gibbs reflective cycle nursing student

The stories help you to identify areas of knowledge and skills for development and help you to explore the context in which you practise. There are many questions that you can ask yourself to develop your learning from a story of practice. This can form part of your informal diary writing or more formal writing for a public portfolio document. As you get more practised at writing you will develop your own ability to ask questions in order to develop your practice insight.

However, writing does not come easily to everyone and some individuals may need regular practice if patterns are to emerge or if deeper learning from experience is to take place. When you first start, it can be useful to share your writing with others: a tutor or a friend, perhaps, who can help you to question your practice. Depending on your preferred way of knowing you may find it challenging. Do not be put off writing just because it is difficult. Try experimenting with different ways of writing, either with different models or just putting your thoughts down in no particular order, just as they come (free-fall writing) and your ability to analyse your experiences will begin to develop.

My preference is to use an A5-size notebook and write two or three times each week. Like many people, I find it easier to write about negative (rather than positive) experiences. However, this tends to remind me of my weaknesses rather than my strengths and this can undermine my self-esteem. Sometimes I go weeks without writing; other times I write in short bursts of 10 minutes most days.

Writing two or three times a week can allow you to process the emotional component of work and re-reading old diaries provides me with insights into my patterns of thinking and behaviour, allowing me to make changes. Several of my diary entries involve pre-planning and these sometimes become ‘to do’ lists (these help me to clarify my need to act). I have evolved my own method of keeping a diary which often is just free-fall writing. When I do structure my writing, I tend to use the following:

• I notice – this tells the story of what happened. • I feel – these notices are how I felt and how I feel after writing. • I imagine – this involves me thinking about others involved in my experience. If I am critical of others what is this saying about myself? What might be some of the consequences of this for myself and others? • I want – this often turns into a ‘to do’ list of actions as it is not always easy to decide what I want. Sometimes I decide what I do not want first! • What have I learned or achieved? – even if the experience has been difficult this helps to reframe it and allows me to let go of the emotional component.

We hope that reading this blog post will encourage you to have a go at reflection and find for yourself its value in your development as a professional nurse. In this way you can learn to become a reflective practitioner and begin to use your personal and professional experience as a means for continuing development.

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• Gibbs' Reflective Cycle

May 9, 2023

Delve into Gibbs' Reflective Cycle, a powerful tool fostering critical thinking, deep learning, and professional growth through reflection.

Main, P (2023, May 09). Gibbs' Reflective Cycle. Retrieved from https://www.structural-learning.com/post/gibbs-reflective-cycle

What is Gibbs' Reflective Cycle?

Gibbs' Reflective Cycle is a popular model for reflection, acting as a structured method to enable individuals to think systematically about the experiences they had during a specific situation.

Gibbs’ Reflective Cycle is a widely used and accepted model of reflection . Developed by Graham Gibbs in 1988 at Oxford Polytechnic, now Oxford Brookes University, this reflective cycle framework is widely used within various fields such as healthcare, education, and management to enhance professional and personal development . It has since become an integral part of reflective practice, allowing individuals to reflect on their experiences in a structured way.

The cycle consists of six stages which must be completed in order for the reflection to have a defined purpose. The first stage is to describe the experience. This is followed by reflecting on the feelings felt during the experience, identifying what knowledge was gained from it, analyzing any decisions made in relation to it and considering how this could have been done differently.

The final stage of the cycle is to come up with a plan for how to approach similar experiences in future.

Gibbs' Reflective Cycle encourages individuals to consider their own experiences in a more in-depth and analytical way, helping them to identify how they can improve their practice in the future.

A survey from the British Journal of Midwifery found that 63% of healthcare professionals regularly used Gibbs' Reflective Cycle as a tool for reflection.

"Reflection is a critical component of professional nursing practice and a strategy for learning through practice. This integrative review synthesizes the literature on nursing students’ reflection on their clinical experiences." – Beverly J. Bowers, RN, PhD

The Six Stages of Gibbs' Reflective Cycle

The Gibbs reflective cycle consists of six distinct stages: Description, Feelings, Evaluation, Analysis, Conclusion, and Action Plan. Each stage prompts the individual to examine their experiences through questions designed to incite deep and critical reflection. For instance, in the 'Description' stage, one might ask: "What happened?". This questioning method encourages a thorough understanding of both the event and the individual's responses to it.

To illustrate, let's consider a student nurse reflecting on an interaction with a patient. In the 'Description' stage, the student might describe the patient's condition, their communication with the patient, and the outcome of their interaction. Following this, they would move on to the 'Feelings' stage, where they might express how they felt during the interaction, perhaps feeling confident, anxious, or uncertain.

The 'Evaluation' stage would involve the student reflecting on their interaction with the patient, considering how they could have done things differently and what went well. In the 'Analysis' stage, the student might consider the wider implications of their actions and how this impacted on the patient's experience.

Finally, in the 'Conclusion' stage, the student would summarise their reflections by noting what they have learned from the experience. They would then set an 'Action Plan' for how they will apply this newfound knowledge in their future practice.

Gibbs' Reflective Cycle is a useful tool for nurses to utilize in order to reflect on their past experiences and improve their practice. By using reflective questions , nurses can actively engage in reflection and identify areas for improvement. 

• Description : Start by objectively recounting the experience. Helpful questions to ask include: What happened? Who was involved? When and where did this occur?
• Feelings : Capture your emotional response to the experience. It's essential to acknowledge both positive and negative emotions, as they significantly affect our interpretation of the event.
• Evaluation : Assess the good and bad aspects of the experience. What worked well, and what didn't? What were the positive impacts and negative consequences?
• Analysis : Dig deeper into understanding why things unfolded as they did. This analysis stage is where you draw on relevant literature and professional knowledge to interpret the experience.
• Conclusion : Determine what you could have done differently and what you've learned from the experience.
• Action Plan : Develop a plan detailing what you'll do if a similar situation arises in the future.

Examples of the Reflective Model in Practice

The Gibbs Reflective Cycle, a model of reflection, can be a powerful tool for learning and personal development across various vocations. Here are five fictional examples:

• Nursing : A nurse named Jane had a challenging interaction with a patient. Using the Gibbs Reflective Cycle, she first described the situation and her initial reactions. She then reflected on her feelings, identifying negative emotions that arose. During the analysis stage, she realized that her communication skills needed improvement. She concluded that better communication could have led to a more positive outcome. Finally, she developed a personal development plan to improve her communication skills, demonstrating the positive impacts of deep level reflection.
• Teaching : A teacher, Mr. Smith, had difficulty managing his classroom . He used the Gibbs Reflective Cycle to reflect on a particularly chaotic day. He identified negative aspects of his classroom management strategy and, through critical thinking, realized that he needed to set clearer expectations for his students. He then developed a plan to implement these changes, showing how the approach to reflection can lead to actionable improvements .
• Customer Service : Sarah, a customer service representative, received constructive feedback from a customer who was dissatisfied with the service. She used the Gibbs Reflective Cycle to reflect on the interaction, identifying her feelings of disappointment and analyzing what went wrong. She concluded that she needed to improve her problem-solving skills and developed a plan to do so.
• Management : A manager, Tom, struggled with delegating tasks to his team. He used the Gibbs Reflective Cycle to reflect on a project that was delayed due to his reluctance to delegate. He identified his fear of losing control as a negative emotion and realized during the analysis stage that trust in his team was crucial. He then developed a plan to practice delegation in future projects.
• Counseling : A counselor, Dr. Lee, felt that her recent sessions with a client were not productive. She used the Gibbs Reflective Cycle to reflect on these sessions. She identified feelings of frustration and, upon analysis, realized that she needed to adjust her counseling techniques to better suit her client's needs. She then developed a plan to implement these changes.

These examples illustrate how the Gibbs Reflective Cycle can facilitate learning and reflection across different vocations, leading to personal and professional growth.

An Exploration of Gibbs' Model

Gibbs' Reflective Cycle offers a structured approach to reflection, making it a helpful tool for educators and learners alike. The model encourages critical reflection , stimulating the ability to analyze experiences through questions and transform them into valuable learning opportunities.

Experiential Learning , a concept closely tied with reflection, suggests that we learn from our experiences, particularly when we engage in reflection and active experimentation . Gibbs' model bridges the gap between theory and practice, offering a framework to capture and analyze experiences in a meaningful way.

By using Gibbs' model, educators can guide students through their reflective process , helping them extract valuable lessons from their positive and negative experiences.

Application of Gibbs' Reflective Cycle in Real-World Scenarios

The flexibility and simplicity of Gibbs' Reflective Cycle make it widely applicable in various real-world scenarios, from personal situations to professional practice.

For instance, Diana Eastcott, a nursing educator, utilized Gibbs' model to facilitate her students' reflection on their clinical practice experience. The students were encouraged to reflect on their clinical experiences, analyze their reactions and feelings, and construct an action plan for future patient interactions. This process not only enhanced their professional knowledge but also fostered personal growth and emotional resilience.

