Visual reflections

Visual reflections

Visual reflections are one way of representing and structuring a reflection you’re making about an event. Rather than writing out a page of text, use text within pictures and symbols to convey emotion and meaning clearly. Drawing it out like a mind map or with symbols can make it easier to notice and connect themes together, as well as being quicker to both do and interpret. It can also make going through the different stages more clear and force you to not omit any difficult stages.

thug life otter

 

An example will be shown here shortly…

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Reflections on policies & trends influencing Mental Health

Reflections on policies & trends influencing Mental Health

Reflections of influences on mental health placements: these were in Community Mental Health Teams (CMHT) and secure inpatient units.

Negative influences

  • Politics  removal of benefits
    • reduction in PIP* for one lady with severe anxiety reduced her support  and reduced access to the community as a result, she felt her MH was worsening
    • What? middle aged man with EUPD & psychosis felt it was unfair the cuts to disabled benefits, when he was assessed for his PIP he felt because he could ‘function’ in the interview and speak coherently he was marked up in his ability whereas he felt he could not manage day to day. He said this reflected people often dismissing mental health because it cannot be seen and he looks ‘normal’.
    • So what? He felt very angry about this and sometimes this was directed at any healthcare staff even those not responsible for benefits, such as when groups were cancelled due to staff shortages.
    • Now what? Reflected at the time that it must be difficult to find an outlet for your frustration and anyone working for public sector could be a symbol of the government, remember to not take anger at service constraints personally.

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Article review: “Rethinking reflective education: What would Dewey have done?” by Rolfe (2014)

Article review: “Rethinking reflective education: What would Dewey have done?” by Rolfe (2014)

Rolfe (2014) goes straight for the jugular and says that reflective practice has failed to become an everyday part of healthcare practice (and as a result failed to improve it), and that this is the fault of managers and educators as well as practising therapists.umm not sure otter

He thinks reflection has been misunderstood- it’s really how we DO reflection-in-action (Schön 1987), not how we WRITE about reflection-on-action after the fact using structured models. Rolfe says believing that reflection-on-action is reflection is how managers/educators/therapists have misapplied it. they should be focusing on reflection-in-action, the bit that Schön thought reflection actually was anyway.

So most reflection takes place at a desk with pen and paper after the event, whereas the people who ‘invented’ it thought it was more reflecting with the situation while you were in it. If you’re rationalising things afterwards it’s the same as a technician carrying out research recommendations, which is fine if it’s an easy patient “tame problem” but if it’s a complicated “wicked problem” which is complex and unique and cant be applied to other previous situations… it’s not much use.

Fish & Coles (1998) also looked at clinical judgement in relation to reflection and tame/wicked cases (except they called them technical rationality and professional artistry). Technical rationality/tame problem are being a drummer in a pop band- following predictable formulaic beat patterns from instructions that already exist; whereas wicked problems requiring professional artistry are like a saxophonist in an improvised jazz ensemble- you’ve got to play along in harmony to sounds you haven’t heard before or will hear again. It is like being a mini-researcher experimenting on small scale on individual case in the moment, rather than carrying out actions based on existing research done by someone else.

 

Being taught in a classroom doesn’t allow you to experience the complex wicked problems of the real world and the associated reflection-in-action. Rolfe therefore sees the current classroom method as an inefficient way of training healthcare professionals and he thinks apprenticeships -which involve more exposure to practical elements than placements do- would be better.

Should students be exposed to tame or wicked problems in their learning? Schell & Schell (2008) said a series of similar tame problems are helpful so a student can recognise patterns and build up a repertoire of ‘answer templates’ to problems. Solving wicked problems happens when one can piece together tame problems relevant to the complex one. It can be seen that the student/novice needs to have tame solutions down to pat first before they can successfully solve wicked problems.

Standing on the shoulders of giants- learning something by building on the existing knowledge/experiences others (Sir Issac Newton)

Rolfe stresses that this opinionated article isn’t written as fact, but a one-sided opinion in order the stimulate a response and a debate. He thinks that more opinion pieces and proposed hypotheses for complex problems should be included in professional journals and not just research studies, because it would create official debate in order to decide which new areas needed research.

