Reflective

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Introduction Your guide to reflective practice

What skills underpin successful

Glossary
reflective practice

How to run a reflective

Extra resources
practice session

Creating a reflective
practice culture
Introduction
Reflective practice is a process of thinking clearly, deeply and There is growing evidence of the importance of reflective practice
critically about any aspect of our professional practice. It requires to support a health professional’s mental health and wellbeing.
creating space to reflect on our work. Making a commitment
to reflective practice has long been recognised as essential to
processing the challenges associated with healthcare work.
NSW Health’s Education and Training Institute (HETI) promotes
Reflective Practice as one of the most important skills a health
professional can develop and integrate into clinical supervision:
Reflection is also being viewed as a
way for practitioners to explore the
emotional challenges of nursing and
cope with escalating pressures. It is
being promoted as a form of self-care
– more necessary now than ever due
Reflective practice is an effective to the unprecedented demands of
process to develop self awareness the COVID-19 pandemic. Nurses are
and facilitate changes in professional encouraged to reflect not just for their
behaviour. It is used in all forms of patients’ benefit, but for their own
clinical supervision. Reflection can mental health and wellbeing.
occur before, during or after an event
(Sanders, 2009). When reflection
occurs in supervision, it can be in
relation to reflecting on day-to-
day clinical practice, triggered by a
challenging clinical encounter or in
anticipation of having to manage a
complex situation.

Your guide to What skills underpin How to run a reflective Creating a reflective
reflective practice successful reflective practice practice session practice culture
Reflective practice is well suited to an environment that can have Essential to maintaining worker wellbeing and performance in
high stress and high risk. It can support the achievement of high a healthcare setting is the practice of deliberately engaging our
performance. The excerpt below from AHPRA, published by the reflective capacities. A good metaphor is to think of standing
Medical Indemnity Protection Society highlights this point well: on a balcony and looking upon our own thoughts, behaviours,
attitudes and inferences we make about what is happening. The
goal of reflective practice is to gain insight and promote greater
personal effectiveness. In this sense it has similar benefits to
what workplace coaching offers in terms of providing space to
process our experience.
Safety and exceptional reflection skills are Reflective practice requires a particular set of skills and a
two of the hallmarks of high-performing certain frame of mind or attitude. There are similarities in
disciplines, take aviation and Formula the approach that underpin effective coaching. For example,
1 driving for example. Paradoxically, to coaching helps us understand our responses and reactions to
achieve nearly error-free performance, events. It is also a process where we: consciously unpack our
these professions have to take into experience; explore multiple perspectives; consider options for
consideration that human error is not action; and find a way forward.
only an ever-present concern but also,
an unavoidable peril of the job. The pilots Reflective practice needs to be regular, ongoing and ideally
and drivers have finely tuned the art of become a career-long practice of taking time for self-evaluation,
‘learning by thinking’ and developed a peer reflection and system evaluation and learning. It is not
reflective approach to error management. something we only do whilst being new in our career, such
…World-class performance is the result of as during an internship or under clinical preceptorship. It is
the careful attention that team members an essential process to meet the complex challenges that
place on forecasting, minimising, and constantly arise in the course of our work.
learning from mistakes.

Your guide to What skills underpin How to run a reflective Creating a reflective
reflective practice successful reflective practice practice session practice culture
The benefits of reflective practice are well researched. The CEC provides the following supporting tools and resources to
uplift reflective practice in Patient Safety teams:
They include:
» improved insight Your guide to How to run a reflective
reflective practice: practice session:
» enhanced wellbeing learn about what access tip sheets to
it is and why it guide applying reflective
» higher motivation is important practice
» reduced job turnover
» enriched on-the-job learning.
There has also been a growing recognition of the importance
of reflective practice as an antidote to work-related trauma and
stress that are common risk factors in healthcare work.
The ritual of reflective practice has traditionally been well
established in allied health roles. However, the value and uptake
has been steadily growing across all roles in healthcare. It is
considered equally important regardless of whether a person’s
role interfaces directly or non-directly with patients, consumers
and the public.
Having regular, scheduled, reflective practice time is What knowledge, skills and Create a reflective
particularly important in roles susceptible to vicarious trauma. attitudes underpin successful practice culture:
Vicarious trauma is described as indirect trauma that can reflective practice:
create an enabling
occur when individuals are exposed second-hand to difficult consider what is required for an environment for
scenarios, situations and stories relating to poor patient individual practitioner and/or reflective practice
outcomes.​This makes it a highly relevant and important ritual facilitator of the process to thrive
for Patient Safety Practitioners to adopt given their exposure to
serious adverse events.

