During this essay I shall demonstrate my knowledge and understanding of two learning outcomes from the Interprofessional Studies for Health and Social Care Module. To achieve this I will describe two reflective models and then use one of these models to reflect on my two chosen learning outcomes. The first learning outcome which I will reflect upon is the importance of team working within the health and social care context, the second will be an understanding of the role of the patients/service users and carers in delivery of health care. The two reflective models which I shall use are Gibb’s model of reflection and Borton’s framework for reflection.
Gibb’s model of reflection as described in Beginning Reflective Practice by Melanie Jasper consists of six stages which take the practitioner through the reflective cycle by asking significant questions. The six stages of the cycle are the description of what happened, the feelings involved, an evaluation of the event, and analysis, a conclusion and finally an action plan.
The description of the event should be as objective as possible asking yourself key questions the where it happened, who was there, why were you in that situation, what were you doing and any other people there doing, in what context did the event happen, what was your part and other peoples part in the event and what was the outcome.
The feelings part of the cycle is about trying to remember the feelings you were experiencing during the event. These should include how you were feeling at the beginning when it started, what you were thinking about as the event unfolded, what did other peoples actions make you feel, how you felt about the result of the event in comparison the how you feel now. When you think about how you felt during the lifecycle of the event, which of the emotions you experienced were the most important.
An evaluation of the event will help us come to some understanding about what happened. The questions we would ask ourselves would be what was good or bad about this event and what particular parts of the event went well or didn’t go well.
Moving on to the analysis of the event involves asking detailed questions about the evaluation stage. We would want to know what went well and what part you played in it that went particularly well, what others did well. What went wrong and what part you and others played in what went wrong. Why did these things happen?
The conclusion stage is the stage where we ask ourselves what else we could have done. We then move into the action plan stage where we think about how we would deal with the same event again. Would we do something differently or would we do the same again?
Borton’s framework for reflection is described by Jasper as a simple model for reflection consisting of three basic questions; what? So what? What now? Jasper describes the what phase as the descriptive level of reflection, asking questions such as what is the problem? What are the reasons for feeling as you do? What was my role is what occurred, what were the consequences of my actions on the other people involved, what was good or not so good about the experience. Jasper goes on to describe the so what? of the reflective cycle as the theory and knowledge building level of reflection, asking so what questions. So what does this event teach me about myself, others, my valves? So what was going through my head at the time? So what should I have done better or differently?
The now what of Borton’s reflective model according to Jasper is the doing part of the reflective model where action is required. The questions to ask oneself are now what do I need to do in order that things will be better next time? Now what do I need to do to improve things for the person I am caring for or supporting? Now what might be the consequences for the actions I have taken?
I am going to use Borton’s reflective model to reflect on the importance of team working in the health and social care context, which is one of the learning outcomes in this module. I find this a simple model to use as it is easy to remember the three main questions of What? So what? and What now? The teams in this case were the groups which we were separated into in Inter Professional Learning (IPL). We were given a scenario to work together on within the groups and were to then make a presentation in glass, this occurred early in the first semester. In the second semester we were supposed to be working together as a group and having a class discussion about our findings.
The initial problem or difficulty we had within our group was that none of us knew each other. The group comprised of 6 students from different health care professions and 1 social work student. The group comprised of 3 mature students and 3 school leavers, 4 females and 2 males. We did not take down each others emails or phone numbers and communications within the group was a huge problem. We arranged to meet up the following week, however one of the students was not in class the first week, which meant he didn’t know where to meet us, we didn’t have any means of communicating with him, or at least no-one took the initiative to find out how to contact him. He didn’t find out out how to contact us either. I felt that the group working together on the scenario didn’t work well together.
One of the mature students took charge, however she did that as no-one else stepped forward. This is a role I often take on myself, however I felt unwilling to do it in IPL as I was uncomfortable with the scenario as I felt I did not have the knowledge to contribute to the group discussions. Everyone ion the group felt that they also lacked the knowledge to make a positive contribution to the group discussion and all felt quite stressed about the added pressure this put upon them. All members of the group felt that IPL was the least important of the subjects they had to work to do for therefore did not put as much effort into the team working exercise as they would have otherwise.
This meant that the team members felt quite resentful that they had to spend time working with the IPL group and resentfulness does not lead to good team working. I felt I did not take a leading role in the exercise and as that is a position I usually hold I felt somewhat powerless as the team working unfolded and clearly wasn’t working. One of the team members did a lot of work, one did no work at all and the others did the minimum possible. This is not a good team working scenario. The consequences of this was that all of the team members felt somewhat frustrated that the team working hadn’t gone well. They all felt it had been a waste of time and effort and the team member who did a lot of work felt resentful towards the other team members.
