Reflection: possible strategies to improve its use by qualified staff

Reflection is now a prerequisite for all nurses, midwives and health visitors (UKCC, 2001). It is the method endorsed by the UKCC to promote the development of informed, knowledgeable and safe practice, and qualified practitioners are required to maintain a personal professional profile containing evidence of reflection on practice. The aim of this article is to examine why qualified practitioners may be reluctant to reflect formally, to speculate on the possible barriers to reflection, and to suggest how reflection can be promoted positively as an integral part of nursing practice. The article begins with an examination of definitions of reflection, reflective theory and the purpose of reflection, and continues by questioning whether the concept of reflection has been embraced as eagerly by nurses at 'grass roots' as it has by academia, the nursing press and the UKCC. It is suggested that several barriers to effective reflection may create a division between practitioners and the professional hierarchy regarding the conceived common practice of reflection, and strategies are proposed that may help to overcome these barriers. The discussion concludes by prioritizing the need for a clear definition and concept analysis of reflection, supported by long-term investment into research that explores the effect of reflection on clinical practice and patient care.