Your guide to What skills underpin How to run a reflective Creating a reflective
reflective practice successful reflective practice practice session practice culture
Glossary of terms
Burnout: is a syndrome resulting from chronic workplace stress Mentoring: is an ongoing relationship of mutual trust specifically
that has not been successfully managed. It is characterised by designed to build capability in a person with less experience,
feelings of energy depletion or exhaustion; increased mental drawing on the experience of a mentor.
distance from one’s job; or feelings of negativism or cynicism
related to one’s job; and reduced professional efficacy (World Metacognitive: is the awareness and understanding of one’s own
Health Organization, 2019). thought processes and understanding the patterns behind them.
The term ‘meta’ originates as meaning ‘beyond’ or ‘on top of’.
Coaching: is a collaborative, solution-focused, result-orientated
and systematic process in which the coach facilitates the Moral distress: is a state when one knows the ethically right way
enhancement of work performance, life experience and self- to act but feels powerless to take that action.
directed learning and personal growth of individuals from non- Psychological safety: is the belief you won’t be punished or
clinical populations. (Greene & Grant, 2003). humiliated for speaking up with ideas, questions, concerns
Compassion: the positive feelings of warmth, concern and care or mistakes.
associated with feeling for another person. Compassion has been Preceptorship: is a period of practical experience and training
found to be neurologically rejuvenating (Singer, 2014). in nursing and medicine, that is supervised by an expert
Critical Incident Debrief: a critical incident is determined and or specialist.
defined by the person having the experience. Being supported Professional self: is the way that a person is expected to
following an incident can result in people experiencing less behave in a job that aligns with the duties and standards of that
trauma in the short and long-term (Coughlin et al, 2017). profession such as being objective, accountable, knowledgeable
Debriefing is about building connection, and offering a calm and ethical.
presence for someone to process their experience, reactions,
learnings at their own pace. Protective factors: are proven practices that lower the likelihood
of negative outcomes or that reduce the impact of risk factors.
Empathy fatigue: depletion resulting from identification with the
thoughts, feelings and experiences of another person (Stebnicki, Psychoeducation: a process of assisting people through the
2006). This often arises from extended exposure to a patient’s provision of providing information, facilitating understanding and
trauma, distress and indirectly experiencing their emotional pain encouraging personal responsibility.
and/or physical stress.

Your guide to What skills underpin How to run a reflective Creating a reflective
reflective practice successful reflective practice practice session practice culture
Reflective practice: a continuous dynamic process that involves
thoughtfully, honestly and critically considering all aspects of
professional experience and applying knowledge to practice.
Safe space: a place or environment in which a person can feel
confident they will not be evaluated or exposed to criticism or
judgement.
Self care: the ability to engage in strategies aimed to promote
one’s own health and wellbeing through awareness, self-control
and self-reliance.
Third Space: a process of reflection, resting and resetting as you
move from one situation to another.
Vicarious trauma: the process of cognitive changes due to
indirect exposure to traumatic events that results in disruptions
to personal identity, worldview, and beliefs about trust and safety.
It is a phenomenon of stress resulting from exposure to another’s
trauma rather exposure to the trauma itself (Figley, 1995).
Wellbeing: is how a person feels about themselves, and their
life, that encompasses a holistic expression of physical, mental,
emotional and social factors.

Your guide to What skills underpin How to run a reflective Creating a reflective
reflective practice successful reflective practice practice session practice culture
01 Your guide to
reflective practice
What might patient safety
What is reflective practice?
practitioners reflect on?

Recognising the effective

What does it involve?
of vicarious trauma

Snapshot of research on
Preventing vicarious trauma
reflective practice

Who should host a

A model of Reflective Practice
reflective session?

Why is reflective
What does good practice look like?
practice important?

The value of reflection

in patient safety work
What is reflective practice?
Reflective practice is defined by Schön (1983) as a continuous Reflective practice helps healthcare workers (in clinical and
dynamic process that involves thoughtfully, honestly and critically non-clinical roles) manage the complexity and uncertainty
considering all aspects of professional experience and applying inherent in their day-to-day practice. This is important given
knowledge to practice. the high rates of burnout, turnover, and trauma-related stress
among healthcare workers. It is critical that reflective practice
To reflect critically requires an ability to conceptualise is conducted within a psychologically safe environment and a
and analyse, together with a willingness to examine the network of strong trusting relationships. These factors have been
assumptions underpinning one’s practice, in order to improve it found as key to reflective practice being successful (Osofsky and
(Napier 2006, p.7). Weterhson, 2016).
The underpinning philosophy of reflective practice is that there
is a difference between mechanically doing something in a
work context and thinking in greater depth about whether one’s
approach constituted the best course of action.
Reflection can occur before, during or after an event. It can
help process something that triggered you in the course of your
work. It can also help shape how you anticipate how you might
approach something complex or challenging in the future. It is
fundamentally about increasing our self awareness.
Reflective practice helps practitioners identify their own
motivations, thoughts, feelings, and behaviours. The processing
that occurs by reflecting can enhance our personal insight and
grow our professional practice.

Your guide to What skills underpin How to run a reflective Creating a reflective
reflective practice successful reflective practice practice session practice culture
What does it involve?
Reflection is more than thinking and discussing. It is also about Engaging in reflective practice can include the following modes:
deconstructing, unpacking or pulling things apart to gain a better
» An individual reflecting personally in a journal guided
understanding. It is about seeing connections and appreciating
by key questions to record their experience; which may
different perspectives.
be later discussed with their manager or in a reflective
Reflection can help you to: practice session.
» Recognise and continue good practices » Participating in a one-on-one Reflective Practice session
» Change and improve what is not working well with a trained person; this may be an independently trained
professional or a suitably trained peer or manager. Often
» Challenge practices that are taken for granted referred to as clinical supervision.
» Deliver learning at the point of care
» Participating in a structured group process self-directed by
» Monitor all aspects of practice on an ongoing basis a group of peers or a trained Reflective Practice facilitator or
» Know when you need to find more information session host.

