sample reflective essay using gibbs model

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Gibbs' Reflective Cycle

One of the most famous cyclical models of reflection leading you through six stages exploring an experience: description, feelings, evaluation, analysis, conclusion and action plan.

Gibbs' Reflective Cycle was developed by Graham Gibbs in 1988 to give structure to learning from experiences.  It offers a framework for examining experiences, and given its cyclic nature lends itself particularly well to repeated experiences, allowing you to learn and plan from things that either went well or didn’t go well. It covers 6 stages:

• Description of the experience
• Feelings and thoughts about the experience
• Evaluation of the experience, both good and bad
• Analysis to make sense of the situation
• Conclusion about what you learned and what you could have done differently
• Action plan for how you would deal with similar situations in the future, or general changes you might find appropriate.

Below is further information on:

• The model – each stage is given a fuller description, guiding questions to ask yourself and an example of how this might look in a reflection
• Different depths of reflection – an example of reflecting more briefly using this model

This is just one model of reflection. Test it out and see how it works for you. If you find that only a few of the questions are helpful for you, focus on those. However, by thinking about each stage you are more likely to engage critically with your learning experience.

This model is a good way to work through an experience. This can be either a stand-alone experience or a situation you go through frequently, for example meetings with a team you have to collaborate with. Gibbs originally advocated its use in repeated situations, but the stages and principles apply equally well for single experiences too. If done with a stand-alone experience, the action plan may become more general and look at how you can apply your conclusions in the future.

For each of the stages of the model a number of helpful questions are outlined below. You don’t have to answer all of them but they can guide you about what sort of things make sense to include in that stage. You might have other prompts that work better for you.

Description

Here you have a chance to describe the situation in detail. The main points to include here concern what happened. Your feelings and conclusions will come later.

Helpful questions:

• What happened?
• When and where did it happen?
• Who was present?
• What did you and the other people do?
• What was the outcome of the situation?
• Why were you there?
• What did you want to happen?

Example of 'Description'

Here you can explore any feelings or thoughts that you had during the experience and how they may have impacted the experience.

• What were you feeling during the situation?
• What were you feeling before and after the situation?
• What do you think other people were feeling about the situation?
• What do you think other people feel about the situation now?
• What were you thinking during the situation?
• What do you think about the situation now?

Example of 'Feelings'

Here you have a chance to evaluate what worked and what didn’t work in the situation. Try to be as objective and honest as possible. To get the most out of your reflection focus on both the positive and the negative aspects of the situation, even if it was primarily one or the other.

• What was good and bad about the experience?
• What went well?
• What didn’t go so well?
• What did you and other people contribute to the situation (positively or negatively)?

Example of 'Evaluation'

The analysis step is where you have a chance to make sense of what happened. Up until now you have focused on details around what happened in the situation. Now you have a chance to extract meaning from it. You want to target the different aspects that went well or poorly and ask yourself why. If you are looking to include academic literature, this is the natural place to include it.

• Why did things go well?
• Why didn’t it go well?
• What sense can I make of the situation?
• What knowledge – my own or others (for example academic literature) can help me understand the situation?

Example of 'Analysis'

Conclusions

In this section you can make conclusions about what happened. This is where you summarise your learning and highlight what changes to your actions could improve the outcome in the future. It should be a natural response to the previous sections.

• What did I learn from this situation?
• How could this have been a more positive situation for everyone involved?
• What skills do I need to develop for me to handle a situation like this better?
• What else could I have done?

Example of a 'Conclusion'

Action plan

At this step you plan for what you would do differently in a similar or related situation in the future. It can also be extremely helpful to think about how you will help yourself to act differently – such that you don’t only plan what you will do differently, but also how you will make sure it happens. Sometimes just the realisation is enough, but other times reminders might be helpful.

• If I had to do the same thing again, what would I do differently?
• How will I develop the required skills I need?
• How can I make sure that I can act differently next time?

Example of 'Action Plan'

Different depths of reflection

Depending on the context you are doing the reflection in, you might want use different levels of details. Here is the same scenario, which was used in the example above, however it is presented much more briefly.

