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Sen HS1210/HS5330 – Critical Thinking and Research Process
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e-Tutorial Week 4: Reflection in critical thinking process
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Learning Outcomes
At the end of the session, the student will be able to:
1. Define reflection-in-action and reflection-on-action.
2. Identify the clinical problem(s), strengths, areas for development and actions in the
nursing practice scenarios according to Gibbs’s Reflective Cycle model.
1. Please discuss as a sub-group and submit one worksheet per sub-group.
2. Submissions are to made via Brightspace by week 6.
3. You may refer to Gibbs’ Reflective Cycle Framework in page 2 and 3 in this
worksheet
Activity 1:
1. What is reflection-in-action and reflection-on-action? Give examples to show your
understanding?
- REFLECTION IN ACTION refers in the midst of an activity or action . As an illustration,
consider a nurse giving medication.A patient is receiving medication from the
nurse.Despite feeling uneasy, the nurse carries out the task.Acknowledges that there
might be a drug interaction to the discomfort.takes into account the patient's medical
background and explores other options.determines to halt the administration, confers
with a coworker, and looks for potential opportunities.Takes lessons from the
experience and resolves to check for possible drug interactions more carefully going
forward.
- A reflection that happens after an experience or action has occurred is referred to as a
reflection on action. For instance, a nurse tries to explain the procedure to a patient, but
the patient is unable to understand her because of a language barrier.The patient
doesn't seem to understand because of a language barrier, which frustrates and worries
the nurse.acknowledges that in order to guarantee that the patient is aware of the
procedure and is able to give informed consent, effective communication is
essential.takes into account how a language barrier affects patient care and thinks
about other ways to communicate, like making gestures, employing visual aids, or
asking a translator for help.Recognizes the need for better communication techniques
when dealing with language barriers and that patient understanding is necessary for
their participation in the decision-making process.
Activity 2:
Mr Ahmad, 45-years-old, was admitted for a fractured right tibia after a soccer game with his
friends. He has a cast on. He has a past medical history of hypertension and diabetes
mellitus. Due to his obesity, he is slow in mobility, although he is on rehabilitation
programme. He prefers to lie in bed most of the time and watch movies via television or his
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d) own laptop computer. Today, he complains to you that he felt pain on his buttock. Upon
an examination, you noticed a Stage I pressure ulcer at the sacrum. His vital signs are normal.
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1. Divide into your subgroups to reflect on the given scenario, using the Gibbs’ Reflective
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ve Cycle Framework.
2. In the Conclusion section of the Gibbs’ Reflective Cycle, include the clinical problem and
strengths.
3. In the Action Plan section of the Gibbs’ Reflective Cycle, include the areas for
development and actions related to the scenarios.
Gibbs’ Reflective Cycle Framework
This model is based on “reflection-on-action” which reflects after the event happened with
the aim of it becoming a learning experience. It can be a positive and negative experience.
There are 6 stages in Gibbs’ model, which has questions to guide a person to reflect
systematically on the situation.
1 Description
Identify and describe any incident without discussing your feelings.
What happened?
Be careful not to identify individual people or places.
Who was involved?
Pt Admitted due to # rt tibia after his soccer game . He has a hx of hypertension and
diabetes mellitus due to his obesity .His mobility is slow despite rehabilitation program.He
often spend time lying in the bed . He developed stage 1 sacral sore / pressure sore
2 Feelings
Discuss your feelings and thoughts
What were your feelings and thinking?
How did you feel at the time? What about afterwards?
What did you think at the time?
What did you think about the incident afterwards?
Be honest with your feelings.
Be careful not to be offensive, make sure not to identify any of the people involved.
How did you response to the situation
The nurse express the feeling of mix emotions including concerns , guilt and desired how
the pressure ulcer develop despite rehabilitation programme . with his condition the
pressure ulcer may develop faster and also the healing process for him might be longer
due to his medical hx and age .
3 Evaluation
Look at how well things went.
How did you react to the situation?
How did other people react?
What factors influence your actions?
Did your actions match with your belief and knowledge?
What was good about the experience?
What was bad about it?
Did you feel that the situation was resolved afterwards? Why/why not?
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Upon assessment , I feel surprised and developed a feeling of concern to see stage I
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pressure ulcer. My team may raise a concern towards the issue as pressure ulcers may
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develop into much more unpredictable stages. Due to his obesity which resulting in slow
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mobility, he prefers lying in bed most of the time which resulted in the pressure ulcer. With
that, I would encourage him to do 2 hourly turning, put blanket under his sacral to elevate
the pressure. I will try to understand my patient perspective on why he didn’t want to move
around and prefer lying in bed . I will advocate the importance of moving around , regular
positioning , changing his would dressing daily to prevent further worsening of the
condition
4 Analysis
Leading on from your evaluation, your analysis will look in greater depth at what might have
helped or hindered the situation.
How or why the incident came about in the first place?
What sense can be made of the situation?
What was really going on, as opposed to what you may have perceived?
You need some theory and the work of other authors to support your analysis.
The development of the pressure ulcer may be contributed by his sendentary lifestyles and
also his medical condition . obesity exacerbate the worsening of the pressure ulcer as
more weight is being put on the sacral if he doesn’t move around .Mr ahmad may not be
aware about the development of pressure ulcer therefore he thinks that its okay to limit his
mobility due to # rt tibia .
5 Conclusion
What was the end result?
How well did you think you managed the situation overall?
What else could you have done in the situation?
What you have learned from it?
Could you have responded in a different way?
For positive experience, will you do the same again to ensure a positive outcome? Is there
anything you could change to improve things even further?
For negative experience, how could you have avoided it happening? How can you make
sure it doesn’t happen again?
We can share to mr ahmad about the importance of sacral sore that with prolonged
pressure on the sacral resulted in the ulcer . we can also provide him nesporin powder and
also analgesic if the pain prolonged for him .
6 Action Plan
Sums up things that you need to do in order to improve things for next time.
If the situation occurred again, what would you do?
Would you act differently?
Is there a skill you can develop or attend some training to help you to be better equipped
next time?
Could you ask your tutor or placement supervisor for some advice?
If the situation ever occurs again , I will keep advocating him about the important moving
himself around and I will show him picture of the gruesome pressure ulcers to create
awareness for him. I would also suggest him to put blankets or pillow when sitting down to
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an a dietician. i would also ask his friends and family to try to encourage him to move around
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References:
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UKKEssays (2020). Gibbs’ Reflective Cycle. Retrieved on 12 March 2020 from
https://www.ukessays.com/collections/gibbs-reflective-cycle.php#whatisgibbs
