making

Practice-Based
Learning
work

Reflection on
PRACTICE

A resource commissioned by the Making Practice

Based Learning Work project, an educational
development project funded through FDTL Phase 4
Project Number 174/02 and produced by staff from the
University of Ulster.

www.practicebasedlearning.org
 Author

Patricia McClure

School of Health Sciences, University of Ulster

www.practicebasedlearning.org
 contents

Reflection on Practice

Introduction 02

The Role of Reflective Practice 03

Reflection on Practice
Time for Reflection 05

Pre-requisites for Effective Reflection and Supervision 09

The Process of a Supervision Session 11

Adopting a Mentoring Approach 12

Tensions and Anxieties in Practice Placement 15

Learning for Students & Practice Educators

Appendix 1 16

Appendix 2 17

References 18

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 REFLECTION ON PRACTICE

Introduction

This resource tool has been devised to;

• inform practice educators about the importance of

reflective practice

• prepare practice educators for their role as

facilitators in students/learners’ development of
reflective practice skills

• identify strategies to facilitate students/learners’ to

reflect during supervision sessions

• provide guidelines for the use of reflective diaries

during practice placements.

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 REFLECTION ON PRACTICE

The Role of Reflective Practice

What is reflective practice? Johns describes critical reflection as “ a window through

which the practitioner can view and focus self within the
The general aim of all placements is to promote clinical
context of his/her own lived experience in ways that enable
reasoning and analytical and evaluative abilities in students
him/her to confront, understand and work towards
through reflective practice. Professional bodies incorporate
resolving the contradictions within his/her practice between
the benefits of applying reflective practice for both students
what is desirable and actual practice” (Johns 2000:34).
and health professionals in their learning strategies. The
importance of developing professional practice and of the
To maximise learning through critical reflection we need to
role of supervision to ensure high quality standards of care
contextually locate ourselves within the experience and
is emphasised in such documents as ”A Vision for the
explore available theory, knowledge and experience to
Future” (Department of Health 1993).
understand the experience in different ways. Thus Boyd &
Fales (1983 p.100) claim that critical reflection “is the core
Reflective practice is not a new concept – Boud, Keogh
difference between whether a person repeats the same
and Walker (1985) stated 20 years ago that it features the
experience several times becoming highly proficient at one
individual and his or her experiences, leading to a new
behaviour, or learns from experience in such a way that he
conceptual perspective or understanding. They included
or she is cognitively or affectively changed”. Critical
the element of learning, as well as involvement of the self,

Reflection on Practice
reflection is thus viewed as transformational learning which
to define reflective practice: “Reflection is a forum of
according to Baumgartner (2001) can happen either
response of the learner to experience” (Boud et al. 1985,
gradually or from a sudden or critical incident and alter the
page18).
way people see themselves and their world.

Johns and Freshwater (1998) also described the value of

Daloz (1999) advocated the concept of development. He
reflective practice as a means of learning. There is no doubt
believes in the role of a mentor in guiding the learner on a
that “reflection” is a complex concept that has defied
journey that is affected by their social environment
consensus on definition although some commonalities
including family dynamics and social class. Daloz (2000
exist. It involves the self and is triggered by questioning of
p18) suggests that there are four important conditions in
actions, values and beliefs. An understanding of the
facilitating development which are;
purpose of reflective practice and its components can be
gained by considering some of the definitions provided in
“the presence of the other, reflective discourse, a
the literature. A few useful definitions include the following:
mentoring community and opportunities for committed
action.”
“Reflection is a process of reviewing an experience of
practice in order to describe, analyse, evaluate and so
Schon (1983) suggests that we can engage in reflection in
inform learning about practice” (Reid, 1993 p.305).
one of two ways; either by ‘reflecting on action’, after the
experience, or by ‘reflecting in action’, during the
“Reflective practice is something more than thoughtful
experience. The latter is a more advanced skill while the
practice. It is that form of practice that seeks to
former is the process more likely to be used when teaching
problematise many situations of professional performance
student healthcare professionals.
so that they can become potential learning situations and
so the practitioners can continue to learn, grow and
develop in and through practice” (Jarvis, 1992 p.180).