In another example, Bob Farmer, a team leader in a tech company, used Gibbs' Cycle to reflect on a project that didn't meet expectations. He guided his team through the reflective process, helping them identify areas for improvement and develop strategies for better future outcomes.

These scenarios underline the versatility of Gibbs' model, demonstrating its value in both educational and professional settings.

• ( Gibbs Reflective Cycle , University of Northampton, https://www.northampton.ac.uk )
• ( Gibbs' Reflective Cycle , Oxford Brookes University, https://www.brookes.ac.uk )
• ( Reflective Practice , San Francisco State University, https://www.sfsu.edu )

Gibbs' Reflective Cycle for Personal and Professional Development

The use of Gibbs' Reflective Cycle can have profound effects on personal and professional development. It aids in recognizing strengths, weaknesses, and areas for improvement, providing an avenue for constructive feedback and self-improvement.

In the context of professional development , Gibbs' model promotes continuous learning and adaptability. By transforming bad experiences into learning opportunities, individuals can enhance their competencies and skills , preparing them for similar future situations.

Moreover, the reflective cycle promotes emotional intelligence by encouraging individuals to explore their feelings and reactions to different experiences. Acknowledging and understanding negative emotions can lead to increased resilience, better stress management, and improved interpersonal relationships.

Transforming Experiences into Learning: The Role of Gibbs' Reflective Cycle

Gibbs' Reflective Cycle is a practical tool that transforms experiences into learning. It incorporates principles of Experiential Learning and emphasizes the importance of abstract conceptualization and active experimentation in the learning process.

In the field of education, Gibbs' model can significantly influence teaching methods. It encourages educators to incorporate reflective practices in their teaching methods, promoting a deeper understanding of course material and facilitating the application of theoretical knowledge in practical scenarios.

Moreover, the model can be used to encourage students to reflect on their experiences, both within and outside the classroom, and learn from them. This process fosters critical thinking, problem-solving skills, and personal growth, equipping students with the skills they need for lifelong learning.

Embracing Gibbs cycle in your organisation

Here's a list of guidance tips for organizations interested in embracing Gibbs' Reflective Cycle as their professional development model.

• Understanding the Gibbs Reflective Cycle : Before implementing, ensure that everyone in the organization understands the Gibbs Reflective Cycle model. This model consists of six stages: Description, Feelings, Evaluation, Analysis, Conclusion, and Action Plan. The goal is to encourage deep level reflection on experiences to foster learning and improve future actions.
• Promote a Culture of Reflection : Encourage everyone in the organization to incorporate reflection into their daily routine. Reflection should not be seen as an added task, but rather as an integral part of the professional development process.
• Use Real-Life Situations : For the methods in education to be effective, use real-life situations when applying the Gibbs Reflective Cycle. This way, employees can relate to the experiences, making the reflection process more relevant and meaningful.
• Encourage Sharing of Reflections : Create a safe space for individuals to share their reflections. This could be through team meetings, one-on-one sessions with managers, or through online platforms. Sharing allows for collective learning and may provide different perspectives on the same situation.
• Integrate Reflective Practice in Training Programs : Use the Gibbs Reflective Cycle in training programs. After each training session, encourage participants to go through the reflective cycle. This can help them understand the training content better and apply it in their work.
• Link Reflection to Personal Development : Connect the outcome of the reflection to personal development plans. The Action Plan stage of the cycle should feed into the individual's personal development plan, helping them identify areas of strength and areas needing improvement.
• Provide Guidance and Support : Provide guidance and support in the early stages of implementing the Gibbs Reflective Cycle. This could include providing templates or guides, or offering training on how to use the model effectively.
• Continuous Review and Feedback : Regularly review the use of the Gibbs Reflective Cycle in your organization and provide feedback. This will help ensure that the model is being used effectively and is helping individuals in their professional development.
• Model Reflective Practice : Leaders and managers should model reflective practice themselves. This shows that the organization values reflective practice and can motivate employees to engage in it themselves.
• Celebrate Success : Recognize and celebrate when reflective practice leads to positive changes or improvements. This can motivate employees to continue using the Gibbs Reflective Cycle in their professional development.

What is the Difference Between Kolb's and Gibbs' Reflective Cycle?

Both Kolb's Experiential Learning Theory and Gibbs' Reflective Cycle are influential learning methods used extensively in education and professional development. While they share similarities, such as promoting a cyclical learning process and fostering a deeper understanding of experiences, there are key differences.

Kolb's cycle consists of four stages: Concrete Experience, Reflective Observation, Abstract Conceptualization, and Active Experimentation. It focuses more on the transformation of direct experience into knowledge, emphasizing the role of experience in learning.

On the other hand, Gibbs' cycle, with its six stages, places a greater emphasis on emotions and their impact on learning. For example, a team leader might use Kolb's cycle to improve operational skills after a failed project, focusing on what happened and how to improve. However, using Gibbs' cycle, the same leader would also reflect on how the failure made them feel, and how those feelings might have influenced their decision-making.

Other notable Learning Methods and Cycles

Please note that each of these theories or models has been developed and refined over time, and they each have their own strengths and weaknesses depending on the specific learning context or goals.

Adopting the Cycle in Education

Gibbs' Reflective Cycle is an invaluable tool for nurturing professional skills and fostering personal growth. By systematically integrating this reflective model into educational practices, institutions can significantly enhance their students' professional development.

Here are seven innovative ways educational institutions can harness the power of Gibbs' Reflective Cycle to boost skill acquisition , operational proficiency, leadership capabilities, and personal skills mastery.

• Incorporate Reflective Practice in Curriculum: Educational institutions can incorporate Gibbs' Reflective Cycle into their curriculum, making it a regular part of learning. This can encourage students to develop professional skills by continually reflecting on their experiences and learning from them.
• Real-World Scenarios: By using real-world situations or case studies, educational institutions can provide practical instances for students to apply the reflective cycle. This will help them understand the type of situation they might encounter in their professional life and how to handle it.
• Promote Skill Acquisition: Gibbs' cycle can be used as a tool for skill acquisition. By reflecting on their performance in various tasks and projects, students can identify their strengths and areas that need improvement. This can aid in the development of operational skills, leadership skills, and personal skills.
• Professional Development Workshops: Educational institutions can organize workshops that focus on the application of Gibbs' Reflective Cycle for professional development. These workshops could provide hands-on training on how to use the cycle effectively.
• Reflective Journals: Encourage students to keep a reflective journal. This practice can help students regularly apply Gibbs' cycle, promoting introspection , and the development of key leadership skills.
• Mentorship Programs: Implement mentorship programs where experienced professionals guide students in applying Gibbs' Reflective Cycle. This can provide students with valuable insights into how reflective practice can enhance their professional skills.
• Assessments Based on Reflection: Design assessments that value reflective practice. Instead of solely focusing on theoretical knowledge, consider students' ability to reflect on their experiences and learn from them. This approach can make learning more engaging and relevant to real-world situations.

In the journey of life and work, we continuously encounter new situations, face challenges, and make decisions that shape our personal and professional trajectory. It's in these moments that Gibbs' Reflective Cycle emerges as a guiding compass, providing a structured framework to analyze experiences, draw insights, and plan our future course of action.

Underlying the model is the philosophy of lifelong learning. By encouraging critical reflection, it empowers us to not just passively experience life, but to actively engage with it, to question, and to learn. It's through this reflection that we move from the realm of 'doing' to 'understanding', transforming experiences into knowledge.

Moreover, the model emphasizes the importance of an action-oriented approach. It propels us to use our reflections to plan future actions, promoting adaptability and growth. Whether you're an educator using the model to enhance your teaching methods , a student exploring the depths of your learning process, or a professional striving for excellence in your field, Gibbs' Reflective Cycle can be a powerful tool.

In an ever-changing world, where the pace of change is accelerating, the ability to learn, adapt, and evolve is paramount. Reflective practices, guided by models such as Gibbs', provide us with the skills and mindset to navigate this change effectively. They empower us to learn from our past, be it positive experiences or negative experiences, and use these lessons to shape our future.

From fostering personal growth and emotional resilience to enhancing professional practice and shaping future outcomes , the benefits of Gibbs' Reflective Cycle are manifold. As we continue our journey of growth and learning, this model serves as a beacon, illuminating our path and guiding us towards a future of continuous learning and development.

• Reflection in Learning and Professional Development
• The Reflective Practitioner
• Reflective Practice: The Teacher in the Mirror
• The Impact of Reflective Practice on Teaching Effectiveness
• Reflective Practice: A Guide for Nurses and Midwives
• Reflective practice in nursing
• Learning by Doing: A Guide to Teaching and Learning Methods
• Gibbs’ Reflective Cycle

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• Learn From Your Past Experience with Gibb’s Reflective Cycle
• Exploring Different Types of Reflection Models with Examples

You must have heard about Gibbs' reflective cycle. It is a widely prominent reflective cycle that helps individuals to work through past experiences and improve future practices. Gibbs' The reflective cycle was developed by Graham Gibbs in 1988 with the main aim of structuring individual learnings from past experiences (Markkanen et al., 2020). Effective utilization of this cycle offers a wide opportunity to examine past experiences and improve future actions.

