In your course, this may take the form of a critical incident report. Assessment tends to focus on how successfully you have demonstrated a capacity to analyse and reflect on events in order to learn from them. Also relevant to assessment is how much you are able to relate your current theoretical learning for example, about the doctor-patient relationship, or about what constitutes effective communication to a real life situation. This section explains what is meant by reflective writing and the term "critical incident" , and helps you explore the reflective learning process.
You will also find a format for the critical incident report , a sample piece of student writing , criteria for assessment and suggestions to help avoid some common errors in reflective writing. In medical and health science courses you are required to produce reflective writing in order to learn from educational and practical experiences, and to develop the habit of critical reflection as a future health professional.
Students sometimes view reflective writing as an annoying interruption to the serious business of developing content knowledge in their subject area. However, there are sound reasons why reflective writing is included in student assessment. Reflective writing tasks are given to students to help students learn through reflection, precisely because of the established link between reflection and deeper learning. Reflection can lead to:. Reflection can lead to greater self-awareness, which in turn is a first step to positive change — it is a necessary stage in identifying areas for improvement and growth in both personal and professional contexts.
You should be thinking about possible subjects and opportunities for reflective writing before and during your placements, not only after them. In the workplace, lack of time frequently limits opportunities for learning through reflection. People may not have time to stop and think. Similarly, time is an issue for students. For students, perhaps the major obstacle to learning through reflection is devoting insufficient time to it, and consequently failing to explore the experience in depth.
Students sometimes write simply to meet the assessment requirements, without genuinely engaging in the process. In the activity-reflection model there are four stages to the cycle of reflection:. Reflective writing often requires movement between past and present tenses, depending on whether you are recounting the actual events or making a more general comment for example, on the doctor-patient relationship, or on an aspect of your current course. Generally, when recounting a particular experience or incident, past tense is used.
As part of my placement at a small rural hospital in north-west Victoria, I worked closely with the nursing staff. I noticed that the nurses had more regular contact with patients than the doctors, and consequently seemed to develop a closer relationship. When two of the patients became agitated I did not know what to do.
I asked them to return to their beds, but they simply ignored me. I did not know what the correct procedure was in this situation. When making a general comment, or relating an incident to current practice or to a particular theoretical perspective, present tense is normally used. It seems that the roles of nurses and doctors are quite different, and that doctors need to acknowledge the importance of the nurse-patient relationship.
Clearly making new staff aware of the procedures and rules is important when they join a new workplace or institution. It's always good to stop and reflect on what you have written. Have your views been affected by your personal or professional experiences? Think about your use of tenses. Check that you have written your reflections in a non-judgemental way. In reflective writing you may be asked to speculate about the future, or about a hypothetical situation.
For example, you may be asked to comment on whether you would like to practice in a rural area in your future career. Notice in the example below the movement between past and present tenses, and the use of 'would' when speculating about the future.
Although my rural placement was a very positive experience, I would not like to work in the country when I first graduate. There are several reasons for this.
Firstly, being a country doctor is more challenging — you do not have the support networks available in the city, so you have to cope with many different situations. In the country I would have to behave as the local doctor all the time, 24 hours a day.
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There would not be an opportunity to just be myself and not worry about what people think. Living in the country I would be far away from my family, and might feel lonely for that reason. Finally, I would have to focus on general practice, whereas my interest lies in more specialized areas of medicine. As soon as I started there, I could see that having a good working relationship with the nurses would make my job much easier, and would possibly result in better health care for patients.
Some writers become confused between self-reflection and self-criticism. Try not to confine your writing to the event and your feelings. If possible, use it to raise new questions or to speculate about possible causes and solutions. Remember where possible to link your reflections to theoretical aspects of your course.
For example:. Planning You should be thinking about possible subjects and opportunities for reflective writing before and during your placements, not only after them. Writing too informally : just because it is based on your experience does not mean you can ignore academic style. You need to describe the experience adequately — the reader needs to be given enough detail to understand the context in which the experience occurred.
However, it is not enough just to describe the experience in great detail: you also need to analyse and evaluate the events and the thinking processes involved. Take time to organise and structure your writing.
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Try to focus on what was most significant about the experience, and relate it to aspects of your course and future career. Be careful that your writing does not seem to simply drift without direction or focus. A critical incident need not be a dramatic event: usually it is an incident which has significance for you. It is often an event which made you stop and think, or one that raised questions for you. It may have made you question an aspect of your beliefs, values, attitude or behaviour. It is an incident which in some way has had a significant impact on your personal and professional learning.
Critical incidents may relate to issues of communication, knowledge, treatment, culture, relationships, emotions or beliefs. Here is a suggested format for this report. The writing style required in producing a critical incident report is different from that of an academic essay; however, it is still important to present ideas in a systematic and organised way, and to use appropriate language. It is simply written, and avoids use of jargon or colloquial language. This report will outline a critical incident which occurred in Week 9, Semester 2 in my clinical tutorial.
The incident was initiated by my tutor, who announced that she would provide individual feedback to students on their performance in clinical tutorial discussions.
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At the end of my clinical tutorial my tutor arranged for us to meet briefly in order for her to discuss her feedback with me. She stated that over the semester she had noticed that I very rarely spoke in the tutorials and did not appear to engage with the other students. Lecturer's comment 1: Note the use of reported speech to describe the conversations between those involved in the incident. In her view the only way to develop confidence was to participate regularly.
I explained that in my culture students were not always encouraged to speak, and for that reason I did not find it easy. I also mentioned that I sometimes feel shy. Lecturer's comment 2: Note the use of first person to describe the writer's reactions and feelings: - I explained… - I mentioned… - I felt embarrassed… - I was worried that… - I realised that….
At the time of this incident, many emotions were running through me.
I felt embarrassed that my lack of confidence was so obvious to her, and also concerned about what impact it might have on my results. At the same time, I realised that her concerns were justified — I had been aware of my lack of contribution throughout the semester, and had even avoided going to some tutorials because of those feelings.
Although I understood that her intention was to help me to do better, I felt very uncomfortable and even ashamed to have to acknowledge my poor performance in this area. This incident was very demanding because it forced me to acknowledge an area where I have always lacked confidence. I also felt anxious about confronting this issue and trying to develop the confidence I needed.
Although this incident caused me discomfort and added pressure in the short term, I realise that it was a very significant event in my studies.
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As a result of the conversation with my tutor I was forced to reconsider my behaviour in tutorials and became more aware of how others viewed me. Fortunately, the tutor gave me advice on how to gradually develop the confidence I needed, and I also sought help from some of my friends. Over the final weeks of the semester I managed to talk at least once in every clinical tutorial, either asking a question or making a comment. I have started trying to talk in other tutorials also, in other subjects.
This incident was therefore very important, because without it I would still be remaining silent in my tutorials, and would have received negative written comments from my clinical tutor in my portfolio. Developing greater confidence at speaking in tutorials may lead to me being more confident in performing clinical examinations on patients. Lecturer's comment 3: Expression: it might be better to say 'less nervous' or 'have fewer nerves'.
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