03
 REFLECTION ON PRACTICE

The Role of Reflective Practice

Becoming A Reflective Practitioner will thus complete the learning cycle and start over again
with a view to refining his/her actions. This is an ongoing
According to the educator Professor David Boud, effective process, so we will never achieve perfection. We will
learning will not occur unless you reflect. To do this, you always find other ways of doing things based on our
must think of a particular moment in time, ponder over it, learning from previous experiences.
go back through it and only then will you gain new insights
into different aspects of that situation. According to Kolb Building up experience is a gradual process. The student
(1984) reflecting is an essential element of learning. This is will develop reflective abilities during the course of their
shown through an experiential learning cycle illustrated learning on placement. Reflection should initially develop in
below. safe environments where mistakes are tolerated. He/she
can then reflect and discuss the decisions that were made
Kolb’s Learning Cycle during their supervision sessions with their practice
educator. Reflection should become integral to these
sessions.
Concrete Experience

Concerned with something When reflecting-on-action, the first step in the process is
that has happened to you or
that you have done. the description of the incident and it is advisable that
Concerned with adopting
your new ideas into practice. student health care practitioners keep a reflective diary (as
memory cannot be relied upon for the detail of events) in
Active Reflective which they record details of incidents that either troubled or
Experimentation
Concerned with reviewing the pleased them, recording details as soon after the event as
Concerned with trying out the event or experience in your
mind and exploring what you possible.
Who is involved in practice education?
new ideas as a result of the
learning from earlier did and how you, and others
experience and reflection. felt about it.

Much attention has been given to the value of recording

Leaving aside for the moment the position of service events and experiences in written form, particularly through
users themselves, Abstract
the main parties involved in the use of reflective diaries and journals (Zubbrizarreta
Conceptualistation
practice education - with
Concerned students,
developing practitioners acting
1999 and Tryssenaar 1995). The exercise of diary writing
an understanding of what
as practice happened
educators, service
by seeking more managers, promotes both the qualities required for reflection, ie. open-
information and forming new
professional bodies, Strategic
ideas about Health Authorities and
ways of doing
mindedness and motivation and also the skills ie. self-
things in the future.
the university. awareness; description and observation; critical analysis
and problem-solving; and synthesis and evaluation
(Richardson & Maltby, 1995).
If you follow this cycle in a clockwise direction with your
student, you will see that after having had an experience
the student has to reflect on what he/she saw or did, by
reviewing the whole situation in his/her mind. This may
be assisted by: looking at it on film, discussing it with
others, thinking abstractly about the event for a while, or
seeking advice or further information.

Eventually the student will probably come up with ideas for

approaching the situation differently next time. He/she will
then try out their ideas to see if they are effective. He/she

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 REFLECTION ON PRACTICE

Time for Relection

For guidance on keeping a reflective diary, please see below Getting Started:
Keeping a Reflective Diary & Reflective Questions. • Set aside time for writing
• Allow time for the sifting of thoughts and ideas
Time For Reflection • Do not worry about style, presentation
• Remember that the aim is to facilitate reflection on
You as a practice educator must make time for reflection so practice
that it becomes part of your and the student’s way of • Find evidence to back-up your thoughts : what
working. Reflection is an integral part of practice and evidence do I have for what I have just written?
students need time to develop this skill. It is not a process
that can be rushed, but neither is it a process that has to Begin by asking:
occur at a particular time. Thus, the student can reflect on • How do I see my role as a healthcare
his/her journey to and from placement, or between visits to professional(purposes and intentions)?
patients/clients or during lunch break. It is a good idea to • Why did I become a healthcare professional?
encourage the student to sum up each day with a reflective • What kind of healthcare professional/practitioner
comment in his/her diary, spending only a few minutes do I think I am?
doing it. If the student knows that you expect them to • What values do I believe in?

Reflection on Practice
reflect on their practice in this structured way, they will be • How do I demonstrate that I am practising in a
more likely to keep and benefit from their reflective diary. way that is consistent with professional values
You may also set them an example by keeping a reflective and codes of conduct?
diary of your own professional practice or indeed your
experiences as a practice educator, thus demonstrating Exercise;
that learning is always ongoing! Reflective Questions

Exercise; The following is a set of questions that could be used to

Keeping A Reflective Diary assist your thinking, perhaps when you are writing up your
reflections on practice in a diary or when you are thinking
Each individual will have a different way of keeping a back over an experience and discussing it with your
reflective diary. There are, however, some general points to practice educator.
reinforce to learners about it.
• What was I aiming for when I did that?
It should be: • What exactly did I do? How would I describe it
• A record which is useful to you precisely?
• A cue to memory • Why did I choose that particular action?
• Honestly written • What theories/models/research informed my
• Enjoyable to you in its production practice?
• What was I trying to achieve?
It can be used: • What did I do next?
• To describe key events in your practice • What were the reasons for doing that?
• To evaluate key events in your practice • How successful was it?
• To engage in focused evaluation of recurring • What criteria am I using to judge success?
themes • What alternatives were there?
• Reflect on what may have become habitual • Could I have dealt with the situation any better?
• Develop and appraise action taken • How would I do it differently next time?

