Reflection: a challenging innovation for nurses

The concepts of reflection and reflective practice have been widely embraced by the nursing profession despite some apparent ambivalence highlighted in the literature. On the one hand, reflection is reported to be a valuable and powerful educational process; it is claimed to develop practice-based theories, encourage practitioners to evaluate their practice, promote learner self-awareness, narrow the theory-practice gap, challenge habitual practice and identify tacit knowledge. On the other hand, commentators point out that there is insufficient empirical evidence to support these claims and that its unstructured implementation can have deleterious effects on practitioners' psychological well-being and the outcomes of nursing education. It will be argued in this paper that the realisation of the benefits claimed to accrue from reflective practice together with the avoidance of its potential deleterious personal and educational outcomes hinges on three factors. These are: firstly, that the frameworks or protocols introduced to promote reflective practice are consistent with the purposes it seeks to achieve; secondly, that the essentially political nature of reflective practice is recognised and addressed; and thirdly, that the resourcing requirements for introducing and maintaining reflective practice in clinical units are also recognised and addressed.