» Let people know when you need support » During clinical teaching where the learner is asked to
think about what they did well, what they could improve
» Uplift a focus on safe, high quality consumer care. and how they would do things next time.

What it isn’t
Reflective practice is a highly personal process with the aim
of learning from experiences in a non-judgmental and safe
space. As such, it is important to distinguish Reflective Practice
from the following processes which have other purposes:
» A critical incident debriefing
» A performance review or disciplinary procedure
» Psychotherapy or counselling
» Preceptorship or mentoring.

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reflective practice successful reflective practice practice session practice culture
Snapshot of research on reflective practice
The benefits of reflective practice have been evaluated over many decades in areas such as health, psychology, education, childcare,
social work, child protection, emergency services and sport. The below provides a snapshot of the many different studies that prove the
positive impact reflective practice has on the wellbeing of the healthcare workforce.

One study by Harrison (2021) of staff in a surgical trauma centre One study found that healthcare workers were over 80% at risk
in the UK found the inclusion of reflective practice helped staff of burnout, compassion fatigue and emotional exhaustion prior
increase their confidence, knowledge and deal constructively with to COVID (Lluch, Galiana, Domenech & Sanso, 2022). This was
the traumatic aspects of the work. The components of reflective then examined further during COVID given the challenges to
practice that were found most impactful were: healthcare worker wellbeing and resilience. An increase in moral
distress was found in some units, which is a state that causes
» Provision of a safe, structured space feelings of guilt, frustration, anger and a sense of injustice when
» Deepening of staff relationships a healthcare worker’s moral codes are compromised. This can
» Sharing and learning together lead to post traumatic stress disorder and depression. Mentally
» Expression of emotions distressed staff have limited capacity to work effectively. They
» Psychoeducation also may be reluctant to speak openly with their managers.
» Improvement in communication. One successful strategy to combat these negative impacts
was the inclusion of a wellbeing champion role who guided
colleagues towards individual wellbeing initiatives and reflective
A study (Curry & Epley, 2022) found a positive impact of
practice focused on positive coping skills and mechanisms
Reflective Practice on healthcare workers’ self-care including:
to amplify positive mindsets. The champions encouraged the
» being better able to care for themselves personally use of reflective diaries to record workers thoughts’, feelings
and professionally and priorities and take personal ownership for their wellbeing.
» having improved emotional health This ensured the engagement in reflective practice sessions
to process the challenges of the job. What was evident is that
» having better satisfaction, sustainability and longevity on
in times of stress, reflective practice becomes more important,
the job
despite a tendency to think there is not enough time for
» developing high standards for their future practice. the practice.
The study suggests that embedding reflective practice into
institutions may help future practitioners deliver better healthcare
whilst caring for themselves.

Your guide to What skills underpin How to run a reflective Creating a reflective
reflective practice successful reflective practice practice session practice culture
Resilient workers have been found to have increased awareness
of their feelings such as anxiety, fear, and grief in challenging
times. This increased awareness can be facilitated through
reflective practice. Staff wellbeing and resilience are strongly
related to each other. A systemic review of resilience interventions
identified that recognition and awareness of the positive thought
process alongside reflective practice can enhance resilience
(Crane, Searle & Kangas, 2022). Through professional reflective
practice, healthcare workers can strengthen their wellbeing by
processing lived feelings, thoughts and behaviours (positive and
negative) and convert these experiences to future resources that
underpin their ‘professional self’.

The ability to engage in reflective practice is enhanced through

the practice of mindfulness defined as being fully present in
the moment, free from distraction or judgement. Mindfulness
has been found to promote the reframing of negative thoughts
and improve compassion for self and others. Reflective practice
that promotes mindfulness practices leads to higher self
care, self soothing and overall wellbeing. Reflective practice
can aid workers’ journey through periods of exhaustion and
disillusionment (British Psychological Society, 2020).

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reflective practice successful reflective practice practice session practice culture
A model of reflective practice
The process of reflective practice involves looking back into the past at a situation, making sense and learning from it. It also involves
looking forward to the future. This can involve: making commitments to strengthen your abilities; uplift standards of work practice; and/or
boost your wellbeing.
The reflective cycle below, adapted from Graham Gibbs Reflective Cycle model (1988), depicts a process which can guide the reflection
practice process. It includes six stages of reflection:

Click on each of the button below to know more

Description

Action 1 Inner
plan experience
6 2

Gibb’s
reflective
cycle
5 3
Learning Evaluation
4

Analysis

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Why is reflective practice important?
Benefits For the broader health system:

The overall aim of reflective practice is to help you thrive in your

» Strengthens patient safety and care
role by positively contributing to your wellbeing, work practices
and performance. Engaging in regular reflective practices has » Contributes to reduced staff turnover, improving staff
numerous benefits for both individual healthcare practitioners recruitment and retention
and the broader health system.
» Improves risk management strategies
For healthcare practitioners: » Promotes quality assurance and the application of
best practice.
» Improves self-awareness and ability to manage emotions,
including reactions to situations, and greater understanding
of triggers
» Fosters higher levels of wellbeing by contributing to and
reducing levels of stress, emotional exhaustion and burnout
» Increases professional discipline, growth and identity
» Strengthens ability to adapt and respond to situations
through the accumulation of insights
» Supports higher levels of job satisfaction
» Enriches on-the-job learning and the development of
new skills
» Acts as an antidote to work-related trauma and stress that
are common risk factors in healthcare delivery.

