John Dewey's Perspective on Reflective Thinking

Reflective Practice

Reflective practice has been described as a state of mind, a continuous attitude towards work and life, and the pearl grit in the oyster of education and practice. Confucius points out that one of the ways through which we may learn wisdom is through reflection, and it is the noblest of methods. Reflection involves more than just being thoughtful, and the process has the potential to help practitioners and other professionals learn from their experiences, which is crucial for effective education dissertation help. Reflection is not a new concept as it has received influence from ancient Greek philosophers like Aristotle in his notions of phronesis or practical judgment and wisdom (Bulman and Schutz, 2013, p. 2). He emphasized the need to reflect on the real world and develop experiences of it while also paying attention to imagination and emotion in the development of our perceptions of the world. He pointed out that vision and feeling should not be relegated to unwanted corrupting influences or self-indulgent urges that hinder good rational thinking but should instead be an elective and responsive part of our thinking. Aristotle pointed out that through this, we could develop real practical insights, understanding, and responsiveness.

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Philosopher and educationalist John Dewey describe reflection as a persistent, active and careful consideration of believes or forms of knowledge in the light of grounds that support them and the further conclusions to which they tend (Bulman and Schutz, 2013, p. 3). Reflective thinking involves thinking with a purpose since engaging in reflection involves periods of thinking to examine situations or experiences that are complex. The reflection period enables the individual to make sense of experiences, liken them to other similar experiences, and place them in context. When professionals are faced with complex decisions, reflecting or thinking them through enables them to separate the different influencing factors and come to reasoned courses of action or decisions.

Reflective practice as a term was first used by philosopher Donald Schon whose work was rooted in attempting to outline the difference of professional knowledge from other types of knowledge found in scientific papers, textbooks, and journals. Schon believed that reflection should be central to continuous professional development as well as curricula, where learning by doing became the core of the programs rather than an add-on. He noted that clinicians usually have to respond to various complex and poorly defined situations, which makes reflection a valuable part of excellent practice standards and continuous professional development (O'Loughlin et al. 2012, p 190). One primary reason for systematically and consciously engaging in the reflection process in various contexts is to consider degrees to which past influences overlap with whatever is needed in the clinical situation we are facing now. Such retrospective critical thinking involves reflection-on-action where one constructs and reconciles events to develop themselves as practitioners. Schon also pointed out a distinguishing feature of expert practitioners, which included reflection-in-action where one experiments and thinks about their practice while they are doing it.

Models of Reflection

Models or frameworks of reflection encourage structured processes that guide the reflection process. Many models and tools are available that can aid in engaging in the process, and there right model as individuals are advised to choose one that is most comfortable to them and which best assists them to learn from their experiences (Barksby et al. 2015). Since reflection is ongoing, and learning from one reflection is taken forward into practice and future skills, many models are represented as a cycle. Common models include Gibb's reflective cycle, John's model of structured reflection and Rolfe, Freshwater, and Jasper's framework of reflective practice. The reflective cycle by Graham Gibbs was developed with a basis on every stage of Kolb's experiential cycle. Gibb's model applies to reflections on any experience and is especially useful in helping one learn from everyday situations (Wareing, 2017). It encourages the individual to think systematically about the experience with critical questions to consider being posted at each of its six stages. It prompts the individual to give a clear description of the situation after which they are led through reflection and learning and what they would do if the situation arose again.

Christopher John's model for structured reflection was developed for use in the nursing context but is also applicable in other contexts. It is beneficial in reflection and analysis involving complex decision making and is useful as one learns how to reflect. John urged that during reflection, one has to look inwards as they consider their feelings and thoughts as well as outwards as they consider the actual situation or incident, their actions, whether they were ethical, and the external factors that influenced them (Coward, 2011). One is led to this through the cue questions provided in each phase of the model. Rolfe and his colleagues built their framework based on a personal and professional development perspective. It builds on fundamental questions of what, so what and now what that was part of earlier models. The model is made up of probing questions aligning with each of these three questions that guide the individual to more in-depth and broader reflection (Karunanayaka et al., 2016). The model is useful to anyone, whether they are novice or expert, as it enables reflecting on different levels of questions.

Throughout this unit, I have utilized the Rolfe, Freshwater, and Jasper's framework for reflective practice as it aligned perfectly with my professional development goals. The what, so what, and what now questions helped in descriptions of the experiences or events, understanding and making of decision son what should be done to improve the experience. In nearly all situations, it provided guidance on reflecting on the problem or reason for issues, what I learn about myself, the patient, their care, our relationship, the care approach, and the attitudes present. It also helped in reflecting on what needed to be done to improve the situation and improve overall care for the patient.

Reflection on Professional Development

Through Rolfe, Freshwater, and Jasper's framework for reflective practice, I was able to make various professional developments by critically reflecting on numerous experiences with my client as I attempted to help them manage their obesity and weight. My client was 44 years old and worked as a student counsellor and due to the nature of the job, the client did not have enough physical exercises. The client's position is partially sedentary since it involves working in an office where they spend most of their time sitting. In the first encounter with the client, their dietary analysis showed reduced carbohydrates and fiber intakes that were below recommended levels. My initial recommendation, along with an increase in the physical activity, included increasing fiber consumption as well as carbohydrates intake. However, after a few days, the client presented with severe Irritable Bowel Syndrome (IBS), which came as a surprise to me since I had not known that they had the condition.