Table of Contents

Six stages of gibbs' reflective cycle.

• Example of Gibbs' reflective cycle

Hence, the efficacious use of Gibbs' reflective cycle helps individuals to learn from past experiences that went well as well as past experiences that did not. The 6 stages of Gibbs' cycle include description, feelings, evaluation, analysis, conclusion, and action plan (Smith & Roberts, 2015).

For each step of this framework, you can work on a set of helpful questions given below to properly reflect on your past experiences and situations.

Stage 1: Description

The first step in Gibbs' reflective cycle is a description where you get an opportunity to properly describe a situation based on your experience. The following questions can assist you in describing your experience are

• What happened? In this, you will explain the factual information about the experience you want to reflect upon.
• Why did it happen? In this, you will underline the main reason behind the occurrence of the event.
• What did you do? While answering this question, you will highlight all the actions taken by you.
• Who was present? In this, you will highlight all the people that were present during the event.
• What were the major outcomes? In this, you will underline the results of the actions that were taken by you.

Using these questions, you will provide complete background information about an incident as well as a factual description of the event you want to reflect upon.

Stage 2: Feelings

The second step in Gibbs’ reflective cycle is an analysis of your feelings where you can describe your thoughts as well as feelings in detail to reflect on the corresponding experience of your feelings. You can reflect on this phase on the basis of a few assisting questions given below:

• What did you feel? In this section, you will highlight your feelings during the experience.
• Why did you feel this way? You will highlight the major reasons behind feeling the way you were feeling.
• How did other external factors influence your feelings? In this section, you will underline the positive or negative influence of other external factors such as the environment, and other involved people on your feelings.
• How did other internal factors influence your feelings? In this section, you will highlight the influence of various internal factors such as mindset, attitude, and physical or mental health.

These questions will help you to describe your feelings and the way in detail and will also assist in making the reader understand your emotional aspect from the incident you are reflecting upon.

Stage 3: Evaluation

In the evaluation phase, you get a chance to properly evaluate what worked well and what didn't work well. This phase includes the evaluation of experiences from both good as well as bad points, allowing you to mentally create a report of the experience. Below given are the questions that can be answered in this phase

• What worked well? In this, you will highlight the positive outcomes of your actions throughout the experience.
• What didn't work well? This will highlight all the negative outcomes of your actions taken by you throughout the experience.
• What did you contribute? Through this question, you will highlight your contribution to the whole experience.
• What did others contribute? While answering this question, you will highlight the actions of others that were involved in the situation.
• What was missing? In this, you will highlight the actions that were missing in the experience as per your opinion.

Based on these questions, you can honestly and objectively evaluate the past situation which will also help you in setting a base for future actions.

Stage 4: Analysis

In an analysis phase, you can make sense of a whole situation and determine the exact meaning of a situation along with the reasons for its success or failure. Some helpful questions for the analysis phase of Gibbs’ reflective cycle include

• Why did things not work well? In this, you will point out the reason as per your knowledge that contributed to the failures of your actions in your experience.
• Why did things go well? Through this section, you will highlight the reasons behind the success of your actions.
• What is the exact meaning that we can drive from a situation? While answering this question, you will highlight the overall analysis of the situation.

Based on the analysis, you can get a clear picture of the situation and ensure that every aspect of the situation is covered and understood meticulously.

Stage 5: Conclusion

After a proper situation analysis, you can also conclude the whole situation by reflecting on your learnings. In this phase, you can highlight changes that you need to make to your actions while dealing with future situations. In this phase, a list of questions includes

• What did you learn? In this, you will highlight all of your main learnings of the situation.
• What skills do you need to gain to handle situations more effectively? Through this, you will highlight the requirements of the skills for handling the situation better in the future.
• What else could you have done to deal with situations differently? In this, you will highlight the alternative actions that you could have taken to respond to the same situation in a different manner.

After the analysis, in the conclusion phase, using the above questions, you will clearly outline your learnings and the skills gained through the experience.

Stage 6: Action plan

In the action plan stage in Gibbs’ reflective cycle, you can plan to deal with future situations. It is an important phase of this reflective cycle as this phase helps to determine ways to deal with similar situations in the future and actions that you need to take to improve your ability to deal with various situations. Some questions that can be considered in this stage include

• How will you deal with this situation more effectively in the future? In this, you will highlight the actions that you have thought of that will help you in dealing with a similar situation differently in the future.
• How will you develop your skills and abilities to deal with similar situations? In this situation, you will highlight the methods in which you will develop the skills for dealing with situations more effectively.

After understanding the cycle, let us now take an example of reflective practice in health education to reflect on the learning situation using Gibbs’ reflective cycle.

Gibbs’ reflective cycle example in health education

Case assessment - This reflective example will highlight the experience of students in a group task of completing a health project. In this, a student will reflect upon a group task assigned to students during their MSc in health practice.

While doing my MSc in health practice, I was required to engage in various group work assignments and during a certain group work task, my team members decided to divide tasks among group members. All team members encouraged me to divide the tasks among the team. I divided tasks among team members according to their knowledge regarding various healthcare practices to ensure that all tasks are completed within a set deadline. All team members encouraged me to divide the tasks among the team. I divided tasks among team members according to their knowledge regarding various healthcare practices to ensure that all tasks are completed within a set deadline. However, I failed to consider the risk of various contingencies in completing projects and the same occurred when one of our team members was hospitalized due to some health emergency which resulted in a lack of task completion assigned to that team member. My whole team was present when I got a call from the injured team member about the accident that occurred to him. This then resulted in an increased burden to complete tasks among team members and failure to complete a task on time.

Before beginning the health project, I was very confident regarding my team management capabilities. I felt that our team will be able to complete assigned tasks on time due to my strong knowledge and abilities. I was already feeling very guilty that our project got delayed because of my lack of planning but the external factors made me feel even worse. Other than that, I felt like it was my overconfidence that made me feel more guilty because things did not work as planned.

During the group health project, a thing that worked well was the effort of team members to complete work within the extended deadline was cooperation as well as motivation among all team members. However, I believe that the hospitalization of one team member resulted in a lack of task completion on time. I felt that contingency planning is one most important requirement in a team project which was missing in this project. Thus, I believe that I am also responsible for the bad repercussions of this situation as I failed to properly plan and did not consider the risks of contingencies in a group. But still, till the end, everyone contributed effectively and did not lose hope till the end and gave their best.

I think the major reasons behind the successful completion were group efforts, cooperation abilities, self-identification of strengths, effective division of tasks, and ability to help others. However, the only thing that created a problem in completing a project is a lack of time management and planning capabilities. Through this whole experience, I believe that I need to focus on improving my time management skills as well as leading the ability to effectively manage group tasks.

After getting into this group health project, I got to know that time management and contingency planning are important skills that every project manager needs to possess to effectively manage group tasks. I also found that team management is possible only through the cooperation of team members as well as their effort to give the best results to a team project. I learned that as a project manager, it is always better to have a contingency plan ready for implementation than to develop one as risk is taking its toll (Heimann, J. F. 2000). However, I found that various problems can arise in a group task which could be managed effectively by making contingency plans for such situations in advance. I would have prepared contingency plans in the beginning and I believe that it would have helped me in dealing with situations differently.

In order to deal with this situation in the future, I have decided that I will use various time management tools such as PERT and CPM while planning various group tasks to keep separate times for various contingencies. For enhancing my time management and planning skills, I have decided to use time management skills such as making time tables and assigning time blocks for each task. If a similar situation occurs again in the future, I will ensure that in the planning phase only, I take time for contingency planning and plan things accordingly.

How to reference Gibbs reflective cycle?

To reference Gibbs' reflective cycle, include the author's name "Gibbs" and the publication year (if available) in parentheses. For instance, in APA style, it would be: (Gibbs, 1988). If you use a direct quote, add the page number as well.

Can Gibbs' Reflective Model be used in any profession?

Yes, the model is versatile and applicable in various professions and fields, including education, healthcare, social work, and more.

What are the disadvantages of Gibb's reflective cycle?

Gibbs' reflective cycle lacks a strong theoretical foundation and may not suit complex or long-term learning experiences. Some of you may even find its structured approach restrictive that could potentially overlook unique aspects of individual experiences. Additionally, it may not be universally applicable to various learning contexts.

Previous Model

Markkanen, P., Välimäki, M., Anttila, M., & Kuuskorpi, M. (2020). A reflective cycle: Understanding challenging situations in a school setting. Educational Research, 62(1), 46-62. https://doi.org/10.1080/00131881.2020.1711790

Smith, J., & Roberts, R. (2015). Reflective Practice. Vital Signs For Nurses, 222-230. https://doi.org/10.1002/9781119139119.ch14

Heimann, J. F. (2000). Contingency planning as a necessity. Paper presented at Project Management Institute Annual Seminars & Symposium, Houston, TX. Newtown Square, PA: Project Management Institute.