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 REFLECTION ON PRACTICE

Time for Relection

• What do I feel about the whole experience? weeks. I found that using a reflective diary was an excellent
• What knowledge/values/skills were way to clear my mind and ensure a positive, fresh start the
demonstrated? following day. Make time- it’s worth it!
• How did the client feel about it?
• How do I know the client felt like that? Everyone feels under pressure at some point whilst on
• What sense can I make of this in the light of my placement, especially if you are the only student at a
past experience? placement centre. At the end of a stressful and demanding
• Has this changed the way in which I will do things day it is a relief to be able to unload the burdens of the day
in the future? on the pages of your reflective diary before they build up
and become blown out of proportion. Often, when you
Please see students’ accounts of their experiences come to look at the problems you have noted at a later
of keeping a reflective diary during practice date, they are not as bad as they seemed at the time, or
placements in the Case Studies outlined below (Case you have found ways of overcoming these difficulties. I was
Studies 1-3). on my own for both my second year placements and regret
that I did not make use of a reflective diary at this time.
Case Study 1 They would have provided a release for pent up anxiety and
I can remember sitting in my second year placement stress, and perhaps improved my performance throughout
preparation classes, being advised of the benefits of placement.
keeping a reflective diary and thinking…”what a waste of
time!”. In fact, this was a very grave mistake; when will I What is often foremost in a student’s mind during
learn that lecturers know what they are talking about?! I placement is the grade they will be awarded. However,
didn’t use a reflective diary on either of my second year when it comes to completing half-way and final reports, not
placements. At that time I thought the most important thing everyone has the confidence to argue their own case in
was to throw my all into seeing through my placement and terms of their accomplishments and the marks they feel
not waste time on keeping a diary. It wasn’t until my fourth entitled to. I myself tended to be a quiet student, often
year practice educator encouraged me to spend some unaware of my achievements and always lacking the
time recording my thoughts at the end of the day that I confidence to express these in the hope of gaining
realised what I had previously been missing out on. recognition. This is where keeping a reflective diary was of
greatest benefit to me; by noting my capabilities, strengths
If you are anything like me, with university work piling up, a and daily accomplishments every day in my reflective diary
part-time job, family commitments and an all-important I had the evidence I needed to chart a definite upward
social life, you may be thinking ‘I don’t have time’. In actual progression in skills throughout the placement. Although
fact, making fifteen minutes available to note a few things my practice educators never asked to see my reflective
that have happened throughout the day is very therapeutic. diary, I often took it to supervision and allowed them to read
I found that taking a little time out every evening to entries I thought to be important. By doing so, I not only
complete my reflective diary helped me to get the day’s boosted my own self-esteem and confidence, but I also
events in perspective, to focus on any achievements or provided my practice educator with evidence of my
progress I had made that day and also things I had learned developing clinical reflection and skill acquisition.
I would need to improve on. One method I found to be of
great benefit was to make a special note at the end of each
day’s entry; this was usually something I felt I had done
well, or a goal I hoped to achieve throughout the following

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 PRACTICE EDUCATION

Time for Relection

A final note… I spent about 10-15minutes at the end of each day

• Reflective diaries are a private record of experiences completing my diary, and I drew up a simple outline on the
throughout placement and so it is important to use them to computer which my practice educators kept as a template
report thoughts, feelings and opinions rather than merely for future students. I used a text box with ‘date’ and ‘what
the factual events of the day. Only by reporting personal I saw today’ as titles and used a page for each day.
feelings following an event can experiences be built upon
and improved. I really would recommend keeping a reflective diary
throughout placement as it helps you to focus your
• It is important to use your reflective diary to record thoughts about the day and keep note of important things
positive experiences and achievements as well as the not to remember. It is also a useful resource to look back on
so positive ones. A balanced view of what has taken place and remember;
is essential. how different conditions presented in patients;
how the OT process was carried out with these patients;
• Reflective diaries are not just important during how effective that process was;
placement, I kept my reflective diary and think of it to be, what needed to be improved and new/other perspectives
to some extent, rather like a personal ‘Record of on the situation.