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reflective practice successful reflective practice practice session practice culture
The value of reflection in patient safety work
Alignment with principles of patient safety work
Reflective practice can support the delivery of the NSW Patient Safety and Clinical Quality Program given reflective practice strongly
aligns to the guiding principles that underpin Patient Safety work. For example, reflective practice directly strengthens a practitioner’s
ability to:

» Process the factors underpinning failures – reflective practice » See the interplay of culture – Reflective practice can assist
strengthens the ability for practitioners to be open-minded patient safety practitioners to gain clarity on the interplay
and aware of their own biases in problem analysis. It also of culture in shaping incidents, risks and failure bringing a
calls upon an ability to make sense of situations, draw clear clearer perspective on the role individuals play versus
conclusions and offer constructive paths forward. failures of the system.
» Identify opportunities for learning – reflective practice can » Prioritise opportunities for action – a reflective practice
help practitioners understand the opportunities for learning at model is inherent toward defining what actions people can
an individual healthcare worker level, team level and systems take to improve a situation in the future.
level. It can help practitioners generate options to shift failure
into learning. » Strengthen teamwork – reflective practice, if skillfully
hosted in a group setting with other patient safety
» Take an action orientation – reflective practice is essentially practitioners or within a multi-disciplinary team, can
about generating insights that can guide action and bring build a culture of trusting relationships. It can also
heightening awareness to distinguish areas of concern at harness insight only available by looking at situations
a systems or cultural level that might be hard to shift in from multiple perspectives.
the short-term versus areas that are more readily able to
be influenced.
» Distinguish accountability – reflective practice can support
identifying the limits of individual accountability and bring
clarity to areas where accountability needs to be held to
create change and action. Reflective practice can also help
create clear delineation and perspective regarding how
accountability for failures is held by practitioners.

Your guide to What skills underpin How to run a reflective Creating a reflective
reflective practice successful reflective practice practice session practice culture
What might patient safety practitioners reflect on?
There are a range of topics and types of events, interactions or situations that patient safety practitioners could use for their
reflective practice. The aim is to select an area that is current, relevant and has enough substance to explore in some depth. Below are
three broad topics that patient safety practitioners may wish to reflect on: boosting and managing wellbeing, strengthening personal
effectiveness and relational skills, and improving work flow and outputs. It’s important to note that reflection areas under each topic
might also have multiple benefits, e.g., those under the personal effectiveness and relational skills section can also boost wellbeing and
improve work flow.

Strengthening personal
Boosting and managing wellbeing Improving work flow and outputs
effectiveness and relational skills

Potential reflection areas: Potential reflection areas: Potential reflection areas:

» The emotional impacts of » Interactions with team members, » The technical application of
reviewing and investigating managers and stakeholders. knowledge or skills.
serious adverse events. » Interactions with individuals new » Provision and communication
» Situations that cause frustration, to you and any dynamics, biases of information, in particular if
irritability, anxiety and distress. that emerged. uncertainty was present.
» Something that presented as a » Handling of conflict and » Management and delivery
challenge which caught you by contentious situations. of reports.
surprise or which you were unsure » Responding to emotional » Organisation and spread of
how to handle. responses/states of others. work-related tasks.
» Something you did that you were » Employing collaboration practices » Activities which generally are
proud of. and influencing strategies. avoided, despite being important
» Types of work that feel fulfilling to undertake.
and/or draining. » Team effectiveness.
» Participation in and/or leadership
of group meetings.

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reflective practice successful reflective practice practice session practice culture
Recognising the effects of vicarious trauma
Vicarious trauma is the emotional residue of working in a system » Intrusive thoughts associated with another’s situation
that deals with pain, vulnerability, loss of life, and suffering. It can or distress
arise when a worker feels their best efforts to assist do not create
an impact. Vicarious trauma can result from repeated exposure » Disturbed sleep, nightmares, racing thoughts
to traumatic situations and witnessing, too often, other people’s » Problems managing personal boundaries
pain. It can be associated with moral distress which arises when
one must act in a way that contradicts his/her personal beliefs » Loss of connection with self and others, loss of a sense of one’s
and values. Moral distress can present as suffering experienced own identity
by a health professional when they know what is the right » Increased time alone, a sense of needing to withdraw
moral decision though are unable to implement this due to a from others
multitude of factors. These factors can relate to other healthcare
providers’ practice or the norms and practices of the institution. » Increased need to control events, outcomes, others
Moral distress in patient safety practitioners can present as
» Loss of pleasure in daily activities.
psychological discomfort from observing serious adverse events
arising as a result of low patient safety standards, dysfunctional If you experience any of these signs it may not necessarily
communication among clinicians, medication errors, and/or mean you are suffering the effects of vicarious trauma. It is
dysfunctional work attitudes. recommended that you talk through the impact of your work
with a supervisor, supportive peers, mentor, reflective practice
The effects of vicarious trauma vary from person to person. For
group, GP or reach out for help through the Employee Assistance
some people, there may be a wide range of signs and symptoms,
Program or other allied health professionals.
while others may experience problems in one area.
Common signs of vicarious trauma include:
» Difficulty leaving work at the end of the day, noticing you can
never leave on time
» Taking on too great a sense of responsibility or feeling you
need to overstep the boundaries of your role
» Frustration, fear, anxiety, irritability

