Nursing and the clinical world are full of learning experiences. Although licensed practical nurses (LPN)s undertake formal training and keep skills updated through courses, there is so much more to learning and development. With a wealth of experience to learn from one of the best ways for LPNs to be able to develop in the workplace is to use structured reflection and this article explores how it works.
What is Structured Reflection?
Reflection is a conscious action where someone considers something that either had a positive or challenging action, and if appropriate, how it might be improved or done differently in future. There are several structured models to work through which guide an LPN through a series of actions to consider how they have learned from an incident in clinical practice. Some LPNs can do this alone, whereas others wok in a facilitated group where they challenge and support each other.
What Does Reflection Do?
Reflection enables an LPN to delve deeper into a scenario to think about what they have learned about in a structured manner, so they can move on and develop. Some of the things that structured reflection allow to happen include:
- Constructive criticism of how someone works with colleagues
- Study their own decision-making processes
- Identify learning needs
- Face problematic episodes
- Analyze difficulties and identify gaps in learning
Models of Reflection
There are several theoretical models of reflection which enable an LPN to work systematically through a scenario using a structured framework. These models help the LPN to explore the emotions and feelings, and to consider their learning points. The model developed by Christopher Johns uses a framework set around the esthetics, personal feelings, and reflexivity using Carper’s Knowledge pattern. By asking a series of cues or questions to explore how a nurse feels about a situation, the issue can be explored and produce some constructive learning outcomes.
Gibbs also developed a reflective model used in nursing. With a cycle of questions, Gibbs was able to demonstrate how to reflect from issues in practice. This model is commonly used in nursing but does not have the depth of questioning used in the Johns model.
Types of Reflection
There are several scenarios when an LPN can find themselves reflecting on practice. Johns developed a framework identifying the types of reflection with associated behaviors. Reflection on experience is the situation where an LPN reflects on something after the event with the intention of drawing on insights to move forward. The reflection in action scenario is when someone pauses in a specific situation, so they can reframe the issue and move forward. Another scenario is an internal supervisor, describing how an LPN thinks to themselves when in conversation with others in order to make sense of a situation.
Reflection within the moment is the sense of being aware of what the person is thinking as they reflect. It enables some space to think about what to do next. Finally, mindful practice is the sense of being aware of self and what desirable practice is about. All of these types of reflection are forms used by an LPN but the one used most in the structured reflection situation is reflecting on experience.
How to Reflect on a Scenario
If an LPN is planning to reflect on a scenario, this can be done alone or with a colleague. It is best to find some quiet space where the session is unlikely to be disturbed or overheard as this enables the issue to be explored in depth and in a timely way without feeling rushed. The first stage is telling the story of what happened. This is an outline of the issue, so it can be explored further. Working on this in a structured way the next question to ask is what the person was thinking or feeling at the time. Using open ended questions is very important so that thoughts on an event can be more readily explored.
Asking how the person can make sense of the scenario is the next stage in a reflective cycle. This explores their understanding of the context. Analyzing it requires some thoughtful questioning. Exploring what would have happened if someone had not been there or what would have occurred if something had gone unnoticed are just two types of questions that could be asked at this point. Finding out what could be done differently if this situation arose again is vital. This indicates how a person has learned and moved on from the original scenario.
It is important to journal reflective incidents and keep them in a professional development folder. Scenarios such as dealing with something difficult are common interview questions and having an example in hand is good preparation. It also demonstrates continuous learning from clinical practice.
Reflection done in a structured way is an excellent way for an LPN to learn from experience. By exploring the issue, they are able to find ways of learning and moving forward with a particular scenario, so it is done more effectively the next time.
Did learning about structured reflection to learn from experience interest you? Are you ready to become a licensed practical nurse? Gwinnett Institute in Orlando offers a Practical Nursing diploma program that trains LPN students for positions delivering basic bedside care to patients. The Practical Nursing diploma program provides the didactic and skills training needed to take the NCLEX-PN examination.*
*While Gwinnett Institute provides test preparation and review assistance to college students, it cannot guarantee any college student will be able to take or pass any type of licensure exam. College students must be mindful throughout their entire school training program that licensure is a required pre-requisite for employment as a nurse and to diligently prepare themselves to meet this important requirement.
Contact us today to learn more about becoming a license practical nurse at Gwinnett College.