Reflection does not just happen; it is a skill, and therefore must
be learnt in order for it to provide us with continual learning
opportunities. If reflection is the window through which we
can focus on self within the context of our experience, we must
develop an understanding of the techniques that guide our
reflection at a practical and critical level. Johns (2000) has
developed ‘the ten Cs of reflection’ (Box 13-2), which he sug-
gests incorporate the essential elements required for reflection.
The presence of each of these elements is essential for
effective reflection. You may wish to use the ten Cs to guide
you in reflecting about a past issue (reflection-on-action) or
to prepare you for future action (reflection-for-action). By
regularly using and becoming familiar with each of the ten
Cs, you should find that they become part of your everyday
reflective practice.
Models of reflection
Within this chapter we will explore three
reflective models
commonly used in nursing and midwifery preparation for prac-
tice and in professional portfolios. These models have many
commonalities but vary in complexity, from the simplicity of
the Gibbs model, through Johns’ model for structured reflec-
tion to the more complex Mezirow model used for critical
reflection. The Gibbs and Johns models are discussed below.
The Mezirow model is discussed opposite.
Unit III Thoughtful practice and the process of care
244
Gibbs’ reflective cycle
The reflective cycle developed by Gibbs (1988) is a basic
model for reflecting on clinical practice. It is easy to apply to
a range of situations and asks individuals to construct their
stories through the use of critical questions at each stage of
the cycle. This is a good model for those who are new to
using reflection as a mechanism for learning about self and
practice. See Figure 13-3 for an illustration of this model.
Think of a recent situation that would be useful for
you to reflect on. Consider the key elements that occurred.
Follow the steps of Gibbs’ cycle by asking yourself each of
the questions shown. Try to answer openly and honestly,
and document your answers. What did you learn about
the situation, the context, the people involved, your
actions and inactions, your emotions, the contradictions
between desired and actual practice, and any conflict that
arose for you (or others)? Have you developed any new
insights about yourself or others? Have you related your
present experience with past experiences and any future
experiences you may have? What have you learnt
about yourself and/or about your practice?
Johns’ model for structured reflection
The model for structured reflection (MSR) developed by
Johns (Box 13-3) takes into account the need during reflec-
tion for us to look in (towards self) as well as out (at the
situation itself). Johns (2009) cautions, however, that
although this model, and the previous models, are presented
as a series of logical steps that enable a progression of
thoughts, reflection is not a linear process to be imposed
upon people or situations. In particular, he stresses that
reflection is not a concrete technical activity in which the
situation is made to fit the model; rather, it should be used
creatively to enable the individuals to see themselves in the
context of the situation itself.
BOX 13-2 The ten Cs of reflection
Commitment
Believing that self and practice matter,
accepting responsibility for self, having the openness,
curiosity and willingness to challenge normative ways
of responding to situations.
Contradiction
Exposing and understanding the
contradiction between what is desirable and actual
practice.
Conflict
Harnessing the energy of conflict within
contradiction to become empowered to take
appropriate action.
Challenge and support
Confronting the practitioner’s
normative attitudes, beliefs and actions in ways that
do not threaten the practitioner.
Catharsis
Working through negative feelings.
Creation
Moving beyond self to see and understand
new ways of viewing and responding to practice.
Connection
Connecting to new insights within the
real world of practice, appreciating the temporality of
experience over time.
Caring
Realising desirable practices as everyday
reality.
Congruence
Reflection as a mirror for caring.
Constructing personal knowing in practice
Weaving
personal knowing with relevant extant theory in
constructing knowledge.
Description
What happened?
Feelings
What were you
thinking and feeling?
Evaluation
What was good and bad
about the experience?
Action plan
If it arose again
what would you do?
Conclusion
What else could
you have done?
Analysis
What sense can
you make of
the situation?
Figure 13-3
Gibbs’ reflective cycle (1988)
Source: Johns, 2000.
