Quality Assurance, Research and Innovation Unit
Reflective practice and clinical supervision
Commentary
There is a significant amount of literature around the issue of reflective practice as a clinical
supervision model, although as anticipated a proportion of these can be discounted from an
appropriate, contemporary review due to being; older material, from a less relevant perspective
than health care, or being from a minority source.
Approaching this from a non-clinical perspective and without some of the necessary
understanding, this review provides a brief overview of reflective practice and contains summaries
from a number of relevant articles which highlight current evidence. Embedded in the document
are some full documents, which it is highly recommended are read in full so as to ensure any
nuances are not lost through a non-clinical summarisation.
Also included are a number of other recommended source books, which may be useful reference
guides if the Trust was to develop a formal policy or encourage local ones.
Overview
Reflective practice was formally introduced and defined during the 1980s, with aims to enhance
abilities to communicate and making informed decisions. Graham Gibbs defining a key model of
reflective practice as detailed in Figure 1.
Figure 1: Gibbs' Reflective Model (1988)
This model remains indicative of a reflective strategy, and whilst refinements and simplifications to
this model, and other models exist, reflective practice is fundamentally an unstructured, selfregulated process to direct understanding and learning.
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Key findings
Oelofsen, Natius (2012). " Using reflective practice in frontline nursing".
Nursing Times,Vol 108 No 24
Oelofsen defines reflective practice as the process of making sense of events, situations and
actions that occur in the workplace. He posits a simple three step framework for reflective practice.
This encompasses:

Curiosity
This step involves noticing things, asking questions and questioning assumptions.
e.g. What exactly happened? Why did we deal with the situation in that way?

Looking closer
This step involves actively engaging with the questions from the first step
Reflective practitioners do what is needed to find out more, practitioners try to find ways to
articulate the phenomena that were noticed and be aware of all the relevant underlying
assumptions

Transformation
This phase is all about turning sense-making into action. Using observations from the first
step in conjunction with the insights gained from “looking closer”, the transformation phase
is about finding ways to articulate content and process in a format that allows positive
changes to be made.
He also raises five key points it is important to note when considering reflective practice.
1. Reflective practice is a key skill for nurses
2. It enables nurses to manage the impact of caring for other people on a daily basis
3. Reflective practice can be defined as the process of making sense of events, situations and
actions in the workplace
4. A range of models are available for nurses to use to support reflective practice in clinical
practice
5. Effective reflection can take place individually, in facilitated groups, or a mix of both
The full article is embedded below, and the accompanying textbook detailed in the Suggested
Resources section.
Oelofsen 2012.pdf
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Davies, Samantha (2012). "Embracing reflective practice".
Education for Primary Care 23
With specific regard to health care professionals, Davies identified that there are both benefits as
well as limitations to reflective practice:
Benefits