Reflection on Practice
Achievement’.
Case Study 3
Case Study 2 If I am being completely honest, I would have to admit that
I did not make use of reflective diaries during my 2nd year before I went on my first practice placement I could not see
placements, and now as a 4th year student looking back, I what the benefit of keeping a reflective diary would be.
can see how it would have been beneficial for me to have However, I did keep a diary from day one. The first couple
kept a reflective diary at that time. During my 4th year of days were really reflections of how I was feeling, what I
placements I kept a reflective diary and found it very useful thought of the place, the people, etc. As time progressed
at the time. It is also a useful resource that I will be able to I started to reflect more on practice – what had gone well
look back upon in my future practice. and what had not. It is strange but when I started to write
down what had happened each day I was able to analyse
My practice educator at the time advised me to complete the events more clearly. I was able to pinpoint possible
this diary, and gave me some basic ideas of the type of factors that had contributed to the outcomes in intervention
content to include in it. I used the reflective diary as a tool that had been achieved. Some of the factors were that I
for recording the type of things I had done during that day. was a novice others were that on occasions more
This included the type of patients I had seen and their preparation was required. One of the benefits of
conditions, and how these conditions presented. Also any cataloguing events in the diary was that I could look back
assessments I may have seen being used that day, or may over the previous weeks and see how I had improved.
have carried out myself, or any treatment I may have
carried out/observed, and also any administration and form It is important to write up the diary everyday – it doesn’t
completion that I may have done. Any visits carried out take long to do. Trying to document events that happened
were also noted and other general notes and points to two or three days previously is difficult and important facets
remember as well. Any particular feelings I may have had can be forgotten. Also make diary entries on placements
regarding activities throughout the day could also be noted. that may not be going as smoothly as you had hoped for.
It helps to make sense of where things may be going
wrong.

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 REFLECTION ON PRACTICE

Time for Relection

Keeping the diary is a useful tool for completing your end checklist. There should be considerable space for
of placement evaluation. You can flick back through it and discussion and all issues must be addressed in a
see what you have been doing over the weeks. It is then constructive way. Bear in mind that there are many ways
easy to transfer this information to the evaluation sheet. of developing reflection as a crucial skill for practice.
The diary is also useful when you come to fill in job
application forms! Again you can scan the diary and select For further information concerning levels of reflecting and
relevant information that can be matched with essential models of reflection refer to Alsop and Ryan (1996), Making
and desirable criteria in the job specification. the Most of Fieldwork Education, chapter 15.

In conclusion, keep your reflective diary up to date. It is a The practice placement is the learning environment in
valuable tool during placement and long after placements which students from the healthcare professions realise their
are completed. goals of integrating theory with the realities of practice and
where they experience and absorb the contradictions and
Recording experiences in reflective diaries has been conflicts of professional practice. It should be within the
incorporated into many healthcare professional courses context of the supervisory relationship that students are
however it is important to note that while individuals can assisted to reflect upon and understand their experiences
complete stages of their reflective process model on their and where they are encouraged to face contradictions and
own “there is a limit to what each of us can achieve inconsistencies within themselves and between themselves
unaided”(Boud, Keogh & Walker, 1985 p.36). Errington and and other aspects of the practice environment. Therefore,
Robertson (1998) emphasised the value of dialogue after the supervisory relationship is pivotal in assisting the
studying how OT practice changed as a result of reflective emergent professional identity of the student/learner as a
practice in a group forum where practitioners were given reflective practitioner.
the opportunity to articulate ideas.
Supervision
Reflective practice could be implemented and encouraged
in a group setting by practitioners and/or students. The relationship between the concepts of clinical
Alternatively it can be implemented within a one-to-one supervision and reflective practice can be viewed in two
forum such as formal supervision. When thinking about the ways. Firstly, clinical supervision can be seen as a
purpose of clinical supervision, it is clear that reflection and legitimate tool in which practitioners engage in reflection.
supervision are inextricably linked(Racey, 2005). Alternatively, reflection can be seen as an essential
component of supervision.
Creating A Reflective Context for the Learner
Students should be given feedback informally throughout
Reflection is an essential element of learning. For reflection the placement, preferably on a daily basis. Students should
to be used to advantage during practice placement, much also have formal supervision once per week. This should
will depend on the kind of experience that you as a practice be arranged at a specific time when the practice educator
educator have had in developing an understanding of and and the student have time and privacy to discuss the
using reflective skills. Reflection is relatively new and many learning experiences of the previous week and decide on
healthcare professionals have not yet been exposed to or action plans for the following week.
had experience in reflection themselves. Guard against
using the framework as if it were a set of instructions or a

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 REFLECTION ON PRACTICE

Pre-requisites for Effective Reflection and Supervision

Key stages of the reflective process Informal Feedback

• an awareness of uncomfortable feelings
and thoughts; Feedback, when given regularly and constructively,
• critical analysis, including attending to feelings; stimulates learning. It may be defined as a form of non-
• development of a new perspective on the situation. judgemental communication that can be both formal and
informal (Henry, 1985). Informal discussions may take place
Pre-requisites for effective reflection and supervision at any time, sometimes several times a day. They are part
of the general process of enabling students to integrate
Pre-requisites for effective supervision and reflective their educational needs with service delivery ensuring that
practice include honesty and openness. Gillings (2000) they understand practice (Alsop and Ryan, 1996). These
states that a commitment to self-enquiry and a readiness discussions usually take place before, during and/or after a
to change practice are important if the individual is to get treatment intervention with a client. Feedback usually takes
the most out of the process. place informally between sessions during refreshment
breaks or while travelling between appointments.
Many authors identify self-awareness as essential to the
reflective process. This implies that the individual needs to Feedback should have the following characteristics:

