Reflective practice

10.9 Reflective practice

There was a general opinion amongst the interviewees that reflective practice was a natural occurrence in everyday working life. Reflective practice happened frequently, either collectively as a group with other sonographers, with another sonographer or individually on a personal basis.

Reflective practice is important: a recalling practice that is accepted as an ordinary everyday practice. For instance, we discuss cases and get textbooks out all the time, so it happens

anyway, naturally. (Fred)

Reflection was regarded as an important part of working life, but it was noted that during a busy day there may not be time to be totally reflective. In addition, even though reflection was important, at times care was needed:

… too much – you will never get on with job, too little is dangerous. Without reflection we will never learn the broader picture, but there are many things that could be reflected on in a day, so not all will be reflected on. (Ann)

Ann went on to comment that there is the possibility of reflecting too much and then it may not have

a positive effect, as was confirmed by Bob’s remark,

I reflect all the time in a variety of ways. Asking new people what they do, compare others with myself. I change things regularly because of this. I look for reasons why. Self-confidence can be affected by this though, because you start to wonder if you look like an idiot because of all the enquiries. (Bob)

The most usual form of reflection for this group was group or collective reflection. These were either formal or informal in nature, but informal chats about cases tended to be a common form of group reflection.

Reflection is something that should done, but sometimes there is little time during the day. One of the best times is during informal chats 9 and then staff do reflect. Also students will instigate reflection by querying different things leading to discussion. (Celia)

9 Once a patient has been scanned, images are checked in a central ‘sorting-room’ and preliminary reports written up. There is often more than one sonographer present in this area and it is common to discuss findings and ask opinions of

others and check with text books if necessary. The discussions are often continued at break times and even at drinks after work.

When asked why sonographers did not tend to reflect in writing: … ideas are bounced between individuals and the whole group both in informal and formal

settings. Ideas are discussed and perhaps tried out, evaluated and then maybe used or not. (Gloria)

…there is teamwork in practices with more than one sonographer in that each can discuss cases with each other. (Jan)

When asked why sonographers may not change practice after reflection on CPD: … could be that they are actually happy with their practice and so are comfortable with just

the reinforcement that CPD offers. Or perhaps they haven’t taken it on board, but more likely the former. (Jan)

Sometimes when we have been doing the job for a while we need to find time [to reflect] as we get stuck in habits, always done it this way and we need to think outside the square

sometimes. (Celia)

In summary, the interview participants displayed and discussed a natural tendency towards reflection. These findings are congruent with those of the survey and again, demonstrated that although sonographers do not tend to reflect in writing, they actively reflect daily. With this they appear to differ from colleagues in other health professions and with their radiographer colleagues (O’Sullivan, 2004; Sim et al., 2002). Eraut (2004) and Fuller et al. (2000) all discussed the benefits of group discussions for transference of learning and increasing motivation and confidence. Reflection in such a form may also encourage sonographers to keep abreast of the latest skills and techniques. The practice of group reflection will also enable the sonographers to remain grounded, neither becoming over- or under-confident (Ng, 2009). According to Hiemstra (2004), this type of reflection will also allow the sonographer to become more self-directed. Whilst the reflection may not always lead to change it is clear that it did reinforce practice, and in addition, ideas are discussed between sonographers, finally being used or rejected as required.