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• v.9(2); 2023 Feb

Master of nursing specialist experiences of an internship through the use of written reflections: A qualitative research study

Ting-ting zhan.

a Department of Brain Center, The First Affiliated Hospital of Anhui University of Chinese Medicine, No. 117 Meishan Street, Hefei, 230031, Anhui, China

b School of Nursing, Anhui University of Chinese Medicine, No. 103 Meishan Street, Hefei, 230031, Anhui, China

Cai-jie Sun

Associated data.

Data included in article/supp. material/referenced in article.

Reflective practice is an educational strategy and an essential part of the professional development of nurses. However, there are few reflective journals in the master of nursing specialist program or clinical nursing education.

Based on Gibbs' reflective cycle theory, masters of nursing specialists (MNS) will use a diary to record their reflections on a particular clinical event. The purpose of this study was to identify reflective practice as tool to help MNS improve their professional and personal development.

A descriptive qualitative study.

The purposive sampling method was used in the qualitative study. The data were derived from the master of nursing specialist who interned at the hospital from June to December 2021. After completing the job rotation and relevant course training within 6 months, a clinical experience was selected as a reflection. The traditional qualitative content analysis method was applied to analyze the collected data in the research.

A total of 10 reflective diaries completed by ten students were analyzed. This qualitative study demonstrated that the Gibbs' reflective cycle is valuable and helpful in the clinical practice of master of nursing specialists. This program helps master of nursing specialists reflect on their clinical practice and translate real-life experiences into valuable learning experiences for developing their professional development and personal skills.

Conclusions

By writing reflection diaries, master of nursing specialists can reflect on the problems encountered during clinical rotations and take action following that reflection, which can assist them in improving their professional development and personal skills to handle clinical nursing aspects in the future, as well as improve their full participation in clinical practice.

1. Introduction

Reflective practice is not only an educational strategy [ 1 ] but also a core skill for the professional development of nursing students [ 2 ]. Research has shown [ 1 ] that reflection provides caregivers with the ability to learn from clinical experiences through critical thinking. This helps stimulate learning and add new knowledge to clinical practice, facilitating practice transformation and the development of new insights [ 1 ]. The study also found that it can use scientific knowledge, personal knowledge, and experiential knowledge to solve complicated problems in practice [ 3 ]. Moreover, studies have shown that reflective practice, as a cognitive skill that nurses learn from experience, can improve the knowledge and skills of nursing students, novice nurses, and experienced nurses in clinical practice, improve the professional practice of nurses and positively improve the health outcomes of patients [ 1 , 4 ]. It has also been reported that reflective practice can enhance a clinician’s competence through a critical review of clinical practice [ 5 ]. Additionally, an integrative review has demonstrated that nursing professions at all levels are influenced by reflective practices, adding value to the nursing profession [ 6 ].

As a member of the nursing workforce, a master of nursing specialist (MNS) is expected to have higher levels of professional competence, practical competence, critical and reflective ability, and interpersonal communication when faced with complex clinical environments [ 7 , 8 ]. In direct contact with patients in clinical practice, MNS may encounter unexpected clinical situations leading to stress [ 9 ], and most of these clinical experiences have not been effectively addressed. Therefore, reflective practice is necessary for MNS for patient safety [ 4 ] nurses' own physical and mental health, and coping with future challenges [ 4 ]. Reflective practice improves nurses' understanding of their practice by giving meaning to their experiences [ 4 , 10 ], thereby enhancing their personal and nursing professional development [ 2 ], and narrowing the gap between theory and clinical practice in nursing humanistic care dimension [ 10 ]. The reflective journal is the most commonly used tool in reflective practice [ 9 ], and it is seen as a learning tool in postgraduate medical education [ 11 ]. Studies have shown that the process of writing a reflective journal, through the practice of self-reflection and reflective writing, can help release clinically repressed emotions [ 6 , 9 ]. As a reflection tool, a diary is considered to reflect on oneself and others [ 12 ] during critical clinical events, which can facilitate the learning process, personal growth, and professional development of nursing students [ 13 ] through an in-depth understanding of what clinical experience means [ 12 , 14 ]. It is recommended that participants consider their feelings during the six stages of Gibbs’s framework, such as reflection, description, feeling, evaluation, analysis, conclusion, and action plan [ 2 , 15 ]. The Gibbs’s reflective cycle provides a structured approach that has been successfully applied to nursing majors and nursing students, enabling students to logically reflect on clinical events [ 16 , 17 ]. Structured templates, however, may compromise the quality and authenticity of the data collected. Nevertheless, Gibbs' reflective cycle was found to be an effective, useful, and enjoyable method for teaching clinical education [ 18 , 19 ]. The Gibbs’s reflective cycle [ 19 ] also showed that most people’s knowledge and understanding are obtained from a reflection of the experience, and constantly thinking can lead to a better understanding of things, and the guidance of action.

Based on Gibbs’s reflective cycle, reflective practice has been successfully performed in some countries, such as Japan’s public health graduate and undergraduate students [ 19 , 20 ] and nursing staff in China [ 21 ]. The study found that MNS in China must have the ability to enhance personal reflection and professional ability [ 7 , 8 ], and Gibb’s reflective cycle can be used as a theoretical framework for beginning writers to reflect on their behavior, to improve their performance [ 16 , 17 ]. According to researchers [ 21 ] in China, using Gibbs’s reflective cycle can improve nurses' ability to engage in clinical nursing thinking when dealing with adverse events, especially by helping nurse practitioners who work for 0.5–1 year gain a more comprehensive understanding of adverse events.

However, the theoretical framework of the Gibbs’s reflective cycle has not been applied to the analysis of MNS’ clinical experience. And it is not clear whether reflective practice can improve the professional ability and personal development of MNS. Hence, understanding the clinical experience is essential for the personal and professional development of MNS. Reflections on the clinical experience of MNS were explored in the context of clinical practice in this study.

2.1. Type of research design

A descriptive qualitative study was applied to the study.

2.2. Settings and populations

The purposive sampling method was used in qualitative research because it can improve the transferability of research [ 22 ]. The study subjects were all MNS interning at the hospital. The first author has overseas study experience and participated in Gibbs' Framework training abroad. All four researchers participated in a qualitative research course. Participants interested in the program were invited in person by the program leader at the MNS Academic Salon meeting. Participants then signed written informed consent at the site, and the program leader distributed Gibbs’s reflective cycle course schedule along with a verbal statement asking participants to provide at least one written reflection material via WeChat or email at the end of the program. Out of 13 eligible participants, ten eventually agreed to participate and completed and submitted reflective writing.

The respondents included nine females and one male. To protect participants' privacy, all participants' information is encrypted from P1 through P10. Participants are only required to provide their ages and work experience. The students are between 24 and 30 and have completed 10–12 months of clinical practice at the undergraduate level of nursing education before their postgraduate education. According to China’s internship regulations, all of them have full internship experience including but not limited to the internal medicine department, surgical department, ICU, and operating room. Moreover, none of them had prior nursing-related work experience before becoming MNS, only undergraduate internships. In addition, MNS has a clinical internship of at least six months and is required to take classes related to Gibbs’s reflective cycle. During the six-month internship, they were mainly involved in the care of patients with chronic diseases such as Wilson’s disease and Parkinson’s disease, including intravenous injection and the implementation of traditional Chinese medicine nursing techniques.

2.3. Data sources

The reflective diary based on Gibbs’s framework is used as the original material for this study. In diary writing, the study adopted the structure of Gibbs’s reflective cycle, which consists of six modules: reflection, description, feeling, evaluation, analysis, conclusion, and action plan [ 2 , 15 ]. This model was chosen because of the successful application of the Gibbs Reflection Cycle to reflection in the nursing profession [ 16 ], which not only allowed participants to write a reflection diary step by step but also allowed them to take into account their feelings about clinical events [ 2 , [15] , [16] , [17] ].

The concept and steps of the Gibbs reflective cycle, application cases in the clinical field of nursing, and writing principles were explained by the project leader. There are eight classes, each lasting about 20 min. The research team leader at any stage of the study didn’t affect the MNS internship phase of the score, also won’t for internship experience in an oral or written judgment. Gibbs’s reflective course is taught face-to-face in the classroom. Gibbs' reflective practice courses and reflective writing are guided by nursing professionals or program leaders with at least ten years of experience. After six months of clinical practice, participants were asked to describe their feelings about clinical events based on the Gibbs reflection cycle model. In addition, students were required to complete and submit at least one clinical experience diary about their reflective learning experience.

