement of self-motivation and self-directed learning
- Could act as a source of feedback
- Possible improvements of personal and clinical confidence
Limitations of Reflective Practice
- Not all practitioners may understand the reflective process
- May feel uncomfortable challenging and evaluating own practice
- Could be time consuming
- May have confusion as to which situations/experiences to reflect upon
- May not be adequate to resolve clinical problems [this would point to a further learning need.]
Reflection is something we do every day we just don’t notice that were doing it much of the time. A lot has been written about reflection, but it can be best illustrated by an example:
You start a new job and have a new journey to work. Before your first day you think about the journey to work, which route to work will be best and how long will it take. This indicates what time you need to set off to arrive, at the time you want. As you have not done the journey before you may drive it before hand or allow extra time so you can allow for delays. This then becomes your daily commute. However on this drive there is a roundabout that always holds you up. One day you try a slightly different route and it works, you avoid the holdup and save five minutes on your journey Time. You have tried a new route and it worked, you have learnt something from trying something new. Another day there is a bad accident and your normal route is blocked so you have to take another one to try to get round it. You are forced to react to the situation.
These are examples of reflection and how it could help in professional practice. You try something out to overcome a problem you have and see if your idea improves the situation or not. Most of the time, we do this in our minds. In more ‘formal’ reflection, we take that a stage further and write in down. This separation helps us to consider what we are doing and consider our thought processes. It also means we can demonstrate this to others. [It will be part of revalidation with the GDC, when it comes.]
If we look at a Dental example: you have a number of new patients that have advanced periodontal disease, you would normally do quadrant scaling for these patients {which you were taught at Dental school}, some seem to be helped and others don’t seem to respond. In this situation you could carry on doing the same thing or start to reflect ‘I’m not sure this is the best way to treat them’. This might prompt you to go on a Periodontal update course and see if what you were taught at Dental school is still the current treatment being taught. It highlights a possible learning need.
In practice if we take the time to reflect on things that happens it can help us to identify areas we need to improve in our own practice. If you like Endodontics and get good results then it should not be a priority for your personal development plan. The temptation is to go on another endodontic course as you enjoy it. It may to the case that a Periodontal course would be more useful. This thought process can be developed by reflection. You are able to consider the areas of dentistry that you are comfortable with and get good results against those areas that you feel you could improve or feel you don’t have all the understanding to do well.
Lots of different ways of reflecting have been described, none of which is necessarily better or the correct way to do it. One way that is widely used is Gibbs reflection cycle [1988]
This is an example of a reflective cycle. It fits in with the pro forma the Post graduate has on the web site. Like any new skill it takes time to develop. There is no correct or right way to reflect. It however might be useful to use a template at the start as it helps to prompt the thought process.
As a professional we gain experience and part of that is to keep asking ourselves are we getting the right results and not just making the same mistakes with increasing confidence. Reflection on what we do is how we find out and demonstrate this to others.
David Lee
2013
Further reading:
Davies, Samantha (2012). "Embracing reflective practice". Education for Primary Care 23: 9–12
Gibbs, G. (1988) Learning by doing: A guide to teaching and learning methods, Oxford Centre for Staff and Learning Development, Oxford Polytechnic. London: Further Education Unit.
For more of the theory and further reading on the subject the two following books are a very good start:
Reflection in Learning & Professional Development: Theory & Practice. By Jennifer Moon
The Reflective Practitioner [How Professionals Think- in Action] By Donald Schon