Reflection on Practice
be well informed/appraised of his/her own character,
including beliefs and values. Many models of reflective • It should be sufficient.
practice also include self-awareness and questioning of • It should be specific.
beliefs, values and attitudes. • It should be timely.
• It should be regular.
The last stage of many models of reflection relates to a • It should be encouraging.
willingness to change practice, where new conceptual • It should be relevant.
perspectives are reached in order to inform practice. If the • It should be reciprocal.
learner is not willing to change practice he/she will not gain • It should not be unexpected by students.
the potential benefits from the process in terms of practice • It should include recommendations
development, advances will not be made and professional for improvement.
practice will not evolve. • It should be provided while the behaviour is still
fresh in the student's memory.
Many of the skills identified as essential for a good • It should relate to behaviours that are remediable.
supervisor are required by the practice educator to guide • It should deal with specific problems rather
the reflective practitioner. A willingness to commit time to than generalisations.
the process and to listen to the learner helps foster a • It should deal with decisions and actions rather
relationship that can bring challenging issues to the fore. than assumed intentions or interpretations.
• It should be based on information which is
There are many similarities between reflective practice and objective by first hand observation.
supervision, therefore learners can make effective use of
reflective practice as a learning tool within the context of
supervision. It is however important that the learner and the
practice educator are committed to the process and have
a shared understanding of the process to make the
experience effective.

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 REFLECTION ON PRACTICE

Pre-requisites for Effective Reflection and Supervision

Formal Supervision REFLECTING ON PRACTICE STUDENT

SUPERVISION FORM
Formal supervision, by contrast, should occur regularly at
prearranged times in a quiet environment free from the To Be Competed Weekly.
distractions of service delivery. Supervision sessions should
last about one hour and form an essential feature of the Date: ___________________ Student:
placement and supervisory process. Alsop and Ryan
(1996) state that formal supervision should be used for four
What has gone well? What has not gone well?
main purposes:

1. reflection, feedback on and dialogue about practice;

2. review of the achievement of learning goals;
3. revision of the learning contract, until the next
supervision session;
4. exploration of practice issues to a deeper level of What does the student see What does the practice
understanding. as his/her learning needs? educator see as the
student’s learning needs?
Therefore, formal supervision is essentially a time for
exploring practice, a time for learning, where the real
objective is facilitating the students' growth. Practice
educators must therefore ensure that they acknowledge
the importance of these sessions and allocate appropriate What has the student learnt What does the practice
from these experiences. educator feel the student
time for them.
What will be done could have learnt? What
differently? could be done differently or
Both the practice educator and the student need to improved?
prepare well for the formal supervision sessions. The
student needs to be encouraged to think through selected
experiences, reviewing them in his/her mind, so that he/she
learns from what happened. The practice educator may See Appendix 1 for copy of form.
guide the discussion, prompting the student and probing
his/her knowledge and understanding, but essentially the The following outline of the process of a formal supervision
student must do the work. Please see the Reflecting on session summarises how learners should prepare for,
Practice Student Supervision Form provided within this participate in and learn from the supervision session.
resource as an example of a tool designed to assist
students in developing reflective skills. The student should
complete this form prior to the supervision session and it
can serve as a stimulus for discussion within the session.

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 REFLECTION ON PRACTICE

The Process of a Supervision Session

The Process of a Supervision Session needs clearly and honestly with the practice educator.
Open discussion allows a practice educator to gain an
Prior to the supervision session the student/learner should: accurate assessment of the level of development at which
the student is functioning.
- review his/her learning contract
- review the work undertaken to date Feedback, both informal and formal, from a practice
- identify and note his/her achievements during educator is an essential feature of supervision but the
that week student must also take responsibility for participating
- review the University's assessment form actively in the supervisory process and for monitoring
- identify his/her further learning needs his/her own performance in practice. Adopting a mentoring
- note any concerns he/she has and topics for partnership can be an effective way of achieving this.
discussion in supervision
- make an agenda.

