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Updated: Jun 18, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
The float model: visualizing personal reflection in healthcare.
Leo C Aukes1, Janke Cohen-Schotanus, Rein P Zwierstra
1University of Groningen, Groningen, the Netherlands. l.c.aukes@med.umcg.nl
Healthcare professionals must critically assess themselves for improved patient care. A new "float model" visualizes the unseen mental processes, like clinical reasoning and personal reflection, that influence behavior and learning.
Area of Science:
- Medical Education
- Healthcare Professional Development
- Cognitive Science in Medicine
Background:
- Healthcare professionals require self-assessment skills for continuous learning and enhanced patient care.
- The concept of 'reflection' is crucial for self-assessment but often remains abstract and difficult to teach or evaluate.
- Existing methods struggle to visualize the internal cognitive processes underlying professional behavior.
Purpose of the Study:
- To develop an educational model that visualizes the concept of reflection for healthcare educators and learners.
- To enhance understanding of how reflection functions and how to foster its development in individuals.
- To provide a framework for analyzing the interplay of mental processes influencing healthcare practice.
Main Methods:
- Designed an educational model using the metaphor of a fisherman's float.
- The float's visible part represents observable behavior; submerged parts represent cognitive processes: expert thinking (clinical reasoning, scientific thinking), personal reflection, and unconscious thoughts.
- The surrounding water symbolizes the organizational and cultural context.
Main Results:
- The float model visually distinguishes between observable behavior and underlying mental processes.
- It highlights the dynamic interplay of clinical reasoning, scientific thinking, personal reflection, and unconscious thoughts.
- The model illustrates how context (water) influences the practitioner's (float's) balance and function.
Conclusions:
- The float model can illuminate the unseen mental processes influencing healthcare practitioners' behavior and decision-making.
- It aids in preventing misunderstandings, such as conflating scientific thinking with personal reflection or undervaluing intuitive processes.
- This visualization tool can improve the assessment and facilitation of reflection in healthcare education.
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Flow Sheet
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Graphic Sheet Documentation:
Documentation in Long-Term and Home Healthcare Setting
Long-Term Care Facilities