Through Ralfe's and colleague's framework, I was able to reflect on this situation. The first step involved asking what the problem was and the reason it emerged. The answer to this was the IBS and the reason it occurred was because I had recommended increased intake of carbohydrates and fiber for the patient. So what did this tell me about the patient, myself and our relationship? I was able to discover that the patient previously suffered from IBS and in my hurry to diagnose them I had not conducted a thorough history of the client. It meant that our relationship was not based on adequate and sufficient communication. I felt disappointed in myself for not getting this information from the patient and was distraught for having failed them so soon in our encounter. The preceding step involved asking what I needed to do to improve the situation and the care of the patient. One of AfN's Standards of Ethics, Conduct, and Performance involves acting in the best interest of the client, and this involved balancing between managing their obesity and their IBS condition to ensure their well-being.

IBS is a prevalent gastrointestinal disorder with significant economic impacts and consequences that reduce the quality of life of the patient (Werlang et al. 2019). From my knowledge, I knew that the symptoms of IBS could be exacerbated or induced by dietary modifications with published articles showing evidence of cause and effect relationships between its symptoms and foods like fiber and carbohydrates. Through the framework, I further reflected on what actions I could take. I answered this by deciding on a diet that excluded carbohydrates and high fiber. I also reflected on what I based this action on and was able to retrieve evidence-based research supporting the use of diet regimens that exclude these types of foods to treat IBS symptoms (Werlang et al. 2019). I also reflected on what would be the consequences of this action, and based on the research, the IBS symptoms would be alleviated, and it would also help me and the patient achieve our goals of dietary management of obesity.

Another AfN Standard of Ethics, Conduct, and Performance involves communicating effectively with clients and colleagues. It includes clear communications with the client to obtain accurate and up to date histories of their conditions. Through the framework, I reflected on what the problem was in our communication. The answer I deduced from the situation was that I had not adequately informed the client of the importance of sharing information about all the conditions they might have. They, therefore, did not think it would be valuable. I then asked myself what this meant and concluded that a proper therapeutic relationship had not yet been established between the client and me. I then asked myself what I needed to do to improve this situation and concluded that I needed to educate the patient on the importance and need for open communication about anything and spending more time with the patient was necessary.

Employability

Through the reflection, I was able to make improvements with the client and their care. Within a few weeks of instituting the changes and incorporating the other recommendations, there was an evident improvement in their life quality and weight. I also felt I had advanced professionally through the reflection, and my practice was more aligned with AfN's Standards of Ethics, Conduct, and Performance. My skills also improved, especially when dealing with two or more conditions in nutrition that may be interrelated, such as IBS and dietary intakes. I believe the experience improves my employability in the field of nutrition as the skills gained will be valuable in future practice. I feel I need to make further improvements in communicating with clients and building therapeutic relationships based on openness and trust, as it would make it easier for clients to open up and share needed information about their conditions. Such a link is especially useful when caring for obese clients who may have experienced stigma or discrimination. In the future, I aim to apply reflective models and frameworks from the beginning of the client encounter as it has proven useful in developing my skills and expertise as a professional.

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Self-Reflection

Engagement in the course has enabled me to achieve my learning and development goal of acquiring and retaining the knowledge and skills needed in the provision of high quality care based on the needs of the patient. The course units focus on understanding rather than doing and this has increased my confidence on my abilities and capacities to learn in new clinical situations. Being able to think critically was essential when caring for the patient with weight problems and IBS symptoms and this enabled me to apply the skills learned in the course regarding reflective and critical thinking. The AfN's Standards of Ethics, Conduct, and Performance points out that nutrition nurses have to continue applying the principles and skills they learn in education and continuing professional development. The course has enabled learning related to my experiences where my feelings, thoughts, theoretical and practical experiences are part of the learning process. The course has made it possible to work with value sets, meanings and approaches that have made reconsidering and discovering of new experience versions possible, such as the use of Ralfe's and colleague's reflection framework. Such skills from the course and practice enable me to be valuable addition to the nutrition workforce. It had also been beneficial in bringing to light the areas that I need to improve on in order to provide effective care to patients such as improving communication to foster therapeutic relationships. I aim to make these improvements throughout the remainder of the course.

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References

Bulman, C., & Schutz, S. (Eds.). (2013). Reflective practice in nursing. John Wiley & Sons. p 2-6

Coward, M. (2011). Does the use of reflective models restrict critical thinking and therefore learning in nurse education? What have we done?. Nurse Education Today, 31(8), 883-886.

Karunanayaka, S. P., Naidu, S., Kugamoorthy, S., Dhanapala, A., Ariyaratne, A., Gonsalkorala, M., ... & Sudarshana, N. M. R. K. (2016). Towards open educational practices with Reflective Practice.

O'Loughlin, K., Guerandel, A., & Malone, K. (2012). A reflection on continuing professional development. The Psychiatrist, 36(5), 189-193.

Wareing, M. (2017). Me, my, more, must: a values-based model of reflection. Reflective Practice, 18(2), 268-279.

Werlang, M. E., Palmer, W. C., & Lacy, B. E. (2019). Irritable Bowel Syndrome and Dietary Interventions. Gastroenterology & hepatology, 15(1), 16.

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