Slowing down to speed up development

This week whilst couching a junior staff member on their clinical skills, we discussed the importance of reflection in learning, especially when building new professional skills.?For those of us who are used to making fast decisions on the go, reflection just seems like “something we don’t have time for”, but, can be critical in making a good decision (or reversing a bad decision) rather than just making a decision and going on with a plan that may just not go anywhere.

In this particular scenario, we had a case where the patient had initially presented with a particular back and hip issue.?We had implemented a plan from his initial examination, he had gotten better, but after a busy weekend of activity had re-aggravated the injury.?The clinician had assessed the area again, implemented a new plan, but on this occasion, despite treatment, there was no change in the patient’s pain and condition.

The clinician was getting frustrated with the lack of progress on the patient’s condition and had put the client’s problem down to being “too complicated”.

We sat down together, reviewed all the testing and treatment that had been implemented from the start of client’s time with us, with particular attention on the time of the flare up.?When we were able to examine the scenario without the pressure of the client right in front of us and anxiety of having to come up with the right answer right there on the spot, the problem became much clearer.

Upon reflection, it became very clear that during the flare up, the clinician had assessed an area that could have caused the pain, but not all the areas that may have caused the pain.?Looking back at the initial examination (before the flare up), the client had had a previous issue with another area which could have been the cause, however, this area was not examined at the time of the flare up.?BINGO.?

When the client returned, we examined the other areas and they were positive.?As a result, the plan was changed, implemented and we were able to get the client’s program back on track.

Reflection is a normal and useful part of adult learning

According to Osterman (1990), reflection-on-practice, allow us as professionals to critically think about and analyse your own actions with the goal of improving your own professional skills.?As in this case, we were able to identify the assumptions and feelings the clinician had at the time (in particular anxieties), and how these assumptions and feelings affected decision making and actions.

Osterman argues that reflective practice is essential because it allows you as a professional, to extract meaning from and make sense of a learning experience, such as this scenario.?In addition, when reflecting, you are able to put your full attention on analysing the situation without the need for immediate action AND can receive assistance from others to get another point of view (Kottkamp, 1990).

Action point:

Do you have a complicated scenario that just isn’t working??Put it down, leave it alone and pick it up again the next day.?Does it make any more scene now?

Reflection means putting your ego aside for the moment (for your own greater good)

The hardest part about reflecting on your own decisions is that you have to put your ego aside, examine yourself and potentially come to the conclusion that “you were wrong”.

As professionals, people come to us for help because “we have the knowledge”.?But, this is not always the case.?They really come to us for a solution they can not achieve for themselves, however, we often make the assumption that the client expects us to have the answer straight away and not be wrong.?This is not true.?The clients know that we are also human and don’t have all the answers.

But, what they do expect, is for us to look for and help them find the answers to the problems they are looking to solve.?In this scenario, we did not get it right the first time, but were able to reflect and determine a better path for the client’s problem.?As a result, we got a better long term outcome for the client because we were about to put our ego aside and look at the scenario form a big picture point of view, resulting in a better treatment plan.

Action point:

Are you okay in putting your ego aside to look at the problem from a big picture point of view, to get a better long term outcome?

Don’t stop at paralysis by analysis

We also had to be careful not to cause that opposite problem, not taking action because we don’t have all the information.

As leaders, in most cases, we will not have all the information to make the best decision.?This is real life.?This should not be the reason we don’t make a decision and implement an action plan going forward.

We can make a decision and take an action plan on the best information we have at the time, however, once the plan is implemented, the results of the plan allows us to reflect and re-direct our plan based on results.?This is how all great plans are implements, one step at a time, using feedback to guide the next move and adjust course.

Action point:

Is there a plan you are NOT implementing because you don’t have all the information??What is the next step you can take with the information you have (allowing space for feedback to change your action if needed)?

References:

Kottkamp, R. B. "Means for Facilitating Reflection." EDUCATION AND URBAN SOCIETY 22, no. 2 (February 1990): 182-203.

Osterman, K. F. "Reflective Practice: A New Agenda for Education." EDUCATION AND URBAN SOCIETY 22, no. 2 (February 1990): 133-152.