Unit-1; Reflective writing & Critical thinking tlp by nursing tutor.pdf

this is the chapter of Teaching & Learning Process of BS- Nursing 5 semester of Khyber Medical University Peshawar KPK Pakistan

1. REFLECTIVE WRITING
AND CRITICAL THINKING
Teaching & Learning Principles Unit-I
Imran Waheed Demonstrator (INS-KMU)

2. Objective
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By the end of this session the students will be able
to:
Discuss thinking process; to understand the
process of
reflective observation.
List and Compare types of thinking.
Define critical thinking.
Discuss the components of critical thinking
Define reflection.
Discuss types and process of reflections
Analyze the role of critical thinking in reflective
practice.
Explain the process of journal writing.

3. Human Brain Thinking
Process
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The thinking process was oriented by
DR.ELIYAHUGOLDRATT TOM.

It is a mechanism that allows us to verbalize,
construct, analyze, and communicate cause
and effect relationships to propose feasible
solutions to the problems.
"The world we have created is a product of
our thinking; it cannot be changed without
changing our thinking.“ Albert Einstein

4. Human Brain Thinking
Process
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Thinking exists as the top mental activity
demonstrated by Human.
All human accomplishments and
advancement come from the results of
thought.
Thought and activity are inseparable.
All human normally perceives an action
in his mind before undertaking an activity.
Cognition refers to the thought process.

5. Types of Thinking
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It can be divided into several opposing
categories;
Concrete Thinking vs. Abstract Thinking
Convergent Thinking vs. Divergent Thinking
Creative Thinking vs. Analytical Thinking •
Sequential (linear) Thinking vs. Holistic
Thinking

6. Conti…
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Concrete Thinking vs. Abstract Thinking
Concrete thinking refers to the thinking on the surface or
are visible allowing any individual to observe and
understand whereas abstract thinking requires much more
analysis and goes deeper.
Concrete thinking will only consider the literal meaning
while abstract thinking goes deeper than the facts to
consider multiple or hidden meanings.
Concrete thinking refers to the process of comprehending
and
applying factual knowledge.
Abstract thinking goes beyond all the visible and present
things to find underlying purpose.
Example:
A concrete thinker will look at the flag and only sees
specific colors, marking, or symbols that appear on the
cloth. An abstract thinker would see the flag as a symbol of
a country or organization. They may also see it as a symbol
of liberty and freedom.

7. Conti…
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Convergent thinking vs. Divergent thinking
Convergent thinking involves bringing facts and
data together from various sources and then
applying logic and knowledge to solve problems
or to make informed decisions or to find a single
answer.
Example;
Sherlock Holmes. puzzles

8. .
answer
facts
facts
facts

9. Conti…
stimulu
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Divergent thinking, involves breaking a topic
apart to explore its various component parts
and then generating new ideas and solutions.
Thinking outwards instead of inward.
A creative process of developing original and
unique ideas.
idea
ide
a
ide
a
ide
a

10. Conti…
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Analytical Thinking vs. Creative Thinking
Analytical thinking is about breaking information down
into its parts and examining those parts their
relationship.
It involves thinking in a logical, systematic order to
analyze data, solve problems, make decisions, and/or
use information.
Creative thinking, refers to conceiving new and
innovative ideas by breaking from established thoughts,
theories, rules, and procedures.
It is not about breaking things down or taking them apart,
but
rather putting things together in new and imaginative
ways.
Example:
An analytical thinker may look at a bicycle to
determine how it works or what is wrong with it. A
creative thinker may look at the same bicycle and think
or an new way to make it faster or a new way to use it.

11. Conti…
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Sequential Thinking vs. Holistic Thinking
Sequential thinking is processing information in orderly
prescribed manner. It involves a step-by-step progression
where the first step needs to be completed before then
second step occurs.
If a = b, and b = c, then a = c
Holistic thinking, means seeing the big picture and
recognize the interconnectedness of various components
that form larger systems.
Example:
When assembling a table, a sequential thinker would
follow the step-by-step directions. A holistic thinker would
want to see or mentally visualize how the table would look
when it is completed.