During the supervision session the student/learner should:

Reflection on Practice
- agree the agenda with the practice educator
- take initiative and participate equally in
the discussion
- review his/her performance to date, expressing
both strengths and limitations
- explore any issues that have given him/her special
cause for concern
- specify particular learning needs which he/she
has identified and prioritise them
- establish which needs might be met and how
- ensure that the learning contract is updated
- give his/her practice educator feedback on the
strengths and limitations of feedback
- agree a course of action for the next few days
- clarify the practice educator’s and his/her own
responsibilities in the action plan

After the supervision session the student/learner should:

- review the session

- make summative notes of the session
- prepare to fulfil the action plan.

Supervision is a multi-faceted concept. It is an educational

process which relies on effective relationships and open
communication between the student and the practice
educator. Good communication enables a student to feel
comfortable about discussing strengths, limitations and

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Adopting a Mentoring Approach

Adopting a Mentoring Approach As part of the mentoring relationship, sessions or meetings

occur which provide an explicit arena for the learner to
The term mentoring/mentorship is interpreted in different articulate what has been occurring in both their
ways across the healthcare professional groups, professional and personal life (Clutterbuck, 1998;
particularly with reference to nursing where the term Megginson & Clutterbuck 1997). These discussions allow
mentorship refers to a very specific role but for the the learner to link actual experiences and the attainment of
purposes of this project we are suggesting that practice particular skills and/or knowledge. In doing this, the learner
educators may wish to adopt a mentoring approach with arguably becomes more acutely in tune with the inherent
their students/learners rather than taking on the full role of complexities of ‘real’ experiences and begins to perceive
being a mentor. and understand situations with heightened awareness
(Sayce et al, 2002).
Mentoring can be characterised in numerous ways but two
leading scholars on the subject, namely David Megginson There is much debate in the literature as to whether an
and David Clutterbuck, (1997) have defined the concept effective mentoring relationship can exist when the mentor
as: is in a position of authority over the mentee. Some theorists
think that a practice educator may be able to adopt the
“Off-line help by one person to another in making mentoring role but if you feel that you can’t, you should
significant transitions in knowledge, work or re- identify a colleague within your practice setting who might
thinking” (1997 : 13) undertake this role.

The above definition raises some important issues about What is Mentoring?
practice-based roles and the manner in which the transfer
of skills and knowledge occurs between an experienced "Mentoring is essentially about helping people to develop
practitioner – the mentor, and a student – the learner. more effectively. It is a relationship designed to build
Firstly, there is the issue of a mentorship being an “off-line” confidence and help the learner take an increasing initiative
relationship. It is most effective that someone who is for his/her own development ".
assuming a mentorship role not be the line manager of the Manchester Metropolitan University
individual they are mentoring, as the line association has
the undeniable pressure for immediate results (Clutterbuck, "Mentoring is a professional relationship within an
1998, Megginson & Clutterbuck, 1997). In contrast the organisation in which an experienced member of staff
mentoring relationship tends more towards giving time and provides support and guidance to assist in the integration
space for taking a wider view of a situation where and career development of a new member of staff”.
significant transitions are taking place. Mentoring is not University of Salford
about merely sponsoring another person’s career, but more
explicitly focussed on a deeper learning or understanding Benefits of introducing a mentoring approach in
of complex situations (Butterworth, 1998; Clutterbuck, practice education:
1998). In addition, issues of trust are paramount to the
“development” of the learner and their acquisition of • reflective practice in the context of leading to
increased skills and knowledge; it is often difficult for an action and development
individual in a position of judgement, such as a practice • integration of learning into the work place
educator, to build a necessary level of trust with the learner. • support for mentees/learners in dealing with the
pressures of work

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 REFLECTION ON PRACTICE

Adopting a Mentoring Approach

• encouragement with the course Benefits to the mentor:

• identification of common problems and successes • makes it necessary to question what we are doing
• individual ownership of the learning process • can learn from mentees
is increased • challenging relationship
• encourages reflective practice
Adopting a mentoring approach with a learner or a student • adds to own personal and professional judgement
during practice placement provides the following benefits • aid to other aspects of job eg appraisal skills
for the mentee and the mentor. • involvement with new courses
• positive effects of being involved in the
Benefits to the mentee: professional development of colleagues
• practical application of knowledge • opportunity to discuss professional issues that
• development of operational skills wouldn't otherwise have found the time to air
• personal development in terms of greater • additional insights into the processes of teaching
confidence and inter-personal skills and learning (because seen from a different
• intellectual development through the sharpening viewpoint)
of analytical abilities • opportunity to examine the basis of own knowledge

