A Guide to Reflective Practice and the Module 3 Reflective

Essay
Contents
Reflective Practice............................................................................................................................... 1
Supporting Reflective Pracice Using the Rolfe Model ........................................................................ 2
Reflective Essay Assignment ............................................................................................................... 3
Structure ............................................................................................................................................. 3
Pointers ............................................................................................................................................... 7
Confidentiality ..................................................................................................................................... 7
Word Limit .......................................................................................................................................... 7
Formatting .......................................................................................................................................... 8
Citing and Referencing ........................................................................................................................ 8
Plagiarism and Academic Misconduct ................................................................................................ 8
Submission .......................................................................................................................................... 9
Marking ............................................................................................................................................... 9

Reflective Practice
As a practitioner it is not only important that you are able to learn the theory and skills
involved in your work, but that you are able to reflect on how well you are developing these
skills. Engaging in reflective practice is associated with the improvement of quality of health
care, stimulating personal and professional growth and closing the gap between theory and
practice.
“The ability to reflect on action (to reflect back in retrospect on a piece of work or
situation) is one of the defining characteristics of professional practice.” - Schön, 1983
“Experience needs to be processed if it is to be turned into personal knowledge, and
one way of processing that experience is by reflecting on it.” - Rolfe, 1997

Some of you may be new to reflective practice and reflective writing; we have therefore
produced this guidance to introduce the Rolfe Model of reflection (Rolfe, Freshwater, &
Jasper, 2001) that may be helpful to structure your reflection in your practice or in clinical
skills sessions. We would also like you to use it in your reflective essay. This guide will
introduce your assignment and the structure we would like you to use for it.

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What is Reflection?

It is a metacognitive strategy which can be used as a process for recapturing experience,

considering what occurred and why, what may need to be done differently in the future and
the implications of doing so. It is an active and individual process which should culminate into
a personalised action plan.
The reflective system forms one of the key elements of the Declarative Procedural Reflective
information processing model (DPR) of CBT-based practitioner skill development (Bennett-
Levy, 2006). According to this model, practitioner development depends upon the interaction
between three information processing systems. The declarative memory system stores facts
and information about the intervention; the procedural system generates and stores practical
skills of the intervention and the reflective system that practitioners use to identify which
aspects of their declarative knowledge and procedural skills need to be refined. This suggests
that once basic skills are learnt, it is by reflecting on clinical experience that a practitioner will
refine their practice and learn which particular skills to use at what time.

Supporting Reflective Practice Using the Rolfe Model

On this programme we ask you to adopt the Rolfe et al. (2001) model, given its suitability in
supporting reflective practice amongst novice reflectors in particular.

So Now
What?
what? what?

The ‘what’, ‘so what’ and ‘now what’ sections in the Rolfe et al. (2001) model, are used to
inform and structure the reflective process. Outlined below are considerations regarding the
content of these sections:

What… So What… Now What…

..is the problem/difficulty? ..were the impacts of my ..do I need to do differently

..was I trying to achieve? actions? to do things better?
..actions did I take? ..does this tell me/teach (literature)
...was the outcome? me?
..did I base my actions on?
..other knowledge can I
bring to the situation?
(literature)

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Reflective Essay Assignment
We would like you to write a 2000 word reflective essay, reflecting on your use of
supervision for a particular patient. In this you will need to demonstrate knowledge and
competence in using case management and clinical skills supervision. Please ensure you
maintain confidentiality in this assignment.

Structure
We have provided the structure for your reflective essays below, there are rough word
count guides for the different sections, but these may vary according to your essay content:
Section one (500 words)
In section one we would like you to discuss your understanding of case management and
clinical skills supervision. This section introduces your knowledge of supervision and its
literature base.
Section Two (500 words)

In section two we would like you to describe your use of BOTH case management and
clinical skills supervision to support an individual patient, using literature in support if
appropriate.
This could include:
- What did you seek case management and clinical skills for?
- What happened?
- What did you do well?
- What did you do badly? What would you like to improve?
- What difficulties did you face in supervision?

