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REFLECTIVE ESSAY 0
Reflective Essay
In the course of the second years of first semester of my degree in Diagnostic Radiography, I took part in a clinical placement program that lasted for 42 days. The main aim for this program was to equip me with skills and experience in the imaging aspects that I had theoretically learning in my degree. Additionally, this learning module also created an opportunity for me to learn and gain experience within the hospital context in matters aligned to clinical practices. Hospital was the institution of choice because it covers wide clinical aspects that would make this placement a success. My assessment was formally conducted by one of the clinical staff based on three types of different procedures that can be used for imaging an x-ray of the knee. This assessment was highly significant to the overall evaluation process that made up my examination at the course. Particularly, I found a need in keeping a note that would be reflective of my experience during the placement period. Ideally, my experience would entail thoughts and feelings attached to the overall examination process, various patient profiles whom I conducted examinations, results of the various examinations as well as challenges or milestones realized during the same period of placement. Among all reflections, assessments at the clinical stages were most significant to the entire course output. It is therefore my goal to use this note as a channel that will provide vivid reflections regarding personal experience during the placement program at the hospital. Beyond reflecting on the clinical skills and experiences, this note will also be useful in illustrating the flow of both personal and professional developments towards the building of an overall experienc.
Primarily, core guiding question is what does refection entail and what is the rationale for using reflection in the course of learning? Reflection can be defined as self-awareness process that is gradual and is very critical to appraising the social realm in connection to its impact in causing impact on thinking transformation. According to Johns et al., 2005, reflection is explained to be process that uses active participation in enabling health care providers to acquire a more elaborate comprehension of experiences obtained from patient encounters. In relation to student radiographers, another definition of reflection is one connected to learning and explains reflection to be term used generically. Further according to (Boud et al., 1985) this generic term is used to explain individual engagement in exploring experiences with the ultimate aim of obtaining new comprehension as well as appreciation. Considering that the placement period involved many feelings and thoughts, using reflection in my journal would help vividly relook at the developments and experiences in the course of the placement period. According to (Kennison, 2006) use of the clinical reflective journal is an instrument for documenting experiences gained through clinical apprenticeship. Kennison also appreciates the clinical journal as tool for improving writing skills, exploring reactions, discovering relationships as well as connect theoretical knowledge to practical skills. Based on Newell, 1992, reflection depends on event interpretation and memory. However, regarding negative events it is possible and easy to apply selective memory to suit personal details within the journal. Most considerately, negative memories were more than positive memories and it was important to strike a balance between both sides of experiences to be able to draw meaningful learning out of the placement program.
In the event I am to use reflection to remember the placement program, I am obligated to select the most appropriate reflection mode. Sterman, 2002, realized that reflection can occur in several models that provide process guidance. Reflective cycle is the model I will first use to help in analysing and exploring my feelings as suggested by Gibbs, 1988. The reflective cycle is made up of 6 entities that include: describing, feeling, evaluating, analysing, concluding and acting. Ideally, this reflection model is providing room for analysing and making sense of an experience because it accounts for feelings that are part of an experience and latter guiding to a conclusion that is reflective of experiences and also prepares for future practices. Diversity of this model ranges both reflection ends of advanced and novice. Secondly, Boud et al., 1985, also provide a second reflection model that provides reflection of periods prior, during and post actions in capturing experiences and feelings related to the placement period (Boud et al., 1985). This method of reflecting is instrumental to radiographers because their activities involve affection and intellect and enables adoption of critical skills of reflection (Boud et al, 1985). Schon, 19995, also holds the same idea about reflection being a generic term for radiographers. Both Schon, 1995 and Boud et al., 1985 also state that reflective abilities should be developed critically with reference to practice. Perfection of reflection is further explained to be possible through active engagement in clinical practice, repeated practice in clinical activities and also receiving gradual guidance on the how best to practice.
Beginning with frameworks presented by Gibbs, 1988 and Boud et al., 1985, it was required of me to describe clinical assessment stages which I had previously completed factoring in a reconciled set of feelings and thoughts regarding the three levels (prior, during and post) process. According to my timetable I was supposed to begin my assessment by performing a knee x-ray. Reason for this was that I would frequent be involved in such exercises in the course of the few first placement weeks more so conducting them on patients in wards regularly. Based on personal opinion, I would prefer to be assesses in week 3 of my placement so that I would have performed numerous examinations and acquired experience and confidence. Beginning of week 2, I was highly confident that I had what it took to conduct such procedures, making me ready for the week 3 assessment. As a result, I was anticipating the 2 days allocated in the timetable for working in the department of Accidents and Emergency before returning to general department. Morning hours of the first day at A&E department I encountered a radiographer who was in charge and she enquired if I had undergone any assessment for purposes of evaluation. I went ahead and explained that according to my plan I was hoping to do knee x-ray at the general department in the week that followed. Out of the anxiety, the radiographer at the A&E department made a suggestion that she was in a position to conducted an assessment on me that very same morning. To add to the surprise, the radiographer also required of me that I would be the one to conduct the next examination on patient lined up for knee x-ray.