Reflection on Practice
• gaining insight into own performance (and the • a fresh perspective on ideas for current and
adequacy thereof) future projects
• overcomes isolation/insularity • enhances organisational reputation
• personal support mechanism • improved job satisfaction
• provides a second opinion • increased peer recognition
• develops networks • increased understanding of learning needs
• advice and encouragement • turning mistakes to profit
• exchange of ideas, focus attention on how ideas • expansion of networks
agree and differ
• provides self-confidence in professional approach The role of the mentor
• opportunity to analyse learning outcomes
• professional development There are two distinct roles that mentors play; one in
• helps newcomers settle in more quickly relation to career functions and the other more concerned
• helps to reflect and examine the principles with the needs, thoughts and feelings of the individual
informing practice mentee. It would be almost impossible for any one person
• learning to cope with the formal and informal to have the ideal personality to fulfil all the roles that a
structure of the organisation mentor may be required to perform, or indeed to possess
• career advice and advancement the vast range of skills that could be attributed to the
• watching and learning from the strategies of others perfect mentor. The aim of this checklist is to show some
• learning to take calculated risks of the roles that mentors have taken on in similar mentoring
• solving and learning from problems (rather than programmes. Above all the mentor should be flexible and
causing concern) responsive to the needs of the mentee.
• handling people

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 REFLECTION ON PRACTICE

Adopting a Mentoring Approach

The role of the mentor might include undertaking the

following roles and tasks:

• An advisor: offering support and guidance

• Providing an objective viewpoint, a stable
point of reference
• An observer: of treatment sessions, preparation etc
• A sounding board: someone to bounce new
ideas around with and to generate new ideas
• Providing an opportunity to reflect
• A counsellor: a sympathetic, non judgemental ear
• A problem solver: to discuss and
consider problems
• A questioner: someone who will challenge ideas
• A supporter: providing encouragement,
reassurance, motivation and building confidence
• Providing feedback
• A coach
• A good listener
• A helper in setting standards
• A task setter
• An information source/resource
• A networker, friend and ally.

www.practicebasedlearning.org
 REFLECTION ON PRACTICE

Tensions and Anxieties in Practice Placement Learning for Students & Practice Educators

Tensions and Anxieties in Practice Placement Quality supervision is a balance between support for the
Learning for Students & Practice Educators student in the new environment and new role, and
appropriate challenge.
Practice placements are generally very enjoyable aspects
of the educational programme for the majority of students A positive student-practice educator relationship is one
and their practice educators. However it must be that is:
acknowledged that during the periods of practice based
learning the students often experience anxiety-provoking • open;
situations and this is sometimes also the case for the • caring;
practice educators (when dealing with the failing student). • mutually meets each other's needs;
Although anxiety may be a positive factor that enhances • honest;
performance, too much anxiety can inhibit student learning • tolerant; and
and supervisor effectiveness. • respectful of each other.

Student anxieties are centred around fitting into a new Dealing with Negative Feedback
unknown environment, getting on with the practice

Reflection on Practice
educator, adapting to the as yet undefined new role, taking Some students who are with practice educators who
responsibility for patient/client progress, coping with the constantly criticise them, are unapproachable and
feeling of being constantly observed and of course passing unsupportive, feel afraid and tense. The student's
the assessment. performance continues to decline in this environment.
These students are unable to ask for the assistance they so
Practice educators can help students deal with the desperately need and are in constant fear of making
anxieties of the practice environment by: mistakes.

• supporting students through the different stages Some ideas for how practice educators should deal with
of the practice placement; problems once they have been identified:
• providing a supportive learning environment;
• encouraging students to use more effective • create an accepting environment in which
coping behaviour; learning can take place;
• role modelling appropriate professional behaviour; • communicate any problems about the student's
• providing clear and realistic expectations; knowledge base, skills, attitudes or behaviours as
• giving honest feedback which provides clear soon as they are identified;
guidelines for improved performance; and • document feedback and give the student a copy;
• using learning contracts. • share your concern with the student and the
university tutor;
• establish measurable objectives for change that
are explicit, overt and observable; and
• remember no matter how appropriate the
supervision, there are some students who need
more time to develop competency.

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 REFLECTION ON PRACTICE

Appendix 1

Reflection on Practice: Student Supervision Form

To Be Competed Weekly.

Date: ___________________ Student:

What has gone well? What has not gone well?

What does the student see as his/her learning What does the practice educator see as the
needs? student’s learning needs?

What has the student learnt from these What does the practice educator feel the student
experiences. What will be done differently? could have learnt? What could be done
differently or improved?

www.practicebasedlearning.org
 REFLECTION ON PRACTICE

Appendix 2

Supervision Session; Action Plan

Action Agreed - Practice Educator;

An Introduction to Practice Education

Action Agreed - Student;

Signed.................................................................... Date....................................

Signed.................................................................... Date....................................

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 REFLECTION ON PRACTICE

References

REFERENCES

Alsop A & Ryan S (1996) Making the most of fieldwork Gillings B (2000) Clinical supervision in reflective practice
education: A practical approach. Stanley Thornes, cited in Burns S & Bulman C, Reflective practice in nursing.
Cheltenham. Blackwell Science, Oxford.