SECTION 2 EXAMPLE:
I took my patient to case management supervision (CMS) for “further support”. They
were experiencing depression and struggling to engage with BA due to their persistent
pain and I didn’t know how best to support them. I found it hard to request supervision
for “further support” because I was worried what my supervisor might think about me
and that it would reflect badly on me as a practitioner, but I did because I was keen to get
the best care for my patient. I prepared my notes for supervision in advance, using the
IAPT proforma. This meant that in CMS I fully and efficiently offered my supervisor a full
patient background as well as my patient’s present difficulties with low intensity BA. I was
open and honest that I was unsure what to do. We discussed potential ways forward,
including that pacing may be helpful and together we came up with a clear plan including

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 discussing pacing with my patient to see if they felt it would be a useful addition to BA
and with the patient’s GP to ensure BA with pacing for depression would fit with best
medical practice for this patient’s physical wellbeing. I had not used pacing before and
was nervous so we agreed I would raise it in clinical skills supervision. Unfortunately I
didn’t have much time to prepare for clinical skills session so I introduced my patient from
memory, with some difficulty, and asked a supervision question “how can I use pacing to
support a patient with persistent pain to engage with BA?”. We discussed how to
introduce pacing into BA and using a physical symptoms diary to inform the use of pacing.
I practised this in a roleplay. Whilst it was nerve-wracking to roleplay in front of
colleagues it was helpful to practise introducing this in a safe environment and to receive
their feedback to build my skills.

Section Three (1000 words)

a) In section three we would like you to firstly critically reflect on your use of supervision
with this patient, analysing what happened, using literature in support. A literature search
should add to your analysis, offering new ways of looking at things, challenges to your own
interpretation of events. What does the literature suggest I did well / should do differently
next time? What does the literature say about why it is important? What may be the
possible consequence of this? What are the implications of my actions and the
consequences of my use of supervision for me, my patient, and my service?
b) On the basis of this, please secondly then consider ways forward in your supervision
practice including an action plan for your future practice? What do you need to do to
maintain your good supervision practice or how you will address any areas for
improvement? Try and be really specific in your writing to identify clear ways forward (you
may use literature here e.g. regarding what has been shown to help develop certain skills). If
appropriate you may consider what are the implications of these changes to your use of
supervision for you, your patients and your service?
Much of the literature around supervision derives from different therapeutic modalities.
You will need to draw upon this due to the limited LICBT-specific content and it is good
practice to recognise this and any associated limitations in your writing,

E.g. Drawing on HI-CBT supervision research:… though it is important to recognise

this may be more challenging with regards to the high caseloads of PWPs…
Any one of the highlighted areas from the Section 2 example could go on to be a personal
topic for reflection, considering your own supervision practice. Taking this as a starting point
it then forms a thread that runs through the piece, ending with an action plan relating to
this starting point.

SECTION 3 - EXAMPLE 1:

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I found it hard to request supervision for “further support” because I was worried what
my supervisor might think about me and that it would reflect badly on me as a
practitioner.

a) I found it hard raising my need for support in supervision as I was concerned what my
supervisor might think about me and my practice. Many therapists do not
highlight/disclose when they are having difficulties in their supervision (REF), which has
been particularly linked to feelings of embarrassment and shame (REF). This means that I
am not alone in this concern. It also means that if my concern continues it could lead me
to hide when I am struggling from my supervisor. As a consequence I wouldn’t develop
my practice and my patients wouldn’t receive the best care. In the long run this would
impact the quality of care offered by my service. My concern is therefore an important
issue to address on all levels. Whilst my concern seems a common one amongst
supervisees, an alternative viewpoint is that supervision is an important feature of
ongoing therapist development (REF). It is expected and indeed encouraged that trainees
draw on the knowledge of more experienced practitioners in supervision (REF) suggesting
that my concern may not have a strong foundation. Indeed proactively raising areas for
development in supervision is seen as ethical responsibility (REF) and good practice (REF).
This means that far from being concerned about raising difficulties in supervision, I could
regard this as evidence I am an insightful and responsible practitioner, which would be
seen positively by my supervisor.

b) Reflecting on this has partially alleviated my concern. Moving forwards it would be

useful for me to have a conversation about my concern with my supervisor and seek
some feedback about her view of my practice. Hopefully this will further alleviate my
fears and further increase my confidence in seeking “further support” with important
consequences for my own development and the optimal care of my patients. I will email
my supervisor to request a meeting for this purpose.