12. Critical Thinking
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Definition:
A careful and goal-directed thinking that is used
to assess complicated situations, identify actual
and potential problems, and make decisions
about an action plan.
Critical Thinking (CT) is considered a fundamental
cognitive process for knowledge development and
utilization; and it is applicable to problem solving
and decision making in any context whether it is
social, clinical, ethical, managerial, or political
(Simpson & Courtney,
2002)

13. Key Components of Critical
Thinking
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1. The process of thinking is as significant as the
outcome
2. Be attuned to your own beliefs, values, and
prejudices as
well as your personal experiences
3. Challenge assumptions
4. Consider the arguments
5. Consider alternatives
6. Consider the context
7. Know the sources of information
8. Assume a posture of reflective skepticism

14. Nursing and Critical Thinking
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The ability of critical thinking increases as the
work years increase, and the critical thinking
skills can be improved during nursing
education.
Be rapid and dynamic change in the health
care system, nurses in providing optimal
patient care, problem solving, ethical decision
making, determine priorities and trends in
clinical decision making and critical thinking
skills you need to use (Yıldırım 2010b)

15. Reflection Definition:
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Reflection is an important human activity in which
people recapture their experience, think about it,
ponder over & evaluate it. It is working with
experience that is important in learning’.
OR
“Reflection is an essential phase in the learning
process whereby people explore their experiences
in a conscious manner in order to acquire new
understandings and new behaviour patterns.”
(Professor Peter Jarvis ,1987).
Reflective practice is "the capacity to reflect on
action so as to engage in a process of continuous
learning

16. What matter most is how you see
yourself.

17. Critical Reflection
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Think about an experience or event that revealed an area of concern
(Boyed & Fales, 1983; Baker, 1996)
E.g. nursing student making a clinical error
Lack of knowledge about a disease
Personal assumption or bias towards a patient
Learn about yourself, your gaps in knowledge, assumptions and
biases and thought processes.
Adopting to new knowledge through personal growth and change .
Reflection:
Informal & Formal
Informal Reflection
Involves self- questioning • Develops our awareness of our own
assumptions(true without proof)
Formal Reflection
Draws on research & theory
Provides guidance & frameworks for practice.

18. What is Reflective Learning?
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Reflective learning is a learned process that requires time
and practice.
It is an active process involving thinking through the
issues yourself, asking questions and seeking out
relevant information to aid your understanding .
Reflective learning works best when you think about
what you
are doing before, during and after your learning
experience.
Reflective learning is not only about recognizing
something new, it is also to see reality in a new way.
Reflection is an important skill to develop and requires
you to think about how you are personally relating to
what is happening in the learning environment.

19. Process of Reflective
Learning
What do I think about this\
issue/topic/experience?
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Explore my understanding, perceptions and ideas
Question my assumptions
Identify anything confusing or difficult to understand
What more do I need to know to help my
understanding
Develop and refine
my
ideas and beliefs
Identify, locate and
interpret relevant
information and resources
How can I use this experience to improve
my learning, thinking and working?
e.g. What would I do differently next time?

20. What should you write about?
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What do you think about issues discussed at the
learning event?
What do you understand so far?
How can you reach a better understanding?
What do you need to know more about, and how
can you go about finding out more?
What resources have helped you to understand
and/or been interesting to use?

21. Cont...
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How do you feel about the way you have
approached the subject/topic so far?
Have you changed your opinions or values
during process/experience?
How can you improve your learning, thinking and
working in the future?
Have you identified the next step for your
development?