Increased learning from an experience for situation

Promotion of deep learning

Identification of personal and professional strengths and areas for improvement

Identification of educational needs

Acquisition of new knowledge and skills

Further understanding of own beliefs, attitudes and values

Encouragement of self-motivation and self-directed learning

Could act as a source of feedback

Possible improvements of personal and clinical confidence
Limitations

Not all practitioners may understand the reflective process

May feel uncomfortable challenging and evaluating own practice

Could be time consuming

May have confusion as to which situations/experiences to reflect upon

May not be adequate to resolve clinical problems
Pranata, Herlina (2006). "Facilitating reflective practice in clinical supervision".
Dissertation Abstracts Int'l: Section B: The Sciences and Engineering, 2006, 66/11-B(6290)
The study examined the perspectives of eleven nominated reflective supervisors on what they
thought and did in facilitating a reflective process in supervision.
Supervisors in the current study reported that their current reflective process in supervision
(supervisory alliance, supervisor's ways of being and doing) was shaped by their framework and
intention, theoretical orientations, past supervision experiences, current self-reflective practices
and contextual factors. Supervisory alliance was critical as it served as the foundation of reflective
process in supervision. Supervisory alliance provided the "spaciousness" needed for supervisors to
be able to reflect. Supervisors' ways of being and doing facilitated the reflective process.
Supervisors used their selves and intuition to facilitate the reflective process. As they did so,
reflective process was meant to help supervisees develop their own intuition, and eventually
developed their own internal supervisor.
Supervisors also reported that their past supervision experiences served as a model in facilitating a
reflective process. Furthermore, their current self-reflective practices pointed to the importance of
self-care, self-expression, personal and professional endeavours. These self-reflective practices
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helped supervisors to stay reflective by providing the "spaciousness" they needed to be facilitative
in their supervisory work. Finally, supervisors also paid attention to contextual factors, such as
time, energy, and supervisees' personal and developmental factors in facilitating reflectivity.
"Best Practice Guidelines for Reflective Supervision" (2008).
Minnesota Association for Infant & Early Childhood Mental Health
Whilst this document is from an a non-UK source, it does provide some practical guidance and
considerations when implementing reflective practice and may be useful in informing any local
policies that may be developed.
The full guidelines are embedded below.
Best Practice
Guidelines.pdf
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Quality Assurance, Research and Innovation Unit
Suggested resources
A number of key books / chapters were highlighted by the review as being of particular relevance
to reflective practice. All of these listed below have been referenced or reviewed in journal articles.
Best Practice in Professional Supervision: A Guide for the Helping Professions (2010)
Davys, Allyson; Beddoe, Liz; Kingsley, Jessica
Summary: Best Practice in Professional Supervision is an authoritative guide to being an excellent
supervisor, covering the role, functions and dispositions involved. The authors consider basic skills,
the practicalities of forming and maintaining the supervision relationship, and the organisational
context and culture of supervision. The book offers practical examples and a model of supervision
which draws together ideas from adult learning theory and reflective practice. Viewing supervision
as a place for learning, this guide considers how supervision can assist practitioners to develop
professional resilience and manage the stresses of complex work environments. It also includes
specific chapters on supervision of clinical student placements and in child protection settings. This
book covers a range of professions including social care, nursing, counselling, social work and
allied health professions, and is an essential guide for all those in these and related professions
undertaking supervision or supervision training.
Practising Clinical Supervision, A Reflective Approach for Healthcare Professionals (2007)
Driscoll, John
Summary: This title is directed primarily towards health care professionals outside of the United
States. With contributors from the UK and Australia, the second edition builds on the success of
the original, which was praised for engaging readers and being a pragmatic and practice-orientated
addition to the literature on clinical supervision. This edition is written in accessible style and will
appeal to those both new to clinical supervision or experienced. It provides a thought-provoking,
user friendly and practical guide to the subject.
Supervising the Reflective Practitioner: An Essential Guide to Theory and Practice (2010)
Scaife, Joyce
Summary: Development as a reflective practitioner has become an essential quality for
practitioners in the fields of health, education and social care. Supervising the Reflective
Practitioner provides guidance for supervisors, focusing on what they can do to facilitate the
development of reflective practice in supervisees.
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Developing Reflective Practice: A Guide for Students and Practitioners of Health and Social
Care (2012)
Oelofsen, Natius
Summary: Developing Reflective Practice is suitable for students and practitioners in a variety of
fields, including nursing, psychology, social work, therapeutic child care, and education. What all of
these fields have in common is that practitioners deal with fundamental human needs such as
physical and mental health, housing, and education.
can benefit from reading this book and working through the reflective exercises that accompany
the text.
The goal of the book is to help the reader feel confident and competent when confronted with
complex and emotionally demanding situations in the workplace. By working through the numerous
and varied activities and exercises detailed in this book, both students on placement as well as
qualified and experienced practitioners will acquire the skills needed to make sense of their
experiences in a professional context.
Positive reviews were given by Nursing Standard (August 2012) and Nursing Times (October
2012).
Routledge Handbook of Clinical Supervision: Fundamental international themes (2011)
Chapter: "Implementing clinical supervision in a National Health Service Community Trust: Sharing
the vision.", Bennett, Jenny; Gardener, Bob; James, Fiona
Abstract (from the chapter): This chapter outlines how a group of practitioners facilitated the
widespread implementation and development of clinical supervision within a NHS Community
Trust. Drawing on the experiences of health visitors, general nurses and community psychiatric
nurses, the authors describe the phases or stages of this implementation process. Furthermore,
they describe their particular roles involved in the implementation and use case examples of the
introduction of clinical supervision into each practice discipline. The chapter concludes with
reflections on the implementation process and identifies some of the barriers to introducing clinical
supervision.
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