 

 

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Reference

Fish D and Coles C (1998) “Professionalism eroded: professionals under siege” In Fish and Coles (editors) Developing professional judgement in health care: learning through the critical appreciation of practice. Oxford: Butterworth-Heinemann
Rolfe G (2014) Rethinking reflective education: What would Dewey have done? Nurse Education Today 34(8): 1179–1183.
Schell BAB and Schell JW (2008) Clinical and Professional Reasoning in Occupational Therapy. Lippincott Williams & Wilkins.
Schön D (1987) Educating the reflective practitioner (1st edition). San Francisco: Jossey-Bass.
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Guide to models of reflection – when & why should you use different ones?

Guide to models of reflection – when & why should you use different ones?

“Difficult, but important”

Reflection is an important yet ethereal skill that all Occupational Therapists need to master.

Part of completing a reflection is an inner sense of discomfort (in fact the first stage of reflection as described by Boyd & Fales 1983) so it’s no wonder many people put it off and may even try to get by without it, perhaps carrying out token reflections just to comply with CPD or course requirements. To begin with, reflecting on your actions is something that requires conscious effort after the event but eventually, according to Johns (2000), it will become an automatic thought process even when you’re in the middle of experiencing the event. When deciding which model to use, it can helpful to find out what learning style you are according to Honey & Mumford. You can relate these to the knowledge types shown in Carper/Johns’ reflective models.

Below is a rough guide to the different models of reflection out there, and which situations they’re best geared towards. They are ordered (in my opinion) from the easier ones for the beginner who is trying to break down and evaluate a situation, to the more complex ones that build on the basics and hope to elicit a change in your personal beliefs and challenge your assumptions. Gillie Bolton suggests exercises for creative ways to reflect in her book Reflective Practice: Writing and Professional Development (chapter 4).

otter reflection
What?  So what?  …Now what?

Like  Inception, you’ll naturally find yourself going deeper with your analysis of an event the more experience you gain with reflective models. Enjoy the ride!

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Gibbs reflective cycle (1988)

Gibbs reflective cycle OT

Good for: Good old Gibbs. Basic, good starting point, six distinctive stages. Makes you aware of all the stages you go through when experiencing an event.

Criticisms are: superficial reflection- no referral to critical thinking/analysis/assumptions or viewing it from a different perspective (Atkins & Murphy 1993). Does not have the number or depth of probing questions as other models.

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What does Evidence Based Practice mean to me now that I have studied it at MSc level?

What does Evidence Based Practice mean to me now that I have studied it at MSc level?

Since starting the research module on my course, I have gained an understanding of the need to be critical of the evidence itself!  And also how complicated the process of creating bias-free valid evidence is, and how many opportunities for bias there are in each study.

umm not sure otter

I have gained lots of skills around the methods for gathering and analysing data. I feel that I already had a fairly questioning thought process as default, but now I am able to articulate more clearly why something is biassed or can only be trusted so far.

I never thought I would have a blog or enjoy blogging as much as I do, so I am really grateful that I was forced to start as a result of my course.  Although it is nice to see other people reading the blog it is mainly an ‘online study notes’ tool that I use; it enables me to quickly search for topics, search for module content by date, and reminds me to cover all aspects of a topic, such as the need to create a blog entry for each OT model. It is proving to be a real motivating factor (organising my thoughts, finding an otter picture that represents the topic, seeing a pretty blog page at the end) and helps make what I have typed more memorable- as well easier to link ideas together. This is probably helped by needing to categorise and tag the blogs each time; by grouping ideas from different modules or timescales together it make it easier to see how they might all connect. I suppose I probably have more technical social media knowledge now as a result, although I don’t think I was terrible to begin.

Already both when reading articles and overall in life I find myself dialoguing with myself in my head about the possible devil’s advocate outcomes of an article or a situation. I guess this could be the start of reflection-in-action!

 

Protected: Practising reflection – situations that could be relevant when working as an OT professional

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