22. Models or Frameworks of
Reflection
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Models OR frameworks for reflection, encourage
a structured process to guide the act of
reflection.
There is no right model.
Often it is appropriate to use one model of
reflection as a basis, but use prompt questions
from other models if they best fit your particular
situation.
Common models
Kolb’s
Gibbs'
Johns'
Driscoll (by Borton)

23. David A. Kolb’s experiential cycle
(Kolb 1984)
cycl
e
Concrete
experienc
e
Reflective
observatio
n
Abstract
conceptualisati
on
Active
experimentatio
n

24. Gibbs' Model
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Graham Gibbs developed his reflective
cycle (Gibbs 1988) based upon each
stage of David
A. Kolb’s experiential cycle (Kolb 1984).
Full structured analysis of a situation
Most commonly used model by health
care professionals

25. Johns'
Model
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Christopher Johns designed his model for
structured reflection (Johns 2006) through
analyzing the dialogue between practitioners and
their supervisors .
Johns used Barbara Carper’s patterns of knowing
in his model (Carper 1978) which includes the
following:
Aesthetics (the art of what we do)
Personal (self awareness)
Ethics (moral knowledge)
Empirics (scientific knowledge)

26. Driscoll (by Borton)
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Terry Borton’s (1970) 3 stem questions: 'were
developed by John Driscoll in 1994, 2000 and 2007.
1. What?
2. So What?
3. Now What?
This is a description of the event. Trigger questions:
What…
… is the purpose of returning to this situation?
… what happened?
… did other people do who were involved in this?
… did I see/do?
… was my reaction to it

27. Conti…
•Trigger questions:
So what…
What did I feel at the time of the event? Is there any change in my
feelings now?
Is there anyone who can help me to reflect on my practice? Were those
feelings I had different from other people?
Trigger questions: Now what…
Are the implications for me and others in clinical practice based on
what I have described and analyzed?
Is the main learning that I take from reflecting on my practice in this
way?
Help do I need to help me 'action' the results of my reflections?
…aspect should be tackled first?
How can I modify my practice if a similar situation arises again? How
will I notice that I am any different in clinical practice?

28. Layers of reflection -
exercise
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Reflection involves describing, analyzing
and
evaluating our thoughts, assumptions,
beliefs,
theory base and actions.

29. Simple example: layers of
reflection
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I saw a health care member inserting ETT
Level 1: Descriptive

I saw a health care member inserting ETT, which I had not
seen before.
Level 2: Descriptive, some reflection

I saw a health care member inserting ETT, which I had not
seen
before. It really sensitized me!
Level 3: Descriptive, reflection and awareness/learning.

I saw a health care member inserting ETT, which I had not
seen before. It really sensitized me! I will learn and try it
under supervision.
Level 4: Descriptive, reflection, learning and future action.

30. Layers of
Reflection
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I saw a health care member inserting ETT
Level 1: Descriptive
I saw a health care member inserting ETT, which I
had not seen before.
Level 2: Descriptive, some reflection
I saw a health care member inserting ETT, which I
had not seen before. It really sensitized me!
Level 3: Descriptive, reflection and
awareness/learning.
I saw a health care member inserting ETT, which I
had not seen before. It really sensitized me! I will learn
and try it under supervision.
Level 4: Descriptive, reflection, learning and future

31. Reflective
Practice
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Description
Layered with your reflection using emotions
your awareness of yourself in the action.
Layered again with what you learned from
reflection and awareness
Layered again with how and what you learned
through your reflection has changed your
Future learning, thinking, behaviour, ideas

32. Gibb’s Reflective Model (1988)
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Gibbs' suggestions are often cited as
Gibbs' reflective cycle or Gibbs' model of
reflection (1988), and simplified into the
following six distinct stages:
Description
Feelings
Evaluation
Analysis
Conclusion
Action plan

33. Gibb’s Reflective Model Cont…..
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Description:
"What happened? Don't make judgments yet or try to draw conclusions; simply
describe.
Feelings:
"What were your reactions and feelings? Again don't move on to analyzing these yet."
Evaluation:
"What was good or bad about the experience? Make value judgments.
Analysis:
"What sense can you make of the situation? Bring in ideas from outside the experience
to help you.“
"What was really going on?" • "Were different people's experiences similar or different in
important ways?"
Conclusions:
"What can be concluded from these experiences and the analysis you have undertaken?
Personal Action Plans:
"What are you going to do differently in this type of situation next time?"
"What steps are you going to take on the basis of what you have learnt?"