2.4. Data analysis

Qualitative research data was conducted from ten independent texts with a total of 11, 899 Chinese characters. The writing template of all manuscripts was A4 paper size, the Chinese font was required to be Song style, the size of the font was 4, and the line spacing was 1.5 times. Traditional content analysis, which aims to describe a phenomenon, is often used in qualitative research designs [ 23 ]. All the researchers through qualitative research training, study the authenticity of the data, data collecting, sorting, and analysis by different researchers. Initially, the texts were entered into NVivo 12 software, by the researchers (second author) on the material number and document, personally involved in the data sorting, repeated readings, and immersed in the data, to have an integral feeling of the information. Then, data are analyzed and coded based on Gibbs’s framework, and categories and topics are extracted by two researchers (second and third authors), respectively. At the same time, the two researchers have professional accomplishments and social relations, making it can grasp the role and status of the research team, to enhance the reliability of the author. In this process, the researchers will be meaningful words, phrases, sentences, or passages marked, and begin to open coding. Subsequently, the categories and subcategories were discussed and evaluated by the members of all the studies, and the final themes were identified. After this stage, to encode the original material, the researchers carried out the coding system will be the same or similar coding classification form a category or categories. The study design is designed under the framework of the Gibbs’s reflective cycle, so will be the same or similar code, again classified to the Gibbs’s framework. When data after the complete category, the researchers again take out each category file, read all the excerpts, and ensure that materials and categories, can find corresponding extracted from the data sample. Encoding steps above all by two different researchers (second and third authors) for the first time after coding, and face-to-face to check coding categories, after carefully discussion decided to subject classification. If any disagreement, after discussing with the fourth author and project director. Additionally, to guarantee data integrity and authenticity, a compiled manuscript subject was returned to participants for comment and/or correction. The whole data analysis process was conducted in Chinese and finally translated into English. The consolidated criteria for reporting qualitative research (COREQ) were followed by this study [ 24 ].

2.5. Establishment of trustworthiness

Studies have reported [ 22 , 25 ] that researchers can use Lincoln and Cuba’s criteria, including credibility, reliability, confirmability, and transferability, to ensure the trustworthiness of qualitative research. First, credibility refers to confidence in the authenticity of the information from the participant’s point of view [ 25 ]. In this study, all nursing graduate students participating in the study had at least ten months of nursing clinical practice experience during their undergraduate years, as well as at least six months of clinical practice experience in different departments for MNS postgraduates, to ensure that participants had authentic experience and opinions about the clinical practice experience, thus ensuring the credibility of the study. Second, reliability refers to data stability in different places at different times [ 25 , 26 ]. The study ensures the reliability of the data collection process by carefully describing the investigator’s recruitment and reflective practice courses so that readers can see the content of the entire research process. Third, conformability refers to the objectivity or neutrality of the data and refers to the agreement of independent people on the relationship or significance of the data [ 25 ]. The Gibbs reflective cycle framework is applied to the reflective process and is used for data analysis, making the writing structure visible. In addition, the two authors (the second and fourth authors) analyzed and encoded the text data independently. If there is any disagreement during the analysis, discuss it with the third author (first author) and resolve it through negotiation. Fourth, transferability refers to the significance of the research results for other groups in similar situations, also known as suitability, meaning the extensibility of the data [ 25 ]. Gibbs’s theory is applied to this qualitative research, and if it is based on the same approach, it can be applied to similar research.

2.6. Ethical issues

This study was approved by the ethics committee of the First Affiliated Hospital of Anhui University of Chinese Medicine. The Declaration of Helsinki [ 27 ] was used to follow the ethical guidelines for this study, which mainly analyzed the empirical reflection of MNS in clinical practice and had no impact on patient care. All data were anonymously encoded and then analyzed to ensure the participants' privacy. Participants received detailed oral and written information about the research presented by the researchers (first and second authors) during the course. All willing students were asked to sign an informed consent form after the researchers introduced the purpose of the study and how the data were collected. Although all participants were required to sign a written informed consent form, they were also informed that anyone was free to withdraw from the study at any time.

3. Findings

Based on Gibbs’s framework, the topic categories of this study are proposed. This paper summarizes the reflections on the clinical practice experience of MNS, as shown in Table 1 .

Participants' reflections.

3.1. Descriptions of the clinical practice experience

The traditional qualitative content analysis of reflective journals indicated that MNS most frequently described the clinical practice experience as the three themes of adverse events, professional knowledge, and nurse-patient conflict. First, the adverse events were described by the MNS as the use of the wrong medication when the patient received the treatment and the scalding of the patient due to the failure to assess the patient’s skin condition in time or unclear account. Second, participants described their lack of professional expertise in clinical practice, including insufficient theoretical preparation and unskilled operation skills, and the lack of professional knowledge caused inevitable pain to patients or made them feel embarrassed when facing patients. Third, nurse-patient conflict was described as patient bias towards MNS clinical practice and a lack of communication and feedback between nurse-patient.

3.2. Feelings

Negative emotions associated with the clinical practice were anxiety, guilt, worry, and nervousness. For example, when nursing graduate students were involved in the care of patients with scalds that were not immediately detected and treated by nursing staff, participants often experienced feelings of anxiety and guilt. Worry and nervousness usually arise when MNS care for patients with a lack of professional skills, resulting in patients being exposed to certain risks. Such as, participants described feeling guilty about giving patients the wrong medication or the wrong infusion, as well as feeling nervous and worried about patient safety.

Conversely, in clinical practice, positive emotions of happiness are also mentioned. The participants described their feelings after answering the patients' nursing knowledge of a particular specialty. For example, when the participants were trusted by the patients and successfully solved the patients' questions by seeking relevant literature, they were generally recognized by the patients, thus feeling the value of the internship and having a happy mood. These unique experiences motivate the participants.

P4: “Although I don't care much about what other people think, I am happy to be acknowledged by patients. I also felt self-worth as a nursing graduate student, although people always have a skeptical attitude towards nursing graduate students. ”

Moreover, the safety of the patients and understanding of the situation was often described by participants when referring to thoughts during and after this situation. In this situation, participants usually remain calm, such as quickly ending the unfair treatment or infusion of the patient, and removing some potential risk factors that may endanger the patient’s safety. In addition, participants will try to understand and find the cause of the event and then evaluate the harm their behavior has caused the patient.

P10: “ I could not bear the consequences if other special drugs were changed by mistake. ”

P9: “But the scalding incident proved me wrong and I felt very guilty for causing such a young child to suffer.”

3.3. Evaluation

The evaluation consists mainly of two aspects: what was a good experience and what was a bad experience. In clinical practice, good experience primarily referred to the response of nursing graduate students to conflict. Participants reported that they were able to quickly disengage from a conflict situation and remain calm when confronted with a conflict, which impressed them when they administered an infusion or hot compress of Traditional Chinese medicine. This similar experience enabled participants to learn how to deal with these situations encountered in clinical practice, such as help from clinical teachers and seeking forgiveness from patients and families.

P2: “The patient’s infusion sequence was disrupted. The conversation with the patient went well, and she finally showed understanding. I also explained this matter to the superior teacher later.”

The bad experiences were associated with concerns about the situation. When participants participate in patient care in ineffective or unprofessional ways, this interaction often leads to some distress for the patient. For example, nursing graduate students lack the skills to perform infusion operations, leading to the behavior of secondary puncture, even if the patient understands, but also increases the patient’s physical pain. Patients also often suffer the negative consequences of medication errors, burns, and other physical and mental injuries.

3.4. Analysis

What was done well and what was done wrong were described by participants in clinical practice. Seeking help from clinical teachers and being empathetic to patients were described by participants as doing well in clinical practice. For instance, when the participants found that the patients had burns, they immediately sought the help of clinical teachers to relieve the patient’s pain. In addition, personal unprofessional behavior not only increased the cost of patient treatment but also caused patients to bear different degrees of physical and mental pain. The participants were able to be patient-centered, understand the patient’s feelings of dissatisfaction, and empathize with the patient’s experience.

P1: “ The pain caused by the swelling of the arm caused by the improper operation is unbearable to the patient. The patients and their families are not satisfied with me, but I can understand the discomfort caused by the patient ’ s pain and sincerely apologize to the patients and their families. ”

P9, P6, P8: “Even though the patient understands my unprofessional nursing practices, I still feel empathy for the patient, and I feel guilty.”

In clinical nursing, the lack of professional skills (theoretical or operational skills) and the lack of information communication and feedback between nurses and patients, nursing postgraduates, and clinical teachers lead to some undesirable phenomena. Such as, participants reported that a lack of professional skills or poor communication led to scalds or nurse-patient conflicts. Furthermore, it has also been reported that ignoring a patient’s emotions can lead to dissatisfaction with the caregiver, even if the individual’s behavior does not negatively affect the patient’s health.

P3: “I felt deeply guilty and uneasy about my actions. At that time, I found that I did not change the wrong liquid, ignoring the patient’s psychological feelings, and deliberately playing down this matter. As a result, the patient complained.”

