Becoming a Reflective Practitioner. Группа авторов
to grade and reflect on how they graded.
Chapters 16 and 17 are illuminations of guiding nursing students in dedicated guided reflection sessions. The two situations: ‘Michelle finding a woman upset about her breast biopsy’ and ‘Hank’s complaint’ are real situations shared in guided reflection. As you might expect, guiding the first year group is more directed, whilst guiding the third year group is more open. The chapters illuminate the use of theoretical mapping, the way can be fed into the dialogue between guides and students.
Chapter 18 is a narrative of guiding of Trudy within the context of her clinical practice whilst also undergoing the Becoming a reflective and effective practitioner programme set out in Chapter 14. The narrative reveals how a particular experience is unfolds over six guided reflection sessions leading to profound insights. Of particular note is the richness of Trudy’s reflective description imbibed with MSR cues.
Chapter 19 reveals Sally’s narrative ‘a small voice in a big arena’ which was written as her conflict management assignment on the MSc Leadership in healthcare degree. It reflects how conflict is an everyday occurrence for many practitioners and hence a common focus for reflection. Her effort to respond to conflict from her vision of leadership heightens the conflict tension dramatically revealing the struggle to realize her vision of leadership as a lived reality within a transactional healthcare organization.
Chapter 20 sets out the Learning Organizations inspired by the work of Senge (1990) concerned with creating an environment in which reflective practitioners work collectively towards realising their vision of practice as a lived. This is exemplified through the Burford NDU Model of nursing: caring in practice. This model consists of four reflective systems set against the background of the Learning Organization. Two systems concerned with implementing the vision through reflective cues and communication are explored.
In Chapter 21, I set out ‘A system to live and ensure quality’ through developing clinical audit, standards of care, and group guided reflection that each foster reflection, personal mastery and team learning.
‘A system to enable practitioners to develop personal mastery towards realizing their vision of practice’ is the focus of Chapter 22. Within healthcare organizations guided reflection is usually termed clinical supervision that comes with a political agenda to essentially safeguard the public. Hence a tension exists between its regulatory and developmental intentions. Susan’s narrative, completed as an assignment on the MSc Leadership in Healthcare degree, gives focus on instigating clinical supervision as an element of leadership against the background of developing the Learning Organization.
Part 2
Awakenings [Chapter 23] reveals how arduous reflection can be for some practitioners, such as Aileen, in despair about her nursing predicament. As she quotes ‘There is much truth that learning through experience is arduous work’. For Aileen reflection was a rope to pull her out of her despair but her hands are slipping. The rope is hard to grasp. And what is it pulling her into?
In Chapter 24, Gerald Remy reflects on his leadership two years after completing the MSc Leadership in healthcare degree. Gerald, like Susan and Sally noted in earlier chapters, undertook the MSc Leadership in Healthcare degree. He was part of a learning community of 10 aspiring health care leaders. I emphasise community for a number of reasons. Firstly, from a leadership perspective, creating community is fundamental for any leader to create. Secondly, I believe that learning through community whereby others in a similar aspiring boat are available to each other through a period of time [in this case, 28 months] enhances learning through reflection. Community creates the condition for dialogue for a group of people learning towards similar goals. This idea permeates through many of the chapters in the book and reinforces the need for guides to be themselves leaders and skilled at guiding others to learn through reflection. Indeed this ability to guide learning in others is a prime quality of leadership.
Thirdly, is whether learning can be sustained without guidance, especially in a hostile culture that puts constant pressure on the practitioner to conform to organisational norms that are previously learnt ways of being. The ability to sustain learning, against the grain, so to speak, is reflected in the extent reflection has become inculcated within the practitioner’s community rather than an individual thing. Gerald suggests he has achieved that to some extent, although it remains precarious as he continues to hold creative tension. Of course, in terms of the efficacy of reflective learning, this issue of sustained learning at the depth of is of vital concern, that reinforced the necessity of first, a clear understanding the nature of reality [organisational norms that govern everyday ways of relating], and secondly, being able to detach self from the anxiety of transgressing these norms. Living this tension is akin to playing a subversive and dangerous game of survival where guidance is vital.
Gerald’s narrative gives a dimension on expressing learning through metaphor. Gerald, like all NHS staff have been socialised into the transactional culture that governs health care organisations. Hence the idea of being a servant‐leader or a transformational leader is immediately at odds with this culture. It begs the question – ‘how can one come to appreciate and separate self from this culture whilst being immersed within it where one’s every action has been socialised towards being transactional from either a subordinate or managerial perspective’. Gerald used the metaphor of David and Goliath to see and work with this tension. If the tension is not addressed then learning is limited and yet one can see how difficult it is to unlearn learnt ways of knowing [embodiment] to begin to respond differently and without coercive fear.
Fifthly, Gerald highlights the significance of one’s background in shaping the person. To become a leader from a servant‐leader or transformational perspective required Gerald to look back at his upbringing in order to understand how his background influences who he is now and who he seeks to become. He recognises the tension between a Goliath within and a David within and the need to vanquish his Goliath through his David. Anybody learning through reflection will need to consider their background‐ perhaps using the influences grid [How does my background influence the way I respond within this particular situation/experience?].
Chapter 25 offers a teacher of teachers’ perspective on reflective teaching. In particular it highlights how a ‘reflective mindset’ results in challenging previous ways of teaching that had been viewed as successful. The reflective teacher seeks to give responsibility to the students to find their own way with minimal guidance. Not easy to do when you think you know the best way, but it opens to door for the teacher to learn and be challenged through post‐exercise dialogue. Adenike also explores the culture of the classroom, highlighting the difficulty teachers face with issues such as control and emotions.
Chapter 26 offers a Canadian perspective on reflective teaching using the MSR and stimulating reflection through constructed narratives. Arlene lifts to the surface the dynamic nature of reflective teaching offering new perspectives on learning through reflection for both guides and students.
References
1 1. Boyd D (1994) Rolling Thunder. Delta, New York.
2 2. Johns, C (1998) Becoming a Reflective Practitioner Through Guided Reflection. PhD thesis, The Open University.
3 3. Johns C (2002) Guided Reflection: