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Reflective Practice

Stages of reflection

Models and stages of reflection

There are many different models of reflection – you will find some examples in this guide. Although the structure and format of these models may vary, they share many common features.

Reflection usually begins with a description of what has happened. This ‘sets the scene’.  It is important at this stage to identify exactly what the key elements are – what makes this an incident worthy of reflection? This starting point relates to a low or superficial level of reflection.  

Very often a negative or uncomfortable situation (a ‘critical incident’) prompts reflection. We learn from our mistakes is certainly true! However, positive experiences can also provoke reflection – it can be very powerful to reflect on what worked, in order to reproduce that again!

The next stages of reflection require you to relate what you already know to the situation – how is theory relevant? Awareness of your own feelings, assumptions and lack of knowledge should also be recognised and challenged – what did you bring to the situation that had an impact? What didn’t you bring (knowledge, openness) that may have made the situation different? Making sense of all of these factors allows you to recognise what has been learnt and what changes you should make for future situations.

The final stage of reflection is one of change – for example, of how you see yourself, how you see others, your beliefs, your values, your views and/or opinions. It is the deepest level of reflection.

 See some models for reflective practice that you might find helpful here.

Reflective practice in action

Types of reflection

Reflection-in-action and Reflection-on-action

Two main types of reflection are often referred to – reflection-in-action and reflection-on-action. The most obvious difference is in terms of when they happen.

Reflection-in-action

This is the reflection that takes place whilst you are involved in the situation, often a patient interaction. Reflection-in-action involves using analysis of observation, listening and/or touch or ‘feel’ to problem solve. It therefore sounds a lot like clinical reasoning – where reflection differs is that the problem solving leads to a change in the practitioner’s view of self, values and beliefs. 

It is like ‘thinking on your feet’ but the focus is on gaining a new perspective, rather than just solving the problem.

Because it is happening on the spot, this type of reflection often appears very intuitive. It can take some time to develop the skills of reflection-in-action – it often is a skill associated with the development of expert practice.

 Reflection-on-action

This type of reflection involves a stepping back from the situation, meaning that it happens at some time after the situation has occurred. Therefore it demands a time commitment – something that is often a challenge. Despite this, it has an important place in professional development.

“Routine treatments, based on implicit theories, may have the advantage of being easy to operate in practice, giving physiotherapists confidence and feelings of control. However, they may be based on assumptions, ideas and beliefs regarding practice that have gone unchallenged and as such, demonstrate a lack of clinical competence… There is a need to make professional and personal knowledge accessible for reflection, testing and dissemination”. 

(Donaghy & Morss, 2000, p. 7) 

Donaghy, M. E., & Morss, K. T. I. (2000). Guided reflection: A framework to facilitate and assess reflective practice within the discipline of physiotherapy. Physiotherapy Theory and Practice,16(1), 3-14.  

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