SECTION 3 - EXAMPLE 2:
I prepared my notes for supervision in advance, using the IAPT proforma. This took a long
time to do, but meant that in CMS I fully and efficiently offered my supervisor a full
patient background as well as my patient’s present difficulties.

a) Utilising the IAPT proforma to present information in supervision means I present full
information to my supervisor and reduce the risk of missing something out I had not
appreciated was important. As a trainee I may not always be aware of gaps in my
knowledge/practice (unconscious incompetence) (REF) leading me to miss the importance
of some pieces of information the patient has offered. Full reporting of my patient’s
experience in CMS was important in highlighting and overcoming a gap in my
knowledge/skills, allowing me to become consciously incompetent, aware of a skill that I
needed to develop, and ultimately through clinical skills become consciously competent in
this skill. For me, the consequence of using the IAPT proforma is that I become more

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 aware of gaps in my knowledge and subsequently more skilled and better able to support
my patient. For my patient, supervision led to a more tailored treatment and a better
opportunity to engage in support for their mental health. That said, time is limited in PWP
work and even with a reduced caseload I am finding it takes a long time to prepare my
notes for supervision. Whilst this likely saves time in supervision needing to extensively
review my notes and assessments for each patient to prepare my notes is eating into my
office time, meaning I am rushing other elements of my job and skipping my lunchbreak
on the day of my supervision. Being over-stretched or overwhelmed has been linked to
reduced quality of work (REF) and poorer healthcare wellbeing (REF). This means my
efforts to present a full and accurate picture to my supervisor may actually result in
inaccuracies and consequences for my wellbeing. So whilst presenting a full picture of my
patient’s difficulties in supervision is important, the way in which I am preparing is not
helpful.

b) Moving forwards, I will continue to prepare notes regarding any treatment difficulties I
am having as part of my supervision preparation. In order to achieve this in a way that is
more timely I will prepare notes on each patient at the end of the day, whilst the details
are fresh in my mind. This will reduce the need to revisit my notes and also reduce the
time pressure of prepping for supervision all in one go. I will set a reminder in my diary to
spend the last 10 minutes of each day reviewing my notes and preparing for supervision.
Through doing this I will continue to present a full picture to my supervisor, but without
the negative consequences of rushing or feeling under pressure.

Action Plan
You have the option of including an action plan in your appendices, this should be presented
in the form of a table and its content does not count towards your word limit. Your action
plan should not however replace work that should be included in the main text. The key
themes should at least be summarised in the main body of the text. Your action plan will be
referred to within your reflection, and will outline in greater detail how you will take your
proposed developments into practice, completing the reflective cycle. The context of your
actions should relate to sections 2 and 3 of your essay, allowing the reader to easily follow
the cycle. The action plan should be time limited, it should be clear what you need to do,
how you will achieve this and when you will review/have it done by.
Example:
Action Required How will this be Impact if How will I Will anyone be Target Date
achieved? undertaken measure this? able to help me
with this?

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Pointers
 Reflective writing is written in the first person, for example: ‘During my supervision
session I…..’
 Where possible write critically; critical writing is not necessarily writing about the
topic in a negative way. It is demonstrating that from your reading, you are able to
provide evidence taken from a wide range of sources which both agree with and
contradict an argument. It follows that you will give a more reliable view if you draw
from different sources.
 Remember...whilst your reflective writing will be based on personal experience, it is
essential that it also draws on other sources and types of evidence if you are to
better understand this experience.

Confidentiality
Confidentiality MUST be maintained (failure to do so results in auto-fail). Trainees must
anonymise their case removing all reference to actual patient names or identifying features
(including but not limited to: place of residence, service within which patient was seen,
family or children names, ages, anything too specific regarding their circumstances, health
conditions, background, job etc that could lead to possible identification).

Word Limit
2000 words, excluding reference list and main title. In text citations/references and any other
headings need to be included in your word count. Anything over will not be marked, there is
no 10% leeway.

