Model of reflection: The Rolfe et al. model

So my name is Suzi Villeneuve-Smith, and I teach in the undergraduate nursing space. This year we have 640 students in our cohort, and I've been teaching for approximately ten years. So the reason we embed reflection into our nursing curriculum is twofold. Professionally and personally. Professionally, we're invited by our NMBA standards for practice to include reflection in the seven standards that we have. This enables us to become critical thinkers, and it also enables us to provide safe, patient care. The second benefit is personally, we're able to reflect on our own personal values and morals and how we can link those in to on nursing practice. This allows us to provide holistic, safe, patient care with good outcomes so everybody is happy. The structured model of reflection that I embed into my first year nursing subjects is the Rolfe model of reflection. We've chosen this model because it's simple. It's easy to access and it doesn't overwhelm our students. It comes with three distinct headings, What? So what? And now what? The what aspect of the model is a descriptive model. This allows the students to write their thoughts and their feelings about a situation or experience that they've had. The so what section of the model allows them to really bring across some theory into it?

So what was going on in my mind during this situation? Allows them to give a little bit of depth to where they're at and how they feel they were within the experience. The last aspect of the model is the now what we like to call a reflexive way of thinking, and it's forward-thinking. Now, what have I learned from that situation? Now what do I need to do to do better next time? Now what do I need to look at to research to expand my clinical knowledge? The way we embed this into our subjects is really quite exciting. So during our other three subjects, they learn a little bit about this model. But right at the end of the semester, our students take up 80 hours of workplace experience in the clinical environment and they take an assessment book with them. Yes, they have to do clinical skills along with their clinical placement, but they also need to reflect on why they're doing what they're doing. And again, this is twofold, professional and personal.

Professionally, we align these sections of the models, the what, so what and now what and align them with the Orenstein is of practice. Our students select a challenge and an achievement, and they write about those in alignment with our seven standards. The personal aspect of reflection comes right at the end of their clinical placement, where they're invited to write a short reflection.

They can use the headings to guide their work to describe their overall experience of their placement. I read Reflections on clinical aspects about how exciting it was to do an accurate manual blood pressure on a real person for the very first time, or how they felt they were learning how to develop therapeutic relationships. As I sat with family members while their patients were in theatre. So it's been a really valuable experience for them. I also use a model in my workshops, so prior to placement I will always lead activities with three questions that align with the model.

So by the time they get to really digging into what reflection looks like for them, we've already been doing it, but they haven't necessarily known they've been doing it. What I've learned through teaching reflection is that every single one of our students does it. They know how to do it, but it's not necessarily done in a structured way. And they often allow emotions to overtake what actually happened and seeing them grow and learn personally and professionally is a real joy and a delight. And I've had the pleasure and privilege of working with some fantastic clinicians who are able to reflect on their practice on the ward and reflect personally in the tea room. It's a very rewarding experience.

The advice that I would like to offer to any educator who would really be interested in embedding reflection into their subjects is to meet the students where they are, not where you think they ought to be. There are some incredible models of reflection out there, and we may personally resonate with one or more of them. I know that I do, but these models may also overwhelm, confuse and put students off reflection. We want them to engage with reflection. We want them to love it. So pick the model that resonates with them, meet them where they are.