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reflective practice successful reflective practice practice session practice culture
Preventing vicarious trauma
Patient safety practitioners can experience continuous Reflective practice needs to be regularly scheduled into the
exposure to traumatic cases as part of their day-to-day roles. working lives of employees to prevent vicarious trauma. In
Given that context, it is difficult to prevent traumatic exposure. addition, employees could be further supported by providing:
However, regularly scheduling reflective practice can build
coping strategies and promote protective factors, thereby » Reflection time
preventing the manifestation of vicarious trauma in response to » Vicarious trauma training
ongoing exposure.
» Support to take leave or mental health days
Reflective practice is the commonly recommended strategy to
prevent and reduce the impacts of vicarious trauma (Finklestein » Recognition
et al., 2015; Hazen et al., 2020). Through reflective practice, » Appreciation.
individuals are empowered to develop structured strategies
to cope with risks and strengthen protective factors. Active Employees can further manage vicarious trauma outside of their
prevention of vicarious trauma has been demonstrated to day-to-day roles by:
result in increased feelings of gratitude, personal awareness
» Taking time for self-reflection
and resilience in individuals, as well as being linked with
improvements in work attendance, productivity, job satisfaction, » Taking part in self-awareness activities (e.g., meditation,
professional development and retention (Finklestein et al., 2015; community involvement, therapy)
Sansbury et al., 2015; Varwani et al., 2018). Reflective practice
has also been demonstrated to disrupt the link between vicarious » Keeping a journal
trauma and burnout (Hazen et al., 2020). » Joining a support group.

Your guide to What skills underpin How to run a reflective Creating a reflective
reflective practice successful reflective practice practice session practice culture
Who should host a reflective session?
Reflective practice can be undertaken by an individual on their » Building a psychologically safe space for the participant/s to
own to sharpen their internal reflection skills. There are also share their thoughts
significant benefits to participating in one-on-one or group » Employing empathic listening
reflection sessions facilitated by a trained reflective practice host. » Coaching the participant/s without using judgement, directing
To host reflective sessions effectively requires a specific set of or providing counsel.
knowledge, skills and attitudes. Training in coaching skills and
experience in hosting coaching sessions provides a foundation A person’s work history can mean they have behaviours and habits
that can build reflective practice capabilities. that are not always conducive to Reflective Practice such as:
The gold standard for hosting reflective practice is that the » Working in crisis mode and feeling impatient with
person is independent and not someone’s direct line manager. The deeper reflection
independence supports people feeling safe to share concerns » Action orientation with little time to unpack the assumptions
and failures without the fear of being judged, evaluated and and/or interpretations associated with one’s experience
having any negative perceptions formed about their performance. » Lack of psychological safety and admitting mistakes
If a person has built skills in reflective practice, they may be
» Feeling the need to jump quickly to solve problems
able to consciously step into a host role with one of their direct
reports present, only if the direct report feels safe to do so. » Taking a position of telling people what to do.
Both the session host and individual practitioner need to be A reflective practice host should take the above considerations
aware of the importance of creating a safe space and managing into account. Hosts most suited to facilitate reflective practice
power imbalances. A core principle of the reflective process is sessions include:
to ensure reflection can happen without fear of any negative
consequence. This is why an independent relationship is often the » Independently professionally trained reflective practice
recommended option. supervisors (often referred to clinical supervisors in
allied health)
Overall, the role of the reflective session host includes:
» Peers who are trained in reflective practice
» Hosting the reflection process using a structured approach » Trained coaches
» Facilitators skilled in group process.

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reflective practice successful reflective practice practice session practice culture
What does good practice look like?
The following touchstones are offered to assist with shaping a quality reflective practice session. Both participants and hosts have a joint
responsibility to integrate the following touchstones into a reflective practice session.
Note: A reflective practice host has limited confidentiality and may be required to disclose information raised in a session if it falls within
their mandatory reporting responsibilities or when professional misconduct is identified (as defined by APHRA or their professional body).
This limit to confidentiality should be raised at the start of all reflective practice sessions by the host.

As an individual practitioner As a reflective practice session host

» Mentally prepare for a session and adopt an open and » Create a welcoming space that is physically accessible
reflective mindset. and comfortable.

» Show courage and vulnerability to uncover deeper insights. » Limit distractions (turn phones off).

» See emotions and feelings as holding important information. » Use open questions to surface assumptions and interpretations
without judgement.
» Challenge your own assumptions.
» Recognise when a practitioner needs a level of support or
» Show accountability for your own reflections. psychological intervention and may require a referral.
» Reflect on the outcomes from a session to enhance » Promote and keep confidentiality at all times.
growth in future sessions.
» Continually reflect and build skills to strengthen your role as a host.
» Speak your truth –share and explore exactly what is on
your mind. » Create a psychologically safe space making it safe to share failure.