The following content is not included in a final word count:

• Title
• Reference list
• Appendices
• Words used in tables, graphs, and other forms of data presentation (including titles of
figures)

The following content is included in a final word count:

• Main body of text
• In text quotations
• In text references
• Section headings
• Footnotes containing large amounts of text (unless indicated otherwise by module
convenor)

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Formatting
All written assessments (case studies, reflective commentaries etc) should be word-processed
with the following conventions:
• Use 1.5 line spacing on A4 paper.
• Use a font size of 12 pt.
• Use only Times New Roman, Arial or Calibri.
• Margins: 30mm on the left-hand side, 20mm on the right-hand side and 20mm for
top/bottom margins.
• All pages (including appendices etc) should be numbered consecutively in one sequence
starting with the title page as 1.
• Include the student number in the header but trainees should NOT include their name
anywhere on the assignment, as this will prevent work being blind-marked.

Citing and Referencing

We require in text citations and a reference list (not a bibliography). Psychology has adopted
the American Psychological Association (APA) conventions as the standard for citations and
references. References must therefore be completed using the precise details for APA style.
We use the standard of ‘a publishable article’ and expect citations and references to adhere
to this standard. The information given here is based on the latest edition of the Publication
Manual of the APA. We would encourage trainees to consult these guidelines and copies are
kept in the library or can be obtained online at www.apastyle.org and links to online training
are on ELE. There are many web sites providing summaries of the APA Style Guide (a Google
search will identify these).
More support for APA formatting can be found here APA formatting

Plagiarism and Academic Misconduct

Plagiarism and academic misconduct is a growing problem in all sectors of education, and the
number of reported cases in UK universities has risen dramatically in recent years. Plagiarism
and academic or clinical misconduct are serious breaches of professional ethics. Trainees can
fail the programme, be expelled from the University, or even be prevented from pursuing a
career as a PWP.
In addition to ensuring you only ever submit your own work based on your own genuine
clinical and theoretical practice we would strongly recommend you work through the online
resource about Understanding Plagiarism on ELE to clarify the differences between
academic honesty and plagiarism, and to identify ways in which you can directly or
inadvertently plagiarise. If you are in any doubt at all or are in anyway unsure how to submit
work of clinical and academic honesty, please contact your personal tutor.

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Submission
Submission via the submission portal on ELE by no later than 11 am on the day of assessment,
submitted as a PDF and accompanied by the associated cover sheet (available on ELE).
Confidentiality is essential for this submission, failure to maintain this will result in an auto-fail.

Marking
Marked using University-wide marking criteria for Level 6 (GradCert) and Level 7 (PGCert)
assessments using the College of Life and Environmental Science (CLES) notched marking
scheme (Appendix 3 of the Trainee Handbook), focussing particularly on the following:

 Structure and Organisation: Students are expected to adhere to the required

structure for the reflective piece, writing in a clear way with a progression of ideas.
 Knowledge and Understanding: Students are expected to display a sound level of
knowledge and understanding of supervision based on literature. This will be
displayed by them being able to give relevant and correct information about the
chosen topic. Marks will vary dependent on the level and depth of this knowledge
and the accuracy.
 Theory into practice links: Students should use literature to support their reflections
on their supervision practice
 Critical Reflection: Students are expected to display the ability to engage with their
discussion using a critical and evaluative stance. They are also expected to
demonstrate the ability to reflect on their chosen area and to give appropriate action
plans in response.
 Sourcing: Students must support their writing with reference to literature. The
referencing system to be used is that of APA. Please note that references are a part
of your work and will be scrutinised. Only sources directly referred to in your work
should be in your reference list. This is not a bibliography where you state what
books you have read. Consideration will be given to the depth and breadth of the
literature cited.
Marking is numerical against the University-wide marking criteria for Level 6 (degree level)
and Level 7 (postgraduate level) assessments using the College of Life and Environmental
Science (CLES) notched marking scheme, see https://cedar.exeter.ac.uk/iapt/iapt/marking/.

Results
To pass a trainee must gain 50% or more for the PGCert or 40% or more for the GradCert.
Results are given 3 weeks after date of assessment, via email to the trainee (using their
University email address) and copied to service supervisor.

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In the event of failure, trainees should contact the teaching team to receive detailed
feedback.

Reassessment: 4 weeks from the date results were provided. Marks for reassessments are
capped at the pass mark, and the whole module is also capped at the bare pass mark.

Late/Non-submissions
If trainees are experiencing difficulties in submitting assignments on time, they are strongly
advised to speak to their personal tutor who will be able to offer support and discuss ways
forward. See the Handbook for descriptions of late or non-submission penalties.

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