Learning from the NHS: Why we should adopt reflective practices

Difficult decisions lie ahead in the coming weeks and months, as governments globally try and balance taking care of the health of their citizens and protecting their economies. All of us will face tough calls as we navigate these undoubtedly turbulent waters.

Managers will have to face multiple fronts:

• safeguarding the health and wellbeing of their teams;
• managing risks entailed within business resumption;
• supporting team members to thrive when facing whatever reality awaits;
• navigating the macroeconomic challenges to ensure the survival of their organisations while also evaluating the continually evolving landscape to try and forecast the twists and turns in the road ahead.

At present, the pace and complexity of change can feel unrelenting and overwhelming, however we do not need to look far for inspiration. Given the ongoing healthcare challenges we are facing as a nation, it is our healthcare professionals we can once again turn to for inspiration. Central to the ongoing professional development of our NHS doctors, nurses and other healthcare professionals is the concept of ‘reflective practice’.

What is reflective practice?

Reflective practice relates to what Linda Finlay describes as “learning through and from experience towards gaining new insights of self and practice”. Reflective learning is not simply a matter of thinking about something that has already happened as a retrospective activity; it can and should also be viewed as a predictive activity, a strategy for planning our learning for the future on the basis for what we already know and what we can therefore anticipate, as explained by Melanie Jasper.

Reflection can take place at multiple points in time, in relation to an event.

• Reflection-before-action refers to reflection ahead of time, thinking through a situation in advance (Reed and Proctor’s 1993 book Nurse Education - a Reflective Approach examines this in depth). This can include asking oneself: what may happen? What might be the challenges and what do I need to know or do in order to best prepare?
• Reflection-in-action occurs while working, studying or going about our everyday lives. This includes thinking about what to do next and acting straight away, evaluating events as they occur, asking: is it working out as I expected? Am I dealing with the challenges well? Is there anything I could do, say or think to make the experience successful and what am I learning from this?
• Reflection-on-action relates to thinking about something that has already happened, thinking what one would do differently next time and taking time to reflect upon how practice can be further developed. This can include evaluating one’s insights immediately after an event, while the feelings are still fresh and/or later when one is able to distance ones-self emotionally from an event.
• Reflection-for-action relates to thinking about future actions with the intention of improving or changing a practice.

Why reflect?

As managers there are many benefits that arise from investing one’s time in reflective practice. Reflective practice is a key to professional practice for the following reasons:

Self-awareness

Through engaging in reflective practice, one is able to gain a better understanding of one’s own values and attitudes, through doing so we are able to stand-back in order to evaluate a situation, putting our own views and biases to one side. This allows us to better support our teams, customers and partners, through greater clarity of thought. Even if this means recognising that we are not best placed to meet their needs and must to refer them elsewhere.

Evaluation leads to evolution

By evaluating and developing our practice, we prevent professional stagnation. To continue our professional development as managers, in a situation that is ever changing, it is necessary to critically review our practices and knowledge to recognise areas for growth.  Reflective practice helps us identify actions to help learning, development or improvement of practice as well as greater insight and self-awareness. This ability to step back and evaluate practice helps us to ensure that we remain critical and open, not just relying on the tried and tested ways of doing things.

Enhancing creativity, remaining agility and openness

With the Covid-19 situation changing almost daily, it has never been more important to remain agile in our approach as managers, embracing creativity. It is only through doing so that we can strive for excellence in our professional practice for the benefit of our teams, colleagues and customers.

Creating a space for deep thinking

This helps us be slow to make assumptions. While the pace of change can at times feel unrelenting – with managers often being asked to do more faster and with fewer resources – it is important that we find time and think (even if that sounds like a luxury).

This article was written by two valued members of the CMI community. There’ll be a follow-up article exploring how to actually implement reflective practices in your team, so check back soon.

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