» Objectively observe own behaviours, feelings, thoughts, skills, » Build trust through empathic listening.
attitudes and biases.
» Model curiosity and ask powerful, open questions.
» Suspend critical judgement or self doubt.
» Enter the session focused on the process without an agenda to fix
» Trust the process and take your time. Pause regularly and notice anything or anyone.
what is being surfaced.
» Mirror back content using people’s own language where possible.
» Follow through with action plans and commitments.
» Guide people through the steps in the process moving participants
» Make reflective practice a daily and ongoing practice. through sensemaking toward clarity.

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reflective practice successful reflective practice practice session practice culture
02
What skills underpin
successful reflective
practice
Individual practitioner core Session host core capabilities to
capabilities for reflective practice support reflective practice

Techniques to develop Techniques to develop reflective

reflective capability practice hosting capability
Individual practitioner core capabilities for reflective practice
The following core capabilities are required of an individual to successfully engage in reflective practice:

Adopt a learning and growth mindset Demonstrate self-awareness Engage in critical thinking

Believes that one’s skills and capacity can be Ability to see oneself objectively and clearly: Objectively evaluates a situation or action to
improved over time: form sound judgement:
» Takes note of how one feels and acts
» Embraces challenges in a situation » Looks into the factors behind a
process or action
» Seeks and accepts feedback » Describes the emotion or rationale behind
an action. » Gathers evidence and proof to supplement
» Learns from setbacks and failures. an idea.

Consider multiple perspectives Build emotional resilience Apply insights

Looks at the different angles of how one Ability to adapt to stressful situations: Able to apply insights to future situations:
might perceive a situation:
» Acknowledges and processes one’s » Adopts a learning orientation
» Embraces challenges emotions in the present
» Considers continuous improvement options
» Seeks and accepts feedback » Able to work toward a goal despite set backs
» Openness to experiment and prototype
» Learns from setbacks and failures. » Believes they have agency despite the different actions.
stressors they face.

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Techniques to develop reflective capability
Activities that help one develop the skills required to be adept at reflective practice:

Journaling is a great exercise for individuals to record their In-action reflection is the process of being present in the moment
thinking and feelings about their experiences at work. The and synthesising the current action being done, the available
entries can range from your interactions with people critical to information and critically responding as the situation unfolds.
performing your role, reactions to stress events or scenarios, or In-Action Reflection assists you to respond with curiosity and
perspectives on the outcomes or barriers to progress associated learning on-the-job and in the flow of work. It encourages you
with your work. The act of writing it out can help you make to build your reflective muscle and develop more constructive
sense of your experience and help you unpack any adverse thinking styles in response to live stressors.
feelings. It can help you understand how to better improve your
practice or shift your perceptions to ones that are more helpful. Ritualised reflection at work is the process of normalising
Sharing insights from your journal in a reflective practice session reflection while at work by preparing the environment to promote
(if applicable) is also a great opportunity to further process reflective practice. This can be done through:
information, share learning and gain different perspectives on » Having designated spaces for reflection.
the situation.
» Designing and displaying symbols that prompt reflection
On-action reflection is the process of stepping back from a (pictures, a quote, articles, a question of the day) throughout
situation and reflecting on past scenarios, events and exploring the day.
why you and others might have responded a certain way. It is
assessing how the situation unfolded, what responses were » Designating time in team meetings for group reflection.
chosen and how the result came about. After consideration and » Assigning time at the start/end of each shift for individual
discussion, a commitment is made to amend or continue the reflection to check-in/out of work.
action. The Gibbs Reflection Cycle assists with this reflection.
» Starting a conversation about the effectiveness of processes,
looking for small improvements in day-to-day activities.

Your guide to What skills underpin How to run a reflective Creating a reflective
reflective practice successful reflective practice practice session practice culture
Session host core capabilities to support reflective practice
The following core capabilities are foundational for successfully hosting a reflective practice session:

Demonstrate self-awareness Act as a role model Deliver powerful questioning

Demonstrates an ability to see oneself Shows the qualities of reflective practice Asks questions that surface assumptions,
objectively and clearly: rather than talks about it: beliefs and biases:

» Takes note of how one feels and acts in » Demonstrates deep listening and clearly » Asks questions that help practitioners
a situation reflects back what is heard process their inner experience and move
through the reflective practice cycle
» Describes the emotion or rationale behind » Shares openly and appropriately the
an action. impacts of other’s difficulties on them. » Evokes discovery, insights, commitment
and action through the questioning.

Create a safe space Surface underlying patterns Identify vicarious trauma signs

Creates a hospitable environment conducive Notices and brings to the surface underlying Recognises the symptoms of vicarious trauma
to reflection: feelings, thoughts and unconscious patterns as the brain’s way of coping:

» Builds psychological safety so people can » Be curious about taken for » Gently surfaces intrusive reactions (e.g., feeling
share their fears, failures, vulnerabilities granted experiences irritable, hopeless, doubting one’s abilities)

» Holds space for whatever comes up » Unearths unseen patterns to support » Probes for avoidant reactions (e.g., numbing,
(without shame or avoidance) without trying growth and learning. cutting off) or hyper-arousal reactions (e.g.,
to fix or judge. difficulty concentrating, retaining information).