3.5. Conclusions

Based on Gibbs’s reflective cycle, the good clinical practice includes good communication skills and respect, solid medical knowledge, and clinical teacher support. Good communication skills were considered to be one of MNS the necessary skills [ 28 ]. Especially for nursing graduate students with bias, timely and effective transfer of professional nursing knowledge and the situation that may arise from it, to maintain a good nurse-patient relationship. The study suggested that respect is mutual [ 29 ], the respect and understanding shown by participants towards patients increase the patients' respect towards them. Moreover, solid medical knowledge for MNS of clinical practice was mentioned, as a good clinical practice requires both theoretical and operational expertise, solid medical knowledge can answer the questions of patients and how to complete the operation accurately. It also mentioned the problem of treating patients' intellectual blind spots or emotional distress seriously, not ignoring them, but responding to the literature carefully or paying attention to the patient’s emotions in time. In addition, participants sought help from clinical instructors [ 30 ] to reduce unnecessary problems when their behavior might lead to changes in a patient’s condition or verbal conflict.

P1: “With the accumulation of clinical practice, I realized my shortcomings at that time. I should pay more attention to the patient’s expression and body language, carefully evaluate the patient’s clinical indicators and performance, and learn more skills from teachers should not be blind operation to prevent some of the side effects of scraping. When there are side effects, I should also ask my supervisor to evaluate the situation and do what I can.”

Besides, conclusions about participants' abilities were based on their evaluations of their behavior during and after clinical practice. Participants said they were aware of their professional responsibilities and the severe consequences of their deficiencies, such as the need to improve their attitudes and improve skills in assessing patients in clinical practice [ 30 ]. Through this reflection, the researchers also believe that their lack of crisis awareness [ 31 ], and failure to do an excellent job in nursing which is due to their usual learning and working attitude caused.

In addition, participants' needs for knowledge were related to medication safety, patients' psychological status, and respect for and empathy with patients. Some graduate nursing students who have just participated in clinical nursing practice lack basic knowledge of self-discipline, respect and compassion, medication safety [ 32 ], and clinical work procedures. Therefore, the need for this knowledge was considered valuable and necessary in clinical practice.

3.6. Action plan

It is clear from Gibbs' analysis of reflective data that MNS is sometimes satisfied with their behavior because their performance is professional, and they can gain experience from clinical practice. Respecting and empathizing with the physical and mental suffering of patients, providing timely feedback and effective treatment, paying attention to drug safety [ 32 ], and listening to and understanding the needs of patients were mentioned as being professional behavior.

P7: “I should stop this from happening at the source, communicate with the patient and give feedback to the higher level, provide adequate treatment to the patient, and make sure we have the support and understanding of the patient and the family. At the same time, I should also learn more to strengthen their professional skills. ”

Recommendations for improving action include timely feedback and communication, being patient-oriented, strengthening clinical skills, and following the nursing code of conduct. One suggestion for timely feedback and communication is to maintain effective communication with patients and supervisors when conflicts or adverse events occur and to provide timely feedback on outcomes [ 28 ]. Communication and feedback should also be patient-oriented when the patient’s physical and mental integrity is compromised. Researchers believe that [ 33 ] MNS should have prospective thinking in clinical practice, which is to evaluate the patient’s physical and psychological status comprehensively, observe more during treatment, and reduce the risk of adverse events. Participants also mentioned that when problems are encountered in future clinical practice, they should be more proactive in paying attention to the specific needs of patients and consulting experienced clinical teachers [ 30 ].

4. Discussion

This study aims to promote the learning, personal, and professional development of MNS by reflecting on clinical experiences based on the Gibbs’s framework. Reflective writing by MNS was applied to this study. The study indicated that MNS most frequently described the clinical practice experience as the themes of adverse events, professional knowledge, and nurse-patient conflict. MNS was expected to be the leaders or managers of the nursing profession [ 33 ]. Still, the gap between school education and clinical practice [ 33 ] may lead to the problem of insufficient professional knowledge and communication ability of MNS in clinical practice, at the same time, MNS were not Down to Earth in clinical work, which can lead to adverse events.

MNS had complex emotions in clinical practice, including negative feelings, such as anxiety, worry, tension, guilt, and positive emotions of happiness. Despite the emotional challenges of communicating with patients in clinical practice, the majority of MNS said they understood the feelings in clinical practice and were concerned about patient safety. The study help to understand the feelings and thoughts of MNS as they emerge from complex clinical experiences during clinical work. This is consistent with the results of another study from Taiwan in China, which reported that participants reflected on events with both positive and negative thoughts [ 34 ].

Participants also felt that reflective writing helped them to learn from their experiences and promote professional development [ 2 , 34 ]. Such as being able to remain calm and quickly deal with incidents during conflicts in clinical practice while seeking help from clinical faculty [ 30 ], and seeking understanding and empathy from patients and families. In addition, participants described concerns about the adverse consequences of MNS in the clinical setting due to ineffective and unprofessional communication with patients. This is in line with the concept of “patient-centered improvement of medical service quality” proposed by the National Health Supervision Commission of the People’s Republic of China and reflects the professional concept of nursing staff to take the safety and interests of patients as the criterion at all times.

Although the clinical practice settings described by participants varied, possibly due to the study’s use of Gibbs’s reflective cycle, the study found that reflection was seen as beneficial for participants' feelings, thoughts, and actions [ [18] , [19] , [20] ]. Participants felt it was meant to reflect on events in clinical practice to help them do things the next time they faced a similar situation [ 20 ]. Generally, for MNS, it is not only necessary to master solid clinical expertise but also to learn the ability to communicate and feedback information [ 33 ] so that learn to reduce the impact of adverse events on personal emotions and to think about clinical events more positive and mature way [ 34 ]. The findings of this study suggest that increased reflective writing is necessary for future clinical education in MNS. As in previous studies [ 1 , 2 ], participants in this study were able to gain experience from the clinical experience and provide advice for future action. In summary, reflective learning is not only a valuable learning strategy for MNS in clinical practice but is also seen as a helpful tool for MNS learning, personal ability, and professional development.

4.1. Limitations

This study has some limitations. First, the sample size was small and came from MNS interning at the same hospital, and it is unknown whether the study results apply to different clinical Settings in different countries. In addition, the study did not include the reflection of other clinical populations, such as how clinical teachers and MNS mentors evaluated the content of MNS reflection and whether it promoted the development of the clinical profession. Moreover, the rationality and effectiveness of the reflection practice curriculum design need to be further discussed.

5. Conclusion

This qualitative study presents an analysis of the self-reflective relevance of MNS in clinical practice. MNS needs to deal with complicated and unexpected clinical events in clinical practice. To deal with and cope with these situations on time, MNS needs to have good nursing professional skills, such as theoretical and operational skills, and a good mentality to understand and care for patients [ 33 ]. In this qualitative study, it was demonstrated that the Gibbs’s reflective cycle is helpful in the clinical practice of MNS. It helps MNS reflect on clinical practice and translates clinical experience into a valuable experience for developing personal and professional development.

Author contribution statement

Ting-ting Zhan: Conceived and designed the experiments; Analyzed and interpreted the data; Contributed reagents, materials, analysis tools or data; Li-li Wang: Conceived and designed the experiments; Performed the experiments; Analyzed and interpreted the data; Contributed reagents, materials, analysis tools or data; Wrote the paper.

Yan Wang; Cai-jie Sun: Analyzed and interpreted the data.

Funding statement

Ting-ting Zhan was supported by Provincial Quality Engineering Project for Higher Education Institutions of Anhui Province in China [2020JYXN1053].

Data availability statement

Declaration of interest’s statement.

The authors declare no conflict of interest.

Acknowledgments

The authors would like to appreciate the support from the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, China and all the researchers and participants involved in this study for their support.

Communication in Nursing Practice: Gibbs’ Reflective Cycle Essay

• To find inspiration for your paper and overcome writer’s block
• As a source of information (ensure proper referencing)
• As a template for you assignment

Introduction

Description, action plan, reflective conclusion.

Communication is a fundamental element in nursing practice. This element can possibly determine patients’ satisfaction and even the outcomes of their treatment (Lotfi et al., 2019). The situation described in the paper will exemplify the potential role of communication, which is why it will serve as a Gibbs Reflective Cycle nursing example. The cycle will help to assess the situation and extract lessons from it.

The model is a widely-recognized and crucial learning instrument, allowing individuals to extract lessons from life experiences. The pattern helps one to consider previous experiences, reevaluate them in the light of new knowledge, and implement the freshly obtained insight to improve future practice (Markkanen et al., 2020). The cycle is composed of six stages (description, feelings, evaluation, analysis, conclusion, and action plan), on which the reflection regarding the personal experience will be based (Markkanen et al., 2020). The paper’s principal objective is to outline a challenging situation from personal practice using Gibbs’ Reflective Cycle. The problematic situation is an encounter with a patient suffering from an infected diabetic foot ulcer and in need of amputation. Overall, the paper aims to critically analyze the situation and transform it into a learning opportunity useful in improving my future practice as a wound care specialist.

The situation concerns a 40-year-old patient with diabetes and an infected foot ulcer who was admitted to the hospital where I was working at the moment. The patient had a long history of diabetes, from which he suffered since he was ten years old. A multidisciplinary team examined the patient and established that he needed an amputation. As I approached the patient to get a consent form, I noticed that he looked upset. Given the described situation, it might be suggested that a communication dilemma here is of ethical character, in particular – it is the delivery of the bad news. By applying the model, the provided Gibbs Reflective Cycle example communication will demonstrate what actions were undertaken to resolve the mentioned dilemma.