Adapted from

Gibbs G (1988). Learning by Doing: A guide to teaching and learning methods. Further Education Unit. Oxford Polytechnic: Oxford.

Health and Safety Advice in a Fast Changing World

Nurses and Midwives Reflection Process

Nurses and Midwives in the UK are formally required to record 5 pieces of reflection on either continuing professional development (CPD) or practice related feedback to improve their nursing practice.

Here I start with the theory of reflection (see Framework image) and then give an example from my own nursing history of an awful incident – one I will never forget.

If you don’t want the theory (and let’s face it who does?); scroll down to my real-life example and see how I have applied the Gibbs theory model to a terrible incident which almost made me give up nursing.

Let’s Get Started

To see if Gibbs reflective cycle can help you reflect on aspects of your practice, recall a nursing situation that didn’t turn out as you expected or go to plan.

Look at the Gibbs Model flow chart above –

Stage 1 – Description (Pure Facts)

The first step is to describe what you know. Ask yourself the following questions:

• What are the brief facts of the situation?
• What occurred? Who was involved?
• What did you do? What did others do?

Stage 2 – Description – (Feelings)

• How were you feeling at the time?
• Were there influences affecting others actions/behaviour?
• Were there any known or perceived difficulties with the activity, timing, location, information or resources etc.?

Stage 3 – Evaluation

• What was good and bad about the experience
• How might the facts and feelings (from stage 1 and 2 above) have affected your actions/behaviour
• What other circumstances may have affected your actions or thoughts?
• How issues might influence the activity or practice related feedback?

Stage 4 – Analysis

• Why you picked this incident to reflect on?
• What sense can you make of it? Does it make sense given the preceding 3 stages?
• What is the main area of concern or focus on the future?

Stage 5 – Conclusions

• What have you discovered?
• What have you learned from this incident and circumstances?
• What questions remain?

Stage 6 – Now What? (Action)

You have analysed the incident and want to make sure you improve your practice for next time, so need to move into the action planning stage:

• What will I do differently from now on or the next time this arises?
• What resources/help will you need?

Gibbs, (1988) Learning by Doing: A Guide to Teaching and Learning Methods Further Education Unit, Oxford Brookes University, Oxford.

Example Reflection –  Sadly, a real story!

Night duty drug round.

I am a third-year student nurse ‘in charge’ on night duty, in a London hospital, with a junior nurse to deal with 23 pretty sick people in this medical ward.  A doctor asked me to give a patient (Mrs X,) 0.1 mg of Digoxin (a heart stimulant – steady, slows and strengthens the heartbeat) to relieve symptoms of severe congestive cardiac failure and difficulty breathing.  I had never given such a high dose of Digoxin before and measured 4 tabs from the 0.25 mg bottle.  I checked the script and the tablets with both the doctor, who nodded, and my junior nurse. We were all in agreement. I checked Mrs X’s pulse rate (standard practice for Digoxin), which was in the OK range, before giving the tablets. I kept Mrs X on hourly observations after.

At about 2 am I suddenly realised I had given 10 times the amount of Digoxin as stated on the Doctors script.  In horror, I called the night sister who agreed with me.  We filled in an incident form, informed the doctor and Mrs X’s relatives of what happened. Petrified, I was told to go see the hospital matron in the morning.

Mrs X did not seem to suffer any ill effects from the Digoxin during the night and went on to make a full recovery.

I had been on nights for a long stretch.  It was a very busy ward with only two-night staff and I was “in charge”.  Mrs X was very ill and needed constant monitoring.

I had only ever seen 0.25mgs of Digoxin tablets and did not know there was a paediatric blue table of 0.1 mg made.  I was very reluctant to give such a big dose which is why I checked the four tablets of .25 with the doctor who looked at the tablets and said OK.  I was nervous about the dosage being so high and took Mrs X’s pulse for much longer than the customary 15 seconds.

The doctor too was under tremendous strain, his beeper kept going off and he was rushing about all over the place.  I had never met him before.  He had recently come from a paediatric ward.

Nobody ever blamed me for the incident, neither did they reassure me.  Mrs X went on to make a full recovery and the relatives were very understanding about the situation which was a relief.  Matron was kind to me and impressed I had owned up to the error – nobody would have ever known, she said.

I felt absolutely terrified about the error though and watched Mrs X all night for signs of overdose.  I didn’t sleep all the next day and returned to my next night shift to find Mrs X better.

This incident really frightened me because I had done everything right – I had checked the dosage with both the Doctor and the junior nurse.  I had not known that you could get a 0.1 mg of Digoxin or it was blue.  I have no idea what prompted me to think about the overdose later on that night except that I had been very reluctant to give it.  The Doctor agreed I had shown him 4 white tablets who said “I thought you knew what you were doing” Which isn’t any sort of answer really.  Yet he didn’t get in trouble (like me) at all for overseeing and agreeing my mistake.

I also realised how dependant patients are on the care and insights of the medical profession and the trust they put in us; I’d let Mrs X down.

I believe that this incident was down to a series of incidents linked to overwork, tiredness and misunderstandings. Plus if I’d known the Doctor better I might have had a conversation about the dose.

I was so relieved that Mrs X survived the overdose and the relatives were understanding but, if she had a serious reaction or even died, I’m not sure I could have carried on nursing.

I have learnt to be more careful with drugs and to really understand the dosage.  If necessary now I will look up the drug in the reference books before I give them because it is my responsibility if I do it wrong.

I will always be ultra-careful with new drug scripts in the future and if I am nervous, then to go with my gut feeling and check and check again. Although, as I said to Matron, at the time I’d felt as if I done as much as I could have.

Also, if nurses in my team are involved in incidents where they have made a clinical mistake, I am always on hand to offer support and give them an opportunity to talk to me.

I never want another nurse to go through what I went through alone and I definitely do not want to harm anyone in my care.

Linked to NMC Code of Practice 14 – “Preserving Safety”

Further information.

• British National Formulary (BNF)  the drugs’ bible in the UK, available online with a subscription

Other of my real stories here:

• For a second applied reflection example, see my blog about My Infographic Mistake
• For a third reflection see Dog Walking

I have also published a workbook for nurses where you can see the model and have space to add your own private stories. Available on Amazon With over 400 great reviews.

Thanks for reading and good luck in your career. J

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My site may contain affiliate links. Meaning, I get a commission if you purchase through my links, at no cost to you. However, I do not recommend lightly – if I like it I want you to know about it. J

Reflective writing: Gibbs

• What is reflection? Why do it?
• What does reflection involve?
• Reflective questioning
• Reflective writing for academic assessment
• Types of reflective assignments
• Differences between discursive and reflective writing
• Sources of evidence for reflective writing assignments
• Linking theory to experience
• Reflective essays
• Portfolios and learning journals, logs and diaries
• Examples of reflective writing
• Video summary
• Bibliography

On this page: ​​

Gibbs' framework “emphasises the importance of being able to generalise, to transfer knowledge and insights gained from one situation to another ” Williams et al., Reflective Writing

Gibbs' Reflective Cycle

Similar to Kolb's Learning Cycle , Gibbs (1988) Reflective Cycle also provides a structure for a reflective essay.

The structure of a piece of reflective writing, whether it be an essay or learning log entry, might consist of six components or paragraphs that follow Gibb’s cycle:

Model of Gibbs' Reflective Cycle

Criticism of this framework

Don't let it put you off using Gibbs' Reflective Cycle, but do take into account that there has been some criticism about it's lack of depth. For example, the Open University suggest the following:

Despite the further breakdown, it can be argued that this model could still result in fairly superficial reflection as it doesn’t refer to critical thinking/analysis or reflection. It doesn’t take into consideration assumptions that you may hold about the experience, the need to look objectively at different perspectives, and there doesn’t seem to be an explicit suggestion that the learning will result in a change of assumptions, perspectives or practice. You could legitimately respond to the question ‘What would you do next time?’ by answering that you would do the same, but does that constitute deep level reflection?

