What is it, and why do we need it, and how does it connect to OT supervision?

What is reflective practice?

This involves taking time to pause and review clinical work, the impact of policies and procedures on practice, the quality of working relationships, and the overall benefit of your practice/business for service users. It involves not just looking back on what has already happened but using this information to influence and plan for the future. It is a reflection on experiences that have already occurred.

When we reflect, we do need to describe what has happened. However, deep reflection occurs when we are in analytical mode, focusing on areas such as our professional experiences, skills, behaviour, actions, decisions taken, intersectionality, standards, ethics and the emotions experienced before, during, and after the event. Thoroughly examining the impact of the event or situation, ideally from multiple perspectives.

Why do we need reflective practice?

Reflective practice is an essential tool for all therapists. It is expected as part of the HCPC standards of practice. 

Therapists are reflective throughout the working day, between sessions, while driving between appointments, when writing clinical notes, discussing issues with colleagues, attending team meetings, or in supervision.

We use these reflections to debrief, organise our thoughts and plans, and to understand the context and relationships that impact the client’s progress. This type of reflection is key to our working practice; however, it may not always prompt our deeper analysis of situations and tends to be completed within the immediate or soon after timeframes of an ongoing case.

What to include when recording reflective practice?

When we create space to look at reflective practice with more intention, it allows us to gain a deeper understanding.

By this I mean:

• Reflecting on events from different perspectives, stepping back to examine the client’s journey, the family's impact, and the relationships that had both positive and challenging effects.
• Reflecting on your role, decisions, and actions. Would you do the same again? What impact has this had on your confidence, clinical reasoning, self-awareness, teamwork…? Is there any information that you have learned in hindsight that might have impacted your decisions or the outcome?
• Was there anything about the environment that could have made a difference to the situation? Would you carry out the intervention in the same space in the future, or is there a better environment or factor you need to be aware of next time?
• Using time to look back at both the event and the impact of any changes made over time, did they have the desired effects or not? Did the policy facilitate the desired outcome, or did the identified gap now get addressed? How have relationships evolved? Was there any bias that you were not conscious of at the time?
• How does this event connect to evidence-based practice, and any CPD already undertaken or required in the future?

Models of reflective practice

Using models of reflective practice or frameworks can support this type of deeper reflection.  Having a tool to guide your thoughts can be helpful; there are many available for use, and they are valuable to include in your CPD portfolio. Many platforms, such as CPDme, offer templates for your use. This link will share some examples of models with you.

If you are looking for an occupational therapy perspective on reflective practice, then have a read of Bannigan and Moores’ 2009 article (linked here) on “A model of professional thinking integrating reflective practice and evidence-based practice”. Their model extends the ‘What? So what? Now what?’ approach of Driscoll’s (2007) What Model, to include the broader practice context, professional, organisational, sociocultural, political/economic factors. These are valuable perspectives to consider when taking time to make intentional reflections.

How does OT supervision support reflective practice?

Within the safety of supervision, you can take space to explore any vulnerabilities or emotions that this type of deeper reflection can raise. It is also an opportunity to connect reflection with CPD, to hold yourself accountable for recording your reflections, and to review whether you require further CPD activities as an outcome of the reflection or if you need to focus on implementing the learning you have undertaken. Having a conversation with a supervisor can help identify other factors that you may not have considered, provide support to explore further evidence-based practice, or help you review procedures if this is an outcome of your reflection. You can also use supervision to set a time to revisit and review the impact of any changes on your practice or service users.

Takeaway:

• Book a slot in your diary to record an intentional piece of reflective practice and upload it to your CPD portfolio.
• Bring it to your next OT supervision to discuss any service/business impact.
• Download Bannigan and Moores’ (2009) article (linked here) on “A model of professional thinking integrating reflective practice and evidence-based practice”.

Written by Lynsay McFarlane-Shaw, Occupational Therapist / OT Supervisor