Context

As clinicians, our responsibilities include the use and promotion of reflection to ensure we continue to learn and improve our clinical practice.1 While reflective practice is a key tenet upheld by governing bodies including health practitioner regulation agencies and the health services which we work for, it is rarely harnessed, enforced or facilitated during the clinical workday.2 3 In fact, most clinicians never engage in self-initiated reflective practice.3 4 When they do, clinicians only engage superficially to fulfil summative requirements or as part of a supervisor-facilitated session to unpack a near-miss or critical clinical incident.2–4 Thus, I compare two commonly taught clinician reflection models, one with brief and simple instructions, and another with more complex cues, aimed to encourage clinicians to build reflective practice into their day-to-day clinical duties.5

Ghaye (2010): a reflective model to facilitate positive action

Ghaye’s four-step model (2010) harnesses appreciative inquiry to promote learning and improved clinical care within complex social systems.6 Reflections are used to inspire the clinician to apply a positive, collaborative and solutions-based lens to unpack challenging experiences.

The model guides reflection by asking clinicians to:

1. Appreciate: ask what is successful and positive right now?

2. Imagine: what do we need to keep doing and stop doing to make this better in the future?

3. Design: how do we do this?

4. Act: who takes action and with what consequences and impact?