The incident that will be analyzed is an outstanding Gibbs Reflective Cycle nursing example, which happened several years ago when I began working as a wound care nurse. A 40-year-old diabetic patient with an infected diabetic foot ulcer was admitted to the hospital. He had a long history of diabetes, suffering from the condition for three decades. A multidisciplinary team examined and communicated with the patient; it was established that he needed a below-knee amputation. The group stated their decision and left, and I had to retrieve the consent form. While retrieving the record, I perceived that the patient looked exceedingly sorrowful and depressed. Nevertheless, I did not know whether I needed to intervene in the situation and left.

Although I worked for many years in nursing before the incident, I became a certified wound care nurse relatively recently before it took place. At the moment, I saw the situation as irreparable, so I was not sure whether I should have tried to console the patient. I felt anxious and, to an extent, powerless when faced with the man’s grief. I thought that words or an empathic response would not be able to mitigate his sadness. Additionally, I was also somewhat startled that the multidisciplinary team did not handle the conversation more delicately and left rather abruptly. Overall, I did not feel confident enough to handle the situation and was unsure whether my intervention would be appropriate.

I frequently returned to the incident, trying to understand what should have been done instead. Retrospectively, I believe that it helped me to reevaluate the role of therapeutic communication in my profession. Prior to the incident, I did not perceive preoccupation with patients’ emotional well-being as my duty as a nurse. I believed that administering medications and treatment, performing tests, recording medical history, educating patients, et cetera, was all that was required of me. Nevertheless, I did not fulfill another vital function in the described situation. To understand that a holistic approach to care presupposes therapeutic communication, I had to experience the case (2). As a nurse, showing empathy and consoling patients is a critical function that is sometimes overlooked. Furthermore, the incident demonstrates a lack of cooperation between the nursing staff and the team since communication was needed to ensure that the emotional impact of amputation on the patient was alleviated.

Some medical professionals find the process of delivering bad news challenging and feel psychologically unprepared (Van Keer et al., 2019). A lack of skills in this aspect can negatively affect patients: they might undergo extra stress, have lower psychological adjustment, and have worse health outcomes (Biazar et al., 2019; Matthews et al., 2019). Furthermore, the way the news is handled can impact patients’ understanding of the situation and adherence to treatment (Galehdar et al., 2020). Given the adverse effects, multiple protocols and approaches to communicating bad news and dealing with its consequences were developed. This situation is analyzed in detail in a ‘Gibbs Reflective Cycle example essay pdf’ that focuses on these communication challenges in healthcare.

In the patient- and family-centered approach, the process occurs based on the patient’s needs as well as their cultural and religious beliefs (Hagqvist et al., 2020). Upon communicating the information, a medical professional is supposed to assess their understanding and show empathy (Hagqvist et al., 2020). In an emotion-centered approach, a medical professional is supposed to embrace the sadness of the situation and build the patient-medical professional interaction on empathy and sympathy (Hagqvist et al., 2020). Yet, the patient- and family-centered approach seems more effective since excessive empathy can be counter-productive and impede information exchange.

Managing patients’ reactions is the final and particularly vital step in communicating bad news. Nurses are commonly involved in handling emotional responses, which entails several responsibilities:

• Additional emotional support should be given to those who cannot accept the information (Galehdar et al., 2020).
• Nurses can find more related information and share it with patients (Rathnayake et al., 2021).
• Nurses are supposed to improve the situation if bad news has been delivered poorly (Dehghani et al., 2020).

In the case of amputation, heightened emotional attention should be given to the patient, as limb loss is a life-altering procedure. Such patients commonly undergo the five stages of grief (denial, anger, bargaining, depression, and acceptance) and are prone to developing anxiety, depression, and body image issues (Madsen et al., 2023). Hence, upon delivering the news regarding amputation, it is vital to provide a patient with community resources for dealing with emotional and psychological implications.

Currently, I understand more in-depth that delivering and handling the consequences of bad news is an inescapable reality of the nursing profession. The incident allowed me to notice the aspects of my professional development that necessitate more attention and improvement. Hence, I strive to be more empathetic in my clinical practice and not undervalue the role of patient-nurse communication. I attempt to provide psychological and emotional support to patients and console them to the best of my ability and knowledge, especially if a patient has just received traumatic news. Due to the incident, I comprehended better that a patient’s emotional well-being can be dependent on my actions. I also stopped presuming that other medical professionals provide the necessary emotional support. Moreover, I understand that I am not powerless when faced with a patient’s sorrow.

Consequently, I will not neglect the importance of patient-nurse communication for patients’ health outcomes and mental well-being. I will offer hope where it is appropriate and encourage and validate patients’ emotions to help them deal with traumatic information (Font-Jimenez et al., 2019). In the future, I will use verbal and non-verbal communication clues to show that I care and, generally, be more empathetic (Font-Jimenez et al., 2019). I will not prevent my insecurities from fulfilling my nursing duties, nor will I allow the feeling of hopelessness to affect my clinical practice. Furthermore, I will rely on evidence-based approaches to handle bad news effectively and facilitate its delivery to patients.

Additionally, I will be more mindful in my nursing practice. Gibb’s reflective cycle will assist me in attaining this objective. I will continue to apply it to the situations occurring at work in order to think systematically as well as analyze and evaluate them. Furthermore, Gibb’s reflective cycle will enhance my ability to learn from my experience. The model will help me to refine my communication skills and make patient-nurse interactions more intuitive and productive (Markkanen et al., 2020).

The situation allowed me to understand the actual value of therapeutic communication in nursing. Now, I understand the need to exercise it in my clinical practice, which is a realization that I further explored in a ‘Gibbs Reflective Cycle example essay pdf.’ Learning to provide emotional support and manage the consequences of bad news is an essential quality for nurses, influencing health outcomes and satisfaction from a visit. Additionally, I become more conscious of my own emotions and the way they can prevent me from acting in a patient’s best interests. Overall, the proper tactics of delivering bad news and assisting patients in handling them became a higher priority in my clinical practice.

To conclude, this reflection featured an episode from my practice in which I analyzed a communication situation using Gibbs’ Reflective Cycle. It showed that I need to concentrate on my abilities to resolve the communication dilemma of the delivery of bad news. The above discussion also demonstrated how the implementation of an appropriate and significant evidence-based model – Gibbs’ Reflective Cycle – may result in better patient outcomes.

Biazar, G., Delpasand, K., Farzi, F., Sedighinejad, A., Mirmansouri, A., & Atrkarroushan, Z. (2019). Breaking bad news: A valid concern among clinicians . Iranian Journal of Psychiatry, 14 (3), 198–202. Web.

Dehghani, F., Barkhordari-Sharifabad, M., Sedaghati-kasbakhi, M., & Fallahzadeh, H. (2020). Effect of palliative care training on perceived self-efficacy of the nurses . BMC Palliative Care, 19 , 63. Web.

Font-Jimenez, I., Ortega-Sanz, L., Acebedo-Uridales, M. S., Aguaron-Garcia, M. J., & de Molina-Fernández, I. (2019). Nurses’ emotions on care relationship: A qualitative study . Journal of Nursing Management, 28 (8), 2247-2256. Web.

Galehdar, N., Kamran, A., Toulabi, T., & Heydari, H. (2020). Exploring nurses’ experiences of psychological distress during care of patients with COVID-19: A qualitative study . BMC Psychiatry, 20 , 489. Web.

Hagqvist, P., Oikarainen, A., Tuomikoski, A.-M., Juntunen, J., & Mikkonen, K. (2020). Clinical mentors’ experiences of their intercultural communication competence in mentoring culturally and linguistically diverse nursing students: A qualitative study . Nurse Education Today, 87 , 104348. Web.

Lotfi, M., Zamanzadeh, V., Valizadeh, L., & Khajehgoodari, M. (2019). Assessment of nurse–patient communication and patient satisfaction from nursing care . Nursing Open, 6 (3), 1189-1196. Web.

Madsen, R., Larsen, P., Carlsen, A. M. F., & Marcussen, J. (2023). Nursing care and nurses’ understandings of grief and bereavement among patients and families during cancer illness and death – A scoping review . European Journal of Oncology Nursing, 62 , 102260. Web.

Markkanen, P., Välimäki, M., Anttila, M., & Kuuskorpi, M. (2020). A reflective cycle: Understanding challenging situations in a school setting . Educational Research, 62 (1), 46-62. Web.

Matthews, T., Baken, D., Ross, K., Ogilvie, E., & Kent, L. (2019). The experiences of patients and their family members when receiving bad news about cancer: A qualitative meta-synthesis . Psycho-Oncology, 28 (12), 2286-2294. Web.