Baumgartner LM (2001) An update on transformational Jarvis P (1992) Reflective practice and nursing. Nurse
learning. New Directions for Adult and Continuing Education Today, 12, 174-181.
Education. No89:15-22. Jossey-Bass, San Francisco.
Johns C & Freshwater D (1998) Transforming nursing
Boud D, Keogh R & Walker D (1985) Reflection: turning through reflective practice. Blackwell Science, London.
experience into learning. Kogan Page, London.
Johns C (2000) Becoming a reflective practitioner.
Boyd E & Fales A (1983) reflective learning: the key to Blackwell Science, Oxford.
learning from experience. Journal of Humanistic
Psychology, 23 (2): 99-117 Kolb DA (1984) experiential learning: Experience as the
source of learning and development. Prentice Hall, New
Butterworth, T., Faugier, J., and Burnard, P., (eds) (1998) Jersey.
Clinical Supervision and Mentorship in Nursing (2nd ed).
Stanley Thornes, Cheltenham Megginson, D., Clutterbuck, D. (eds) (1997). Mentoring in
Action: A Practical Guide for Managers. Kogan Page,
Clutterbuck, D. (1998) Learning Alliances: Tapping into London.
Talent. Institute of Personnel and Development, London.
Racey A (2005) Using reflective practice as a learning tool
Daloz LA (1999) Mentor: Guiding the journey of adult in clinical supervision. Therapy Weekly April 14
learners. Jossey-Bass, San Francisco.
Reid B (1993) ‘But We’re Doing it Already!’ Exploring a
Daloz LA (2000) Transformative learning for the common Response to the Concept of Reflective Practice in Order to
good. Cited in Chapter 4 Mezirow J and associates(eds) Improve its Facilitation, Nurse Education Today, 13: 305-
Learning as transformation: Critical perspectives on a 309.
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Richardson G & Maltby H (1995) reflection on practice:
Department of Health (1993), A Vision for the future: the enhancing student learning. Journal of Advanced Nursing.
nursing midwifery and health visiting contribution to health 22:235-242.
and healthcare. HMSO, London.
Sayce, S., Lewis, A., Swann, P., & Squib, B., (2002) Work
Errington E & Robertson L (1998) Promoting staff Based Learning for the Built Environment: A Literature
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Occupational Therapy 61(11), 497-503.
Schon D (1983) The Reflective Practitioner. Basic Books,
London.

www.practicebasedlearning.org
 REFLECTION ON PRACTICE

References

Tryssenaar J (1999) Interactive journals: an educational

strategy to promote reflection. American Journal of
Occupational Therapy 49 (7), 695-702.

Zubrizarreta J (1999) Teaching portfolios: an effective

strategy for faculty development in occupational therapy.
American Journal of Occupational Therapy 53(1), 51-55.

USEFUL TEXTS

Boud D. Keogh R. Walker D. (1985) Reflection: Turning

experience into learning. Kogan Page, London.

Ghaye T & Lillyman S (1997) Learning Journals & Critical

Incidents:

Reflection on Practice
Reflective practice for Healthcare professionals, Mark Allen,
Salisbury..

Ghaye T & Lillyman S (2000) Reflection: Principles and

Practice for Healthcare Professionals. Quay Books, Dinton.

Jasper M (2003) beginning Reflective Practice. Nelson

Thornes, Cheltenham.

Moon J (1999) Reflection in Learning & Professional

Development. Kogan Page, London.

Moon J (1999) learning Journals: A Handbook for

Academics, Students and Professional Development.
Kogan Page, London.

Redmond B (2004) reflection in Action: Developing

reflective practice in health and social care services.
Ashgate Publications, Aldershot.

Rolfe G Freshwater D Jasper M (2001) Critical Reflection

for Nursing and the Helping Professions: a user’s guide.
Palgrave Macmillan, London.

Schon D (1983) The Reflective Practitioner. Basic Books,

New York.

19
PROJECT AIMS

The Project aims to make practitioners more effective at supporting & supervising students in
the workplace across a range of healthcare disciplines.

The professions involved in the project are:

• Dietetics
• Nursing
• Occupational Therapy
• Physiotherapy
• Radiography

The principal questions to be addressed in this project are:

• What constitutes effective practice in placement education?

• How can effective practice be implemented at organisational, professional and

practitioner levels so as to maximise student learning on placement?

• How can this good practice be developed and embedded in the contexts of health
and social care within a multicultural workforce?

Project Administrator
Telephone: 028 90 368 458
www.practicebasedlearning.org