So what does this tell me about myself? I felt that for the good of the team I should have worked harder. I could have found out more information about my subject area instead of which I drew on knowledge which I already had. I felt powerless as I was not in control of the group and because I felt I lacked knowledge I felt I could not put myself into a position of leadership in the team. Although it is normally a role I embrace I did not want to make the commitment in this instance as I felt that it was “only IPL” and therefore not important. However this made me feel angry at myself for devaluing IPL and consequently not valuing the team working role and I felt I had let the other team members down. So what does this tell me about the other team members? Again several of them felt it was “only IPL” and didn’t put in the effort.
The person who had taken on the team leader role felt let down by the other team members and felt frustrated that she ad not been given adequate support in her role as team leader. If a patient or service user had been involved I’m certain our attitudes would have been different, however to devalue IPL is not acting in a professional manner. The whole of the time we were working together as a group I felt frustrated as I knew it wasn’t working. I knew I had the skills to make the team work better being a mature student and having worked in and lead many teams in my previous jobs, however I chose not to use those skills for the good of the team and simply let everyone get on with it. We did not work together as a team, we worked as individual members within the team. So what were the reasons for my actions?
I was annoyed at having to spend the time working as a team in IPL. I felt the time could have been more usefully spent on what I considered to be my own course work instead of working with the team in IPL. As I did not know the other team members I asked myself why I should take on the role of team leader as the other team members didn’t mean anything to me. I feel this was not a professional attitude to have and certainly not an attitude I would want to take forward in my professional career. I certainly feel I could have contributed a considerable amount more to the team working exercises. I knew that the team members should have exchanged phone numbers and emails on the first day, however I thought to myself I’m not doing it. The team working exercise made me question my personal professional values, however although I know I can be a good team member, I choose not to on this occasion to the detriment of the other team members and the team as a whole.
Now what do I need to do to make things better the next time? I know I need to fully engage in the team working effort. This is as much for my own feeling of self worth and satisfaction as it is for the other team members. If this scenario were in a professional setting I would not have been acting in an ethical manner and would not only have let myself down but would have let the service user down. Before I began to reflect on the team working exercise I believed it didn’t matter that I hadn’t contributed 100% as it was only IPL. However on reflection I realise I have to be as involved as I possibly can be and contribute as much as possible to enable me to develop personally and professionally.
The second learning outcome which I have chosen to reflect on is to understand the importance of the role of the patient /service users and carers in the delivery of health care. During IPL we had a talk from someone who had been a patient for some considerable time. She had suffered from meningitis and had quadruple amputations. She explained her journey through the system form the patient’s point of view. She had realised early on in her journey as a patient that a positive attitude was essential in trying to get everyone working together for the good of the patient. As the patient it was the very little things which the carers said or did which made the biggest difference.
Things which may seem insignificant for example in A;E the nurse who asked her how old she was and said she couldn’t possibly be that old, or the nurse who plucked her eyebrows in ICU. These are comments and small acts which build the self esteem of the patient, something which cannot be overestimated enough. Without the feelings of self worth a patient could have a very different outcome. The patient spoke of the reactions and attitudes of staff and how important this was to her. She was an attractive young women whose live had been turned upside down by having amputations, if any one of the staff dealing with her had showed any sort of revulsion then her story may have been completely different. However as the patient her attitude towards the staff was also very important as if she had been abusive to them they may not have acted in such a supportive manner.
While the patient was speaking I was wondering what the point of her telling us her story was. What was she trying to achieve by sharing it with health and social care students? On reflection I think she was trying to show us how it was all down to the attitude of the staff. One member of staff who demanded to know why she was crying really upset her. If the staff member had taken a few minutes to read her notes then she would have known why she was crying. This highlights the importance of stopping and thinking when you are working with patients and service users before saying thoughtless remarks. Although the patient had suffered a terrible life changing experience I felt that it had been a good experience on the whole.
So what does this mean to me? It means that at all times I should think before I speak. Saying something thoughtless to the patient or service user could jeopardise their chances for a positive outcome or set back the road they have already travelled.
The importance of carers in the delivery of health care can not be underestimated. There are many people caring for relatives and many young carers in our communities. One of the talks we have during IPL was about young carers in society. They are often caring for parents with a disability or drug and alcohol issues. I was surprised at the numbers of young carers in our society. On reflection it may mean that I will question my first thoughts when I encounter a young person in my professional career. It may be that a young person is not going to school and teachers assume they simply do not want to be in school, however could there be other issues going on which no one has considered? I would have to question my own initial instincts and try and question the young person more closely to see if there was anything else going on.
What I need to do is not always judge a situation by its first appearance but look beneath the surface of what is going on, always keeping an open mind.
In conclusion, I have used Borton’s framework of reflective practice to reflect on two learning outcomes from the IPL module as the simple what? so what? now what? is an essay framework to use and remember.
Jasper,M. (2003) Beginning Reflective Practice. Cheltenham: Nelson Thornes Ltd