Supporting CSP members to optimise the quality of patient care

CPD habits 03: Reflective Practice

This is the third of 7 information/activity sheets that make up the CPD habits series1.
Reflective practice is designed to:
Provide an easy-to-read explanation of reflection/reflexivity and of how it relates to professional
practice and development
Offer some prompts to help you think critically about the qualities of your reflective practice
Signpost you to resources available via CSPs website that will develop your understanding of
reflection/reflexivity and facilitate the reflective process and its documentation.
Reflective practice highlights the value of reflection as process of critical thinking that is focused on
developing awareness and understanding of oneself as a person/professional and how self shapes
and is shaped by professional practice over time. A powerpoint presentation to accompany this
information sheet is available here2.
Reflective practice: a spiral of learning that connects past, present and future
There are many different ways of defining reflection/reflective practice, but one that might be useful
comes from Dewey, which describes the process of reflection as:
An active persistent & careful consideration of any belief or supposed form of knowledge in the light
of the grounds that support it & the further conclusion to which it tends.
(Dewey 1910. p6)
This description reminds us that reflection is not a new concept3. It is an ongoing systematic process
of critical thinking that produces awareness and a deepening knowledge and understanding of
oneself, of physiotherapy as a practice and a profession, and of how we shape and are shaped by our
professional practice. The reflective cycle is illustrated below:
Doing
Actual
experience
M aking a
j udgem ent

Asking how

Plan act ion using

general principles

O bserve & reflect

on t he experience

Analy sing why

Draw out general
principles & ideas
Reflectiv e practi ce: learning from experi ence (Kolb, 1984)

The CPD Habits series is freely available for members to access/download from the Championing CPD pages of the CSPs
website
2
The presentation could be used to support individual study or peer/group learning sessions. You will find other
powerpoint presentations on a variety of topics available to download/use from the CPD Resources workspace in the CSP
ePortfolio system. Please visit CSP website for information to help you find the CPD Resources workspace.
3
A review of healthcare literature shows reflective practice becoming increasingly prevalent during the 1980s as practice
professions responded to the growing complexity/uncertainty of autonomous professional practice and to the growing
pressure to demonstrate and develop the evidence-base underpinning their practice.

CPD Habits 03: Reflective Practice (March 2015)

Supporting CSP members to optimise the quality of patient care

The process of reflection can be broken down into a series of steps. It is in effect a
cycle of activity that involves deconstructing an experience to build knowledge and understanding of
the 'how' & 'why' of an experience. These analytic stages of the cycle are where there is huge
potential for learning. They are stages that require energy, creativity and a safe space that promotes
interrogation of the knowledge, values and assumptions that underpin our practice. The final stage
of the cycle is where the ideas and learning from the analytic phases are drawn together for testing
out back in practice. And so the cycle continues as an ongoing spiral that generates awareness and
knowledge of self and its impact on practice a process/outcome that is known as reflexivity.
The process of reflection can be exciting - because it has potential to produce learning and new
understandings about self/practice/profession. But it can also be uncomfortable - because it
requires us to attend to our actions/thoughts/feelings and to unpack the knowledge, values and
assumptions that are integral to our personal/physiotherapy practice in order to understand how
these affect our professional behaviour, judgement and practice. It is a critical process that is active
and dynamic, which demands considerable personal investment and generates change in
behaviour, attitude or practice for example.
Recording reflection
While the process of recording reflection may seem a time-consuming luxury, in practice it has
potential to enhance the outcome of reflective practice because:

the process of producing a record can provide a familiar framework/medium for structuring
memories of complex or challenging events/situations associated with professional practice

a recorded account can be reviewed and analysed from multiple perspectives which in turn
deepens knowledge and understanding of the actions/feelings/thoughts and dynamics
present in a particular situation

a recorded account can be re-visited over time which enables the information to be reviewed
in a different light (e.g. with additional experience or knowledge)

it facilitates the development of self-awareness by creating a personal/professional biography

and history.
There are a number of different ways of engaging in/recording reflective practice including:
handwritten text e.g. journaling, use of templates/forms
audio/video recording e.g. using digital recorder on mobile device to record thoughts/peer
reflection
blogging/use of social media an online form of journal keeping that creates possibility for
sharing reflection in real-time with a wider audience
visual records e.g. photographs, drawings, mind-maps, decision-trees.
Consideration should also be given to a number of professional/ethical issues when sharing
reflective accounts of practice in clinical settings4. These issues include:
ensuring confidentiality of any individuals/organisations cited in the account
maintaining the individuals rights (self-respect, self-esteem and personal dignity)
being willing to act on the consequences of sharing the account e.g. documenting the
rationale for changing a physiotherapeutic intervention as a result of peer feedback in the
physiotherapy record, engaging in appropriate reporting processes if sharing account raises
concerns about organisational/individual practices.