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Techniques to develop reflective practice hosting capability
Activities that help one develop the capabilities required to be adept at hosting reflective practice sessions:

Grow your self awareness Be a participant in reflective practice sessions

1. Ask for feedback » One of the most powerful ways to grow your skills to host is to
Then you can adjust the perceptions you have about the impact of regularly be a participant in reflective practice sessions with a
your approach on others to align with other’s experience of you. trained reflective practice host. The more experience you have
reflecting upon and making sense of experiences and processes
2. Self reflect behind them, the more you will grow your confidence to host
Keep a journal to develop your own reflective skills and gain sessions for others.
confidence in reflecting. Ask yourself a series of questions about
your motivation to host reflective practice sessions and the » Participation can include engaging in professional clinical
strengths and weaknesses you might bring to that role. supervision with a training person who holds 1:1 or group sessions
that are founded on reflective practice principles.
3. Complete assessments
Psychometric tests (such as strengths or personality assessments) Grow your coaching skills
can give you insight into your patterns of thinking and behaving » The core capability of hosting is the ability to ask quality questions
that define your characteristics and traits. Knowing your style of that facilitate reflection. Growing this capability can be facilitated by
approaching situations, and realising there are individual differences growing your coaching skills.
can support your hosting capability.
» There are various resources and courses available to facilitate you
4. Cultivate mindfulness growing your coaching skills. You could speak to a Learning and
When mindfulness is practised, behaviour becomes more Development specialist to assist you.
intentional, and increased self-awareness develops. Mindfulness
practice can include meditation, walking in nature, breath work, Learn the art of holding space
physical movement. There are various methodologies that are well documented to support
Read, listen, watch what is referred to as the art of hosting or the art of holding space. For
example Heather Plett has written on the Art of Holding Space and
» We live in an age where we have an enormous amount of quality defines it as a “practice of compassionately witnessing, accepting and
information at our disposal to support our learning and growth. supporting someone without judgement while retaining your boundaries
You can continue to grow your capabilities by reading on the topic, and sense of self.”
regularly listening to podcasts or watching talks by leaders in the
field. This learning can include topics such exploring resources put
out on trauma by Phoenix Australia.

Your guide to What skills underpin How to run a reflective Creating a reflective
reflective practice successful reflective practice practice session practice culture
03 How to run a reflective
practice session
Step-by-step guide #1: Applying the Step-by-Step guide #4:
6 stages of reflective practice Reflective practice session guide

Step-by-step guide #2:

Tip sheets
Hosting 1:1 sessions

Step-by-step guide #3:

Hosting group/peer sessions
Step-by-step guide #1:
Applying the 6 stages of reflective practice
A guide to host patient safety practitioners through the six stages of reflective practice. It should be noted that not all sessions will result
in going through all the six steps. The steps should not be treated as a check list to work through. It may be enough for a person to do the
first three steps in one session.

Click on each of the button below to know more

Description

Action 1 Inner
plan experience
6 2

Gibb’s
reflective
cycle
5 3
Learning Evaluation
4

Analysis

Your guide to What skills underpin How to run a reflective Creating a reflective
reflective practice successful reflective practice practice session practice culture
Step-by-step guide #1:
Applying the 6 stages of reflective practice

Click on each of the button below to know more

Description

Action 1 Inner
plan experience
6 2

Gibb’s
reflective
cycle
5 3
Learning Evaluation
4

Analysis

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Step-by-step guide #2: Hosting 1:1 sessions

Click the buttons on

Set up Reflect Clarify the left to reveal more

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Step-by-step guide #2: Hosting 1:1 sessions

Set up Reflect Clarify

Consider your ‘plan to understand’; Create a shared understanding; take an Commitments, progress and next steps
ways to share power; and the impact empowered coaching approach; and
you can make create a way forward through conversation

Your intention How you will build a shared understanding How you will wrap up with intent

Your approach to ensuring a safe space, balancing

power and multiple perspective taking

How you will create a way forward Other notes:

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Step-by-step guide #3: Hosting group/peer sessions

Opening the session

During the session

Closing the session

Click the buttons to

reveal more

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Step-by-step guide #3: Hosting group/peer sessions

Opening the session During the session Closing the session

» Set expectations » Be flexible » Summarise what the group has discovered:
» Emphasise the power of confidentiality in » Share your own experience » Offer your own narrative
building safety
» Don’t over plan » Reiterate confidentiality.
» No “right” or “wrong” reflections
» Prioritise new questions.
» All voices are valuable
» Explain your role.

How will you set up the session for success? What might you share from your experience? What What might you do during the session to ensure you
personal strengths might you look at leveraging to can close the session well?
facilitate discussion?

Your guide to What skills underpin How to run a reflective Creating a reflective
reflective practice successful reflective practice practice session practice culture
Step-by-step guide #4: Hosting group/peer sessions
This tip sheet is used to guide the structure of a reflective practice session.

Clarify the
Check-in session focus
» Keep your session simple and focused on the
(5mins) (5mins)
practice of reflection.
» If the session is too complicated or layered people
lose the primary focus which is to reflect together.
» The sessions ideally should include a positive tone
in the check and in the consolidation of learning.
» Think about using a timer that has a nice sound Facilitate the
(e.g., calming music or sound bowls) to indicate it Consolidate
reflective
is time to move along the process. Of course, use learning
practice cycle
judgement as to when to move through the process (7mins)
depending on the pacing of the group. However, (40mins)
people will feel more held if the person hosting the
session is conscious of time.
» Encourage people to keep their own notes. Given
the nature of reflection it is the responsibility
of the person deciding to take actions to keep
track of their own accountabilities. However, it is
recommended that the person hosting the session Confirm next
record high level commitments. session
(3mins)

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Step-by-step guide #4: Reflective practice template example
This tip sheet is used to guide the structure of a reflective practice session.