34. Gibbs' Model of
Reflection
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Description
What happened?
Feelings
What were your thinking and feelings?
Evaluation
What was good and bad about
experience?
Analysis
What sense can you make of the
situation?
Conclusion
What else could you have done?
Action plan
If it rose again what would you do?

35. Process of Journal
Writing
A journal is a continued series of writings made
by a person in response to their life experiences
and events.
Diaries contain a description of daily events.
A journal may include those descriptions, but it
also contains reflections on what took place and
expresses emotions and understandings about
them.
It doesn't matter what you call your writing, either
a diary or journal, as long as you see the
distinction between these two ways of writing.

36. Learning journal
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A learning journal is a collection of notes,
observations, thoughts and other relevant materials
built‐up over a period of study time , learning and/or
working experience.
Its purpose is to enhance your learning through the
process of writing and thinking about your learning
experiences.
Your learning journal is personal to you and will
reflect your personality, preferences and experiences.
Journal writing encourages learners to reflect on
their practices.

37. Why use a learning journal?
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To provide a “live” picture of your growing understanding
of a subject experience.
To demonstrate how your learning is developing.
To keep a record of your thoughts and ideas throughout
your experiences.
To help you identify your strengths, areas for
improvement
and preferences in learning.
A learning journal helps you to be reflective about your
learning, this means that your journal should not be a
purely descriptive account of what you did but an
opportunity to communicate your thinking process: how
and why you did what you did.

38. How to Structure your learning
journal
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Your learning journal may be:
A learning log
A fieldwork diary or personal development
planner.
A journal could be a notebook, an electronic
document or sometimes recorded verbally on
tape.
Choose a method that works best for you!

39. Critical Thinking
The intellectually disciplined process of actively
and skillfully conceptualizing, applying, analyzing,
synthesizing, and/or evaluating information
gathered from, or generated by, observation,
experience, reflection, reasoning, or
communication, as a guide to belief and action.
(Michael Scriven & Richard Paul, 1987)

40. Critical Thinking in Nursing
A composite of attitudes, knowledge, and skills
that include “defining a problem, choosing
information for the solution, recognizing stated
and unstated assumptions, formulating and
selecting relevant and promising hypotheses,
drawing conclusions, and judging the validity of
the inferences” (Hickman,
1993)

41. Critical thinking in nursing
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Rubenfeld (2000).
Critical thinking in nursing is an essential component
of professional accountability and quality nursing care.
Critical thinkers in nursing exhibit these habits of the
mind: confidence, contextual perspective, creativity,
flexibility, inquisitiveness, intellectual integrity, intuition,
open- mindedness, perseverance, and reflection.
Critical thinkers in nursing practice the cognitive skills
of analyzing, applying standards, discriminating,
information seeking, logical reasoning, predicting, and
transforming (knowledge. (p. 357)

42. Nursing And Critical Thinking
•
•
The ability of critical thinking increases as the work years
increase, and the critical thinking skills can be improved
during nursing education.
Be rapid and dynamic change in the health care system,
nurses in providing optimal patient care, problem solving,
ethical decision making, determine priorities and trends in
clinical decision making and critical thinking skills you
need to use (Yıldırım 2010b).

43. Reference
s
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Coughlan, A (2007-08). Reflective learning:
keeping a reflective, learning journal. DCU
Student Learning Resources. (p.1-4)
https:
//www.dcu.ie/sites/default/files/students/R
ef lectiv elearning.pdf Retrieved on
13/10/2020
Özkahraman, Yildirim, B. An Overview of
Critical Thinking in Nursing and Education.
American International Journal of
Contemporary Research
http:
//www.brainyquote.com/quotes/keywords/r
ef lectio n.html Retrieved on 13/10/2020

44. The only time you mustn't fail is
the last time you try.
Charles Kettering