See p16 of HCPCs How to complete your professional development profile for information & general advice

CPD Habits 03: Reflective Practice (March 2015)

Supporting CSP members to optimise the quality of patient care

Activity: how do you reflect?5

1. Think about how you would normally respond to an experience (e.g. an unusual situation; meeting
new people; preparing for, and completing a task successfully).
2. Look at the responses listed and record the how often you would respond in that way
(always/usually/rarely/never) with a tick in the appropriate column.
Response to experience
Tend not to reflect much

always

usually

rarely

never

Think about it on my own

Talk about it with someone else
Write it down (e.g. in a diary)
Repeat it as it happened (e.g. replay
conversations)
Focus on things I feel good about
Focus on things I feel bad about
Imagine what I wish had happened
Blame somebody (myself or someone else)
Consider how other people involved felt or were
affected
Identify the essentials of what I read/saw/heard
or of what happened
Identify what aspects are similar to those in
other situations
Identify how to use new realisations
3. Once you have completed the chart, think about how each of your always/usually responses
might:

encourage or discourage your learning and development (e.g. blaming can lead to resentment
or guilt rather than learning);

build your confidence or destroy it (e.g. always focusing on negative aspects of a situation
without learning from it can reduce self-esteem).
4. Use a highlighter pen to mark the responses that you feel would encourage your learning and
development, but that are currently marked as rarely or never. Choose one of those responses
mark it with a star
5. How could you introduce this response into your learning routine? What difference will adopting
this response make?
Remember to record what have learnt about you/your reflective practice from this activity together
with an action plan directed at changing your practice. Log the date you completed the activity, and
store your record, plan and any notes youve made safely in your portfolio. This information will
become part of a larger body of evidence that will allow you to evaluate how you/your practice has
changed over time, and demonstrate the impact of that change on the people who use your service.

Activity is modified from Drew S, Bingham R (2001) The Student Skills Guide. Aldershot; Gower Publishing Ltd.

CPD Habits 03: Reflective Practice (March 2015)

Supporting CSP members to optimise the quality of patient care

Resources
This list is a sample of information and tools about reflective practice that are freely available to you
as CSP members via CSP website.
The FAQs in the CPD pages of the website provides an overview of how to do reflective practice
and links to further information about processes and spaces that facilitate/support reflective
practice in the workplace (e.g. clinical supervision, mentorship and placement education)
If youre looking for examples of the impact of reflection/reflexivity in practice take 5 to have a
critical look at the articles from Karen Middletons In Person series in Frontline. Through these
articles, the reader gets a sense of who Karen is (as a person and as a professional) and of how
knowledge/experiences of physiotherapy shapes her current/future practice (and potentially that of
the person reading the article).
Visit the iCSP Learning & Development network to read a paper drafted by Professor John Cowan &
Dr Clare Kell following their workshop at Physiotherapy UK 2014. The paper encourages the reader
to reflect on their use of reflection and offers a set of prompts to facilitate that.
The CSPs ePortfolio offers members 250Mb of secure online storage and a series of tools designed
to facilitate, structure and record reflective practice. Please visit the ePortfolio page on CSPs
website for a taste of what you will find in your CSP ePortfolio account. To find more about the
reflective templates available in the add new menu in your CSP ePortfolio account, please visit the
text/video guidance published in the help section of the ePortfolio. The CSP ePortfolio also contains
a blogging tool please follow this link for more information.
The video tutorials produced by Championing CPD project 2012-14 will also help you use the CSPs
ePortfolio to support the process of looking backwards (reflection on action) and looking forwards
(reflection for action). Please remember to check the audio settings on your PC/mobile device
before opening the video tutorials. To open the tutorial click the play button, or for best viewing
results click on the MP4 link at the bottom of the tutorial page.
If you prefer to record and store your reflective practice offline (e.g. on a PC/laptop or in a paper
format), or want to experiment using different reflective models, please visit you will find a
collection of downloadable forms available in CPD Syds guide to CPD, reflective practice & portfolio
development in the ePortfolio CPD Resources workspace (Information about the CPD Resources
workspace is available on CSP website).
You will find a wide variety of articles exploring the theory and practice of reflection in
physiotherapy freely available to read/download in Physiotherapy. To access articles exploring
theory and practice of reflection and reflexivity in other professions/disciplines (e.g. nursing, social
work, Occupational Therapy, research) visit the knowledge and evidence service page of the CSP
website to conduct a search.
Recording your learning
A form to help you record and evaluate what you have learnt from working through this
information/activity sheet is available for you to download here. The prompts on the form will help
you log/evidence your own CPD activity, and if you send a copy to [email protected] you
will help other CSP members learn from your experience, and inform the ongoing development of
this resource.

CPD Habits 03: Reflective Practice (March 2015)