Description Describe as a matter of fact what happened during your critical incident or chosen episode for reflection.

Feelings What were you thinking and feeling at the time?

Evaluation List the points or tell the story about what was good and what was bad about the experience.

Analysis What sense can you make out of the situation? What does it mean?

Conclusion What else would you have done? What should you perhaps not have done?

Action plan If it arose again, what would you do differently? How will you adapt your practice in light of this new understanding?

Your guide to What skills underpin How to run a reflective Creating a reflective
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List of tip sheets
Each button below redirects to a tip sheet. They will open in a separate PDF file.

Key qualities to build a

Considering multiple perspectives
reflective practice mindset

Creating reflective space Building a shared understanding

Getting in-sync Re-setting our state

Empathic listening Emotional regulation

Asking impactful questions Positive reframing to shift mindset

Question bank

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04 Creating a reflective
practice culture
Building a reflective practice
learning community

Signposts of a reflective culture

Building a reflective practice

organisation culture
Building a reflective practice learning community
Below are some strategies for building a learning community with a culture of reflective practice.

Reflective journals

Mentor network

Reflective practice board

Professional
learning experiences

Action research

Meetings

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reflective practice successful reflective practice practice session practice culture
Signposts of a reflective culture

» Reflective supervision is included in role descriptions.

» Capacity to host reflective practice sessions is considered essential in leadership roles.
» Individuals and teams are allowed to dedicate work time to learning; moreover, this is celebrated.
» Reflective practice is integrated into supervision sessions.
» Reflective practice sessions are valued, supported and well-resourced.
» All staff members, including the most senior, participate in reflective practice sessions and professional
development.
» Reflective questioning is included in regular meetings and discussions on the job.
» The emotional impact of work is recognised and effective processes are in place to mitigate this.
» Reviews of mistakes, particularly after trying new things, are seen as an opportunity for learning, not a way of
finding scapegoats.
» There are opportunities for ongoing feedback, including immediate feedback close to an event and between
the levels of the organisation.
» There is room for professional autonomy and discretion in practice.
» There are metrics in place to assess that reflective practice sessions are conducted regularly.
» There is vision for the role of reflective practice in promoting wellbeing that is formally captured in a plan.
» Professional development strengthens the capabilities that enable successful reflective practice.

Your guide to What skills underpin How to run a reflective Creating a reflective
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Building a reflective practice organisation culture
Culture building happens in phases and needs sustained focus and effort, led by key champions with the influence and authority to
promote new ways of doing things.

Phase 1 Phase 2 Phase 3

1. Conduct an education campaign » Develop a register of endorsed » Reinforce the commitment to

to raise awareness of the value of reflective practice hosts to facilitate reflective practice through
reflective practice (and what’s in it peer group reflective practice accountability mechanisms that
for me) sessions track level of reflective practice
sessions hosted
2. Create a burning platform of the » Build reflective practice touch points
importance of conducting regular within the employee lifecycle to » Grow workforce’s capacity to engage
reflective practice e.g. align to new uplift normalising the inclusion of with self-directed reflective practice
Safework legislation reflective practice into “the way we
do things around here”. Example: » Celebrate examples of successful
3. Gain senior leader commitment to practice.
champion the value of investing in – Build Reflective Practice
reflective practice education component into
employee induction
4. Deliver capacity building training
and coaching sessions to build – Develop minimum standards for
reflective practice capabilities. the number of reflective practice
sessions per annum
– Include capability building into
learning development cycle.

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reflective practice successful reflective practice practice session practice culture
05
Extra resources
Self Care Grid
Self care grid
During reflective practice, if you recognise signs of burnout (e.g., exhaustion, cynicism and reduced personal efficacy), or vicarious
trauma (e.g., frustration, fear, irritability, loss of connection with self and others), consider using the self care grid to identify factors
that energise the individual, and those that demotivate them. Use this tool to inform conversations around strategies to help increase
motivating behaviours, whilst minimising energy depleting behaviours.

Physically Emotionally Mentally Spiritually

What currently
energises me?

What saps my energy?

What would help to

energise me more?

What holds me back

from doing things
that would help to
energise me more?

Some examples of what you might enter into each column:

Physical: Eating Drinking, Sleeping, Exercise, Breaks, Relaxation Spiritual: Commitment, Values, A deeper purpose, Prayer/
meditation, Giving to others, Nature, Stillness
Emotional: Relationships, Intimacy, Empathy, Processing emotions, Balance, Safety
Mental: Time management, Creativity, Thinking skills, Challenge, Mental preparation, Reflection

Your guide to What skills underpin How to run a reflective Creating a reflective
reflective practice successful reflective practice practice session practice culture
Level 3, 1 Reserve Road
St Leonards NSW 2065
Version 1.0 | 12 October 2022 | SHPN xxxx