EN to SN Conversion Course - Sem 2 – Med & Sur Module – Reflective Diary

Clinical Placement Diary: Students are to keep a diary during their first clinical

placements and submit a 1500 word (+ or – 5%) diary on two clinical placements only.

Submission date of this assignment will be published on the Medical & Surgical

Assignment Guidelines of each respective course intake.

Guidelines for Keeping a Reflecting Diary

Many students find it useful to keep a reflective diary or learning log, but may not really

know what they should look like. The guidelines below emphasise the importance of

paying attention to verbal and non-verbal reactions to the work. They can then assist both

self-learning and use of supervision.

1 Use an A4 notebook

2 Divide each page into two

3 Write up your experience the same day if possible

4 Use right hand side for further reflection/analysis notes

5 Use actual dialogue wherever possible to capture the situation

6 Make a habit of at least writing one experience per day

7 Balance problematic or negative experiences with satisfying or positive

experiences

8 Challenge yourself at least once a day about something that you normally do

without thought / take for granted – ask yourself – ‘why do I do that?’ (ie,

make the normal problematic)

9 Always endeavour to be open and honest with yourself – find the authentic

you to do the writing

Use your reflective diary to:

a) Identify self learning

b) Identify issues that you want to take to supervision (or to other practice

settings) to discuss

c) Identify areas that you want to read up about including both theory and

research findings

Using a Reflective Model

Gibbs Reflective Cycle Gibbs (1988) reflective cycle is fairly straightforward and encourages a clear description of the

situation, analysis of feelings, evaluation of the experience, analysis to make sense of the

experience, conclusion where other options are considered and reflection upon experience to

examine what you would do if the situation arose again. This cycle can be used for your reflective

writing, but if you are using it at level 3 or 4 you need to adjust the cycle so that analysis

permeates through each stage.

Gibbs Reflective Cycle:

Johns (2000) Model for structured Reflection

Johns model for structured reflection can be used as a guide for analysis of a critical

incident or general reflection on experience. This would be useful for more complex

decision making.

Description

What happened?

Action plan

If it arose again what

would you do?

Feelings

What were you

thinking and feeling?

Conclusion

What else could you

have done?

Evaluation

What was good and

bad about the

experience?

Analysis

What sense can

you make of the

situation?

John’s (2000) model of structured reflection:

Looking in

• Find a space to focus on self

• Pay attention to your thoughts and emotions

• Write down those thoughts and emotions that seem significant in realising desirable work.

Looking out

• Write a description of the situation surrounding your thoughts and feelings.

• What issues seem significant?

• Aesthetics What was I trying to achieve?

Why did I respond as I did?

What were the consequences of that for the patient/others/myself?

How were others feeling?

How did I know this?

• Personal Why did I feel the way I did within this situation?

• Ethics Did I act for the best? (ethical mapping)

• What factors (either embodied within me or embedded within the environment) were influencing me?

• Empirics What knowledge did or could have informed me?

• Reflexivity Does this situation connect with previous experiences?

How could I handle this situation better?

What would be the consequences of alternative actions for the patient/others/myself?

How do I now feel about this experience?

Can I support myself and others better as a consequence?

How available am I to work with patients/families and staff to help them meet their needs?

Grid for considering the cue: What internal factors were influencing me?

Expectations from self: · obligation/duty · conscience · beliefs/values Normal practice - felt I had to conform to a certain action Fear of sanction?

Negative attitude towards the patient/family? What factors influenced

my actions?

Time/priorities?

Expectations from others: · in what way? Loyalty to staff versus loyalty to patient/family? Anxious about ensuing conflict?

References:

Burns, S. and Bulman, C. (eds) (2000) Reflective Practice in Nursing. The Growth of the

Professional Practitioner. Blackwell Science.

Johns, C. (1995) Framing learning through reflection within Carper’s ways of knowing in

nursing. Journal of Advanced Nursing, 22, 226-34.

Taylor, B.J. (2000) Reflective Practice A Guide For Nurses and Midwives.

Open University Press Buckingham.