Rathnayake, S., Dasanayake, D., Maithreepala, S. D., Ekanayake, R., & Basnayake, P. L. (2021). Nurses’ perspectives of taking care of patients with Coronavirus disease 2019: A phenomenological study. PLoS ONE, 16 (9), e0257064

Van Keer, R. L., Deschepper, R., Huyghens, L., & Bilsen, J. (2019). Challenges in delivering bad news in a multi-ethnic intensive care unit: An ethnographic study . Patient Education and Counseling, 102 (12), 2199-2207. Web.

• Root Cause Analysis of Decubitus Ulcers
• Nurse Practitioner Cost Effectiveness
• Gibbs’s Reflective Cycle and Borton’s Model of Reflection
• "The Epic of Gilgamesh" by Ryan Gibbs
• The Topic of Diagnostic Measures
• Modern Nurse’s Role: Leadership
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Reflective practice

Reflective practice is a learning strategy that promotes metacognition and develops students’ capacity for self-regulation.

What is it?

Reflective practice is a learner-centred strategy that helps students to make sense of what they are learning and engages them in deep learning. Reflection can be in-action and on-action:

• Reflection-in-action takes place while students are engaged in a practical activity and requires them to act on their reflection immediately
• Reflection-on-action invites students to reconsider and clarify a past event (for example a site visit, an in-class activity, or a practicum).

Students can also reflect on their prior knowledge to prepare for a ‘core’ activity. Reflection tasks encourage students to take a step back, observe, and evaluate their actions to either problem solve or gain a new perspective. Reflection works best when it is regular, scaffolded, and progressively develops in complexity. Through regular reflection, students engage in metacognition and become self-regulated learners.

Why is it useful?

Benefits for students.

• Assesses functioning knowledge, including application of skills and competencies
• Prompts metacognition, which, in turn, encourages students to take responsibility for their own learning
• Develops evaluative judgment through metacognition and analysis of their own thought process
• Promotes the development of professional identity through a reflection on a work placement or a practice simulation.

Benefits for educators

• Gives you access to the thought process of your students, which, in turn, facilitates an effective feedback loop.

How do I implement it?

To implement reflective practice, try these strategies:

• Set a model for students’ reflections. This will prompt students what to include and give you a clear framework to assess the reflection. It will also help students who are less familiar with reflective tasks and unsure where to start. You can use one of the established reflection models:

Driscoll, J.J. (2007) Supported reflective learning: the essence of clinical supervision? Chapter 2 in Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals (2nd edition). London: Bailliere Tindall. pp 27-‐50.

Example question prompts

Kolb DA. Experiential learning: experience as the source of learning and development. Englewoods Cliffs, N.J.: Prentice Hall, 1984.

Johns C. Becoming a reflective practitioner: a reflective and holistic approach to clinical nursing practice, development and clinical supervision. Oxford: Blackwell Science, 2000.

Atkins, S. and Murphy, K. (1994). Reflective Practice. Nursing Standard , 8(39) 49-56.

Leeds Beckett University. Skills for Learning – Models for structuring reflection. Secondary Skills for Learning – Models for structuring reflection 2015.

Whatever model you choose, make sure it is aligned with the task at hand and the intended learning outcomes.

• Engage students in regular reflective practice through blogging or journaling. Based on your subject, students can reflect on weekly readings, practice sessions, site visits, scenario-based group activities or work placements. When setting a continuous reflective task, be clear why you are asking students to reflect and how they will be assessed.
• Integrate reflection in regular learning activities. Give students opportunities to reflect in class. To make this work, it is important to consider reflection when planning a learning activity. For example, if students are working in small groups on a structured case analysis, you can pause the activity at different stages and prompt students to reflect in action and act on their reflection upon returning to the activity. Alternatively, you can use one of the reflection models (outlined above) to prompt a reflection-on-action at the end of the group activity. These strategies can be used with other types of synchronous and asynchronous learning activities. What’s important is to allocate sufficient time for reflection so that students can fully engage in a reflective cycle and reflect on what happened, why it was important, and how they will apply this in future.

Supporting technologies

• Cadmus is an online assessment environment that offers assessment templates for the most common written assignment types, including a reflective journal and a reflective essay. The templates for reflective assessment provide checklists for students to guide them through the reflection process and keep them on track. In addition, Cadmus allows submission of assignment drafts, which you can then use to provide cohort-level feedback.
• PebblePad is an ePortfolio platform – a space for students to blog, journal, and showcase their project work. PebblePad can integrate reflection and self-assessment into digital portfolios.
• LMS Discussions can facilitate blogging . Students can both respond to a reflection prompt and interact with their peers’ responses. This deepens students’ reflection and supports a provision of formative peer feedback.
• H5P allows you to create interactive activities and embed them into the LMS. The Documentation tool in H5P allows you to embed reflection boxes on the LMS pages and prompt students to reflect with structured questions in line with your chosen reflection model. Once students enter their reflection into the text box, they can then generate a downloadable document with their responses.
• FeedbackFruits allows you integrate reflection into peer review, self-assessment and social annotation tasks. You can make this a structured reflection by adding instructions and structured questions for students to reflect on.
• LMS Quizzes can facilitate structured reflection exercises. You can use the essay question type to ask students structured reflection questions in line with one of the reflection models (presented above). Students’ access and completion of quizzes can be monitored via New Analytics.
• Academic Skills, University of Melbourne. Reflective writing .
• Biggs, J., & Tang, C. (2011). ‘ Assessing and grading for functioning intended learning outcomes ’ in Teaching for quality learning at university . McGraw-Hill Education.
• Instructure Community. How do I create a quiz with individual questions?
• Learning Environments, University of Melbourne. Designing reflection activities .
• Learning Management System, University of Melbourne . FeedbackFruits .

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Protective properties of pleated wire mesh shields for spacecraft protection against meteoroids and space debris

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D. B. Dobritsa , S. V. Pashkov , Iu. F. Khristenko; Protective properties of pleated wire mesh shields for spacecraft protection against meteoroids and space debris. AIP Conf. Proc. 22 February 2021; 2318 (1): 140006. https://doi.org/10.1063/5.0037000

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The use of spacecraft shield protection against orbital debris and micrometeoroids in the design of a spacecraft involves optimizing its mass. Study of the metal mesh protective shields confirmed their higher efficiency compared to the solid shields. Increasing the resistance of protective shields can be achieved, in particular, by using various geometric features of their component parts (mutual arrangement of layers, angle of inclination). In this paper, using high-velocity impact tests, the sturdiness of the authors ’ patented pleated wire mesh shield is investigated. The protective properties of the proposed construction have been confirmed to be increased in comparison with conventional mesh shields of equal specific gravity.

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Khimki, Moscow Oblast, Russia

Khimki is a city located in Moscow Oblast, Russia, which is situated about 23 kilometers northwest of Moscow. It is one of the most significant industrial centers in the region and has a population of approximately 253,000 inhabitants as of 2021. The city is connected to Moscow by the Moscow-St. Petersburg highway and the Moscow Central Circle railway.

One of the most beautiful areas in Khimki is the historical center, which is known for its well-preserved buildings from the 19th and 20th centuries. The area is home to the City Hall and the City History Museum, as well as several beautiful parks and green spaces. The housing prices in this area are on the higher end due to the historic charm and central location. The average price for a one-bedroom apartment in the historical center is around 50,000 rubles (about $675) per month. The transportation is convenient with several bus and minibus routes connecting the area to the rest of the city. This area is generally safe, with low crime rates.

Another area worth mentioning is the recently developed residential district of Yaroslavsky. It is located in the eastern part of the city and is known for its modern and comfortable living spaces. The area has a large park with several playgrounds, bike paths, and sports fields. The housing prices in this area are more affordable compared to the historical center, with the average rent for a one-bedroom apartment being around 30,000 rubles (about $400) per month. The transportation is also convenient, with several bus routes connecting the area to the rest of the city. The safety of this area is also high, with low crime rates.

The Sokolniki neighborhood is also a popular residential area in Khimki. It is located in the southwestern part of the city and is known for its green spaces, which include several parks and forests. The housing prices in this area are slightly higher than in Yaroslavsky, with the average rent for a one-bedroom apartment being around 35,000 rubles (about $470) per month. The transportation is convenient, with several bus and minibus routes connecting the area to the rest of the city. The safety of this area is also high, with low crime rates.

Khimki is known for its diverse industry, which includes metalworking, chemicals, and construction materials. The city has several large industrial plants, such as the Sheremetyevo International Airport, which is one of the busiest airports in Russia. The city also has several shopping centers and entertainment complexes, such as the MEGA Khimki Mall, which is one of the largest malls in the region.

The people of Khimki are known for their love of sports, with football, ice hockey, and basketball being the most popular. The city has several sports clubs, such as the Khimki Basketball Club, which is one of the most successful basketball teams in Russia. The city also has several well-known public figures, such as the musician and composer Andrey Makarevich, who is known for his work with the band Mashina Vremeni.

Khimki is a beautiful city with a rich history and culture. The city has several outstanding areas, each with its own unique charm and character. The housing prices in the city are generally affordable, and the transportation is convenient, making it a great place to live. The city is known for its diverse industry, sports, and entertainment options, making it a great place to work and play.