and transformation. At each phase, insights can be gleaned. Reflection creates stories of resistance and possibility, chipping away at resistance and opening up possibility, confronting and shifting these barriers to become who we desire to be as healthcare practitioners. Nothing can be more meaningful for the serious practitioner intent on finding meaning in their practitioner role and realising the most effective care.
Yet, reading about critical reflection and its implications may feel daunting to many readers. Just the language can feel intimidating. Yet think about vision again. Perhaps, most significantly, shifting barriers to change requires practitioner to really want to realise their visions. Perhaps this stems back to one’s motivation to be a healthcare practitioner, to remember what that was before it was knocked out of you by the harsh realities of everyday practice and training. Fay writes (1987, p. 29):
It is highly unlikely that practitioner will change unless the level of discontent they are experiencing is really quite high; otherwise, what might be called the “natural resistance” to fundamental change will act as a counterweight to the desire for change, and will induce these people to accommodate themselves to the discontent they are suffering.
In other words, faced with daunting reality, many practitioners may prefer to rationalise any discontent and turn their backs on reflection, at least in any deep and meaningful sense. Better to swim along the surface of practice rather than dive deep within its murky depths. Understanding barriers is one thing. As I explore in the third dialogical movement, guidance is vital to enable practitioners to become empowered to act on their insights. Empowering practitioners to action is another thing and action to transform yet another thing. It takes time and effective guidance for practitioners to face and overcome ‘the hard wall of reality’. It also requires communities of practitioners to work collectively to act on insights and change things. Perhaps even more it requires organisational shift towards transformational cultures and leadership that actively facilitates reflection rather than resist it as a threat to its status quo as evident in transactional organisations that seek a docile and subordinate workforce. Yet the individual can make a mark. Carson (2008, p. 139) writes:
When you change the way an individual thinks of himself, you change the way he lives in his community and thereby you change the community in some way to a greater or lesser extent.
This is a vital idea about reflective practice – that whilst it is seemingly an individual learning process, it inevitably impacts on the wider community. The truth of the situation is stark – if practitioners truly wish to truly live their visions of practice then they have no choice but to become political in working towards establishing the conditions of practice where that is possible. The practitioner must come to realise a new reality for themself rather than have this reality explained to them. For example, many experiences that practitioners reflect on are concerned with conflict that has a fundamental power inequality at their root that manifests itself through different attitudes, beliefs, and behaviours. This is not difficult to see or understand providing it is sought and not just taken for granted as part of the ‘natural’ background of the experience. Despite the daunting nature of critical reflection, its rewards are huge for both practitioners and those they serve.
Summary
Reflection is the pathway to becoming a reflective practitioner. At its core is a vision for practice that is its driving and motivating force. Its learning potential is a contradiction or creative tension between realising the vision and the reality of everyday practice. Barriers become evident that limit realising one’s vision, which itself is a focus for inquiry. What do the words used in writing a vision mean as something lived? In Chapter 2, I set out the six dialogical movements as a practical way of traversing this pathway to reap its benefit, notably the idea of guidance.
Notes
1 1. I explore constructing a practice vision in Chapter 17 in the context of creating a reflective practice environment.
2 2. The application of the assertiveness action ladder as a reflective framework is illustrated in Chapter 17.
References
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