Self-Reflection: A Tool of Growth for Any Clinician

Clinicians are constantly looking for ways to grow and improve their skills. They attend continuing education courses and presentations to gather insight and knowledge on their ever-changing fields, improving and growing the clinicians’ skill set.

Clinicians strive to grow and help their clients improve, but it is important to invest in themselves to continually grow and strengthen their skills. Self-reflection is a tool that clinicians can use to achieve this, by critically thinking and analyzing their sessions. Reflective practice is the term used to describe the journey. 

What is Reflective Practice?

According to BrightKnowledge.org, a guide for careers, education, and student life, “Reflective practice is a way of studying your own experiences to improve the way you work”. This practice is essential for clinicians that want to continually develop strong skills. 

Reflective practice can be something that is done individually or as a shared task. A clinician can individually reflect on their sessions and analyze them to gain better insight into themselves. If a clinician has a mentor, the clinician can include the mentor in the reflective process and bounce ideas off of them. If the mentor is observing the session, both can reflect on the session using the process discussed below and can compare and discuss their findings and make goals together. This can be a great supervisory tool for a Clinical Fellow Mentor or a supervisor that already observes sessions. This can be a great resource to guide discussions and provide constructive feedback about the observed sessions and also requires the clinician to reflect on themselves as well. If a mentor or supervisor is not available, start the journey with a coworker and have open discussions about the findings. 

This is not just something for new clinicians, but also for veteran clinicians who have been in the field for multiple years. Due to the nature that every session/client is different and exceptional situations arise every day, reflective practice is beneficial for everyone. Clinicians embark on a journey of lifelong learning and this is just another way to enhance that experience. 

What are the benefits?

Reflective practice comes with many benefits. It can increase self-awareness, develop better critical thinking skills, improve and develop self-confidence, and gain insight into weaknesses and development areas. Improving all of these skills in turn improves the sessions for clients. Sessions do not always go as planned, so the more a clinician focuses and reflects on the sessions, the more prepared they will be next time when the same situation arises. Also, if they make goals to improve the “weaker” part of your sessions, then those aspects will be stronger the next time. This all will improve the entire experience for the client as well. 

Improving and developing self-confidence is a vital skill to have as a clinician. Most of the time, clinicians are very hard on themselves and only focus on the mistakes that they have made in the session. Reflective practice allows the clinician to celebrate the victories and successes in the session as well. Sometimes, without reflecting on the session, a clinician might have missed the things that went well and can only focus on the negative aspects, which in turn would only hurt the clinician’s confidence. It is always important to see the positives and celebrate even the smallest victories. 

Models of Reflection 

(Information gathered and adapted from various resources- see reference list at the end of the article)

There are several models of reflective practice to guide reflection to ensure a thorough reflection of the event. The one that will be discussed here is the Gibbs reflective cycle because it does a nice job breaking down the reflective practice and establishing a plan for next time. It is very important to continue the cycle and learn from the reflections. 

The steps of the Gibbs reflective cycle are as follows:

1. Description- what happened?
2. Feelings- how do you feel about the session?
3. Evaluation- what were the positives and negatives?
4. Analysis- what sense can you make of it? This is where you connect the reflection to the research. 
5. Conclusion- what else could you have done?
6. Action Plan- what will you do next time?

Below are some questions that a clinician can answer for each step to guide the reflection.

Description: What went on during the session? What goals were targeted? What materials were used? What strategies were utilized during the session? Was anything new trialed during the session? How was the student’s behavior during the session? 

Feelings: What is your overall feeling about how the session went? How did you initially feel when the session was over?

Evaluation: What went well doing the session? What were the clinical strengths of the session? What strategies worked for the client? What didn’t go so well? What were the clinical weaknesses or difficulties in the session? What strategies were trialed and didn’t work for the client?

Analysis: Why were certain strategies used or trialed? What evidence-based methods were utilized during the session? Why were the materials selected? 

Conclusion: What is something that could have been added to the session? What could have been done differently to ensure a positive outcome?

Action Plan: What are the goals for the next session? What are the goals for next week? What are the goals for the next time a certain client or client with similar difficulties is seen?

The Gibbs reflective cycle is just one model used in reflective practice. There are many other models such as John's Model for Structured Reflection and Borton's/Driscoll's Development Framework. Utilize the references below to dive deeper into reflective practice and explore additional ideas and resources. 

How to Get Started

A clinician can begin their process of self-reflection by creating a simple form of the 6 steps from the Gibbs reflective cycle and including questions they want to answer under each step. Then, the clinician can decide the number of sessions a week that they want to reflect upon. It’s a good idea to start with a small number to ensure it doesn’t become a daunting task and appear to be too much with the already never-ending to-do list. As the clinician becomes more comfortable with the process and sees growth in their skills, they can continue to add more sessions to reflect upon or discover more ways to enhance the process. This could be a daily learning journal, a weekly reflection write-up, creation and monitoring of SMART goals, and researching other tools to use. 

If the structured reflection plan seems like it may be too much to add to the clinician’s busy schedule, start with something more unstructured. Start by reflecting on a couple of questions each day or week to gain more insight into what went well during the sessions and what needs to be worked on for future sessions. Some questions they may ask are “What worked for my clients today/this week?”, “What could have gone better?”, “What are my goals for tomorrow or the next time I see this client?”. This is still an intentional reflection on the day/sessions; however, may not seem like such an overbearing task as a structured reflection might be.

I began using reflective practice this past school year, and it has helped me alter and improve my sessions and clinical skills. It allows me to critically think about my sessions and examine my strengths and weaknesses deeper. I created a little form, based on the Gibbs reflective cycle, and I pick 2-3 sessions a week to reflect upon and create an action plan to improve for next time. To dive deeper into reflective practice, check out the resources listed below in the reference list. They have more information on different models as well as additional information about reflective practice. I hope this assists you in diving deeper into self-reflection and helps you continue to grow as a clinician. If you are a supervisor or mentor, I hope this helps to add reflection to your observations and discussions. “Without continual growth and progress, such words as improvement, achievement, and success have no meaning” -Benjamin Franklin

Author: Paul D’Imperio, M.S., CCC-SLP

Resources:

https://www.brightknowledge.org/medicine-healthcare/what-is-reflective-practice

https://www.physio-pedia.com/Clinical_Reflection

https://www.skillsyouneed.com/ps/reflective-practice.html

https://www.mindtools.com/pages/article/reflective-cycle.html