Big battles for small gains: a cautionary note for teaching reflective processes in nursing and midwifery practice

Since 1988, Australian university nursing courses have adopted the processes of educationalists in embracing reflective practitioner concepts and strategies. The assumption underlying reflective practice appears uniformly to be that if practitioners reflect on and in their practice worlds they can develop ways of changing them. This paper will outline some cautionary points in teaching reflective processes for use in nursing practice, given that they have been processes intent on mobilizing change in densely impacted hegemonic structures in healthcare organizations. To demonstrate that the limits of reflective practice may constitute big battles for small gains, a research project undertaken with practising midwives will be used as a case in point.