Considering this was a change of plan, I was more inclined to decline the suggestion considering my mind was not ready then. Tension and panicking also took away my confidence because I had not acquired adequate practice in operating the x-ray machine posted on a mobile state within the area of resuscitation. This was a mind test that checked for mental strength heading into the future as a provider of healthcare because healthcare decisions involve quick decision making. Consequently, I agreed to the impromptu assessment surprising myself. Time flew that morning because I was tensed that I would be referred the next request card because that would have been my call for assessment. Finally, the request eventually came and I was working on imaging a woman aged 45 years who had come with pains in the knee and chest caused by accident. Speculation was made about a knee fracture because she could not move the knee. She posed in an upright position in patient trolley in the area of resuscitation. The first step was to check the history of the patient in order to check if there were any corresponding images. Following this history check I washed hands, picked a cassette and continued to the x-ray machine putting it in the suitable position since it was mobile. Accompanied by the radiographer I obtained consent from the patient to go ahead as a student examiner. The supervising radiographer watched the entire procedure of obtaining the Horizontal Beam Lateral (HBL) and Anterior-Posterior view. On the part of the patient she was very cooperative and fully aware of the clinical situation facing her. It was consequently possible for the patient to comprehend what I was administering to her. Results indicated a fracture around the knee neck and the image was acceptable for diagnosis. I received a good assessment (Significantly Above Expectations) for my work despite the tension. Instead of been relieved the process was over I instead identified more with pleasure of having conducted an x-ray more so on a mobile machine successfully and at high quality. It was after this clinical event that I identified the importance of keeping the note of reflection considering that everything took place unexpectedly different from the anticipated plan that would not have otherwise yielded the experience emotional conflict necessary for reflection and learning. Furthermore, I was thankful to the radiographer I gained an observation of the emotional conflict and this served to reinforce the reflection process. As argued by Schon, 1995, the process of reflection is not simple and therefore clinical practitioners should be exposed to training and make use of reflective journals and diaries to cope with challenges experienced during clinical practices.
Based on the two reflective models, I was able to analyses the cause of the feeling I had during the unexpected assessment. Weighing between the positive and negative ends as Gibbs, 1988, had conceived, I was able to identify that it was normal to have a nervous feeling and it was part of trial and learning. Every student that I interacted with experienced the same during stage assessment and facing a real patient situation. The expected result was to build the potential of being a radiographer. On the negative side, I showed my weakness of been less confident to the overseeing radiographer and on the other end of optimism I used the nervous feeling to my advantage by using it as the propelling factor towards doing the best imaging based on personal inspiration that I had the required capability to produce good images for diagnosis. This followed the rule of reflection been an active process which brings out behavioral changes, learning, adjustments in perspectives as speculated by Boud et al. 1985. Through reflection I was able to recognize changes regarding clinical behaviors and perspectives as influenced through the placement program. Considering the encountered challenge, I was positively reinforced as a student through people I had encountered with such as the experienced radiographer and the patient. I obtained knowledge of how to support my skills in different situations in making progress. According to Gibbs, 1988, the reflective cycle ends by questioning what I would have done differently. Luckily my first assessment involved a cooperative patient at the assessment stage and even after the initial plan I would have done the same. Building experience will enable me build confidence, skills and adaptability quickly. Framework by Boud et al., 1985, was better because it encourages reflection on personal feelings and lessons learnt towards building a better radiographer and person; unlike the latter framework by Gibbs, 1988, which was inclined towards identifying mistakes and gaps that required upgrading and changing but it was impossible to control emotions in causing an influence in the work results. Through the selected reflective models, I was also able to create a situational analysis that followed logic for future reference. Combining both experience and theoretical knowledge, I was able to read my emotions and identify my clinical limitations and in the overall result would be building of clinical experience towards gaining confidence in practice. According to Maggs et al., 2000, development process was critical to reflection and could easily bring about the desired advantages. Towards development, my note has provided effective assistance despite the challenge of recognizing the advantages and collectively using them (Maggs et al., 2000). It is one thing to identify advantages of a development process but it is another to use the identified benefits considering they are acquired on different knowledge platforms.
References
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