Open University (2014) in  OpenLearn

The Reflective Cycle has six distinctive stages, leading from a description of the event/experience through to conclusions and consideration for future events.

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Gibbs Reflective Cycle

Gibbs’ Reflective Cycle is one of the most well known cyclical models used in professional reflective practice . 

It guides practitioners through an experience in six stages: description, feelings, evaluation, analysis, conclusion, and action plan. 

Gibbs Reflective Cycle was originally developed for use in higher education as a way for teachers and learners to link theoretical learning to experiential practice to reinforce the knowledge they have acquired through the use of real-world examples. It has numerous applications, but it is predominantly used in the fields of teaching and health and social care. As Gibbs’ argues:

It is not sufficient simply to have an experience in order to learn. Without reflecting upon this experience it may quickly be forgotten or its learning potential lost. It is from the feelings and thoughts emerging from this reflection that generalisations or concepts can be generated. And it is generalisations which enable new situations to be tackled effectively….It is not enough just to do, and neither is it enough just to think. Nor is it enough simply to do and think. Learning from experience must involve links between the doing and the thinking.

In this article, we will be discussing this cycle, its pros and cons, along with a worked example of its use in practice and some alternatives to the Gibbs Reflective Cycle.

Table of Contents

About Graham Gibbs

The reputation for excellent teaching at Oxford Brookes University is in large part due to the work done by Professor Graham Gibbs. He was Head of the Center for Staff and Learning Development and later Director of the Oxford Learning Institute at Oxford University, where he helped many students develop strong fundamentals that would help them to succeed beyond academia.

Graham’s career has been dedicated to improving university teaching and student learning. He founded the International Consortium for Educational Development in Higher Education and the Improving Student Learning Symposium while also receiving Honorary Doctorates from Sheffield Hallam University and the University of Utrecht.

He retired in 2007 after a long and distinguished career.

Gibbs’ Model Of Reflection

The purpose of Gibbs’ Model of Reflection is to provide a structured approach to self-reflection or ‘structured debriefings’ as Gibbs himself describes them. He argues that problems relating to discussions following an experience include:

– they often lurch from superficial descriptions of what happened to premature conclusions about what to do next, without adequate reflection or analysis; – if the experience has been especially powerful then discussion may never get further than a description of what happened or of the feelings associated with the experience; – if description and feelings are not dealt with adequately, learners may return to these at a later stage when they should be considering implications and action plans.

These issues may be avoided if a structured approach is used because there is less likelihood of deviation that could inhibit the learning experience. Gibbs proposed the following cyclical process for reflective practice:

Stage 1: Description

The first stage involves making a factual account of what happened during the experience. This should be an objective description and we should try to avoid recording thoughts and feelings or performing analysis as this will come later. Some things to consider at this stage include:

• When and where did the experience happen?
• Is there any relevant background information that influenced the experience?
• Who was present?
• What happened?
• What did each person do?

Stage 2: Feelings

In stage 2, we should record the feelings and emotions of ourselves and others. Again, we should not try to carry out any analysis yet, simply make a truthful account of how we felt at each stage of the experience. Questions to consider include:

• How did I feel prior to the experience?
• How did I feel during the experience?
• How did I feel after the experience?
• What were the feelings of other people that were involved?

Stage 3: Evaluation

Here, we make value judgments about the positive and negative aspects of the experience. Our evaluations should be as objective as possible. Questions to ask include:

• What went well?
• What did not go well?
• What was positive/negative about the experience?
• Were my contributions positive/negative?
• Were the contributions of others positive/negative?

Stage 4: Analysis

In the fourth stage, we critically analyse the experience using the information that we collated in the previous section along with knowledge from other sources, such as theory, research, standards and the perspectives of others. By bringing all the information together, we can begin to make sense of the experience. Questions you may ask include:

• Why was the experience positive?
• Why was the experience negative?
• Did the perspectives of others align with your own? If not, why not?
• Which literature is relevant to the experience?
• How did the experience align with the theory?
• How did the experience align with standards?

Stage 5: Conclusions

Gibbs splits this stage into general conclusions and specific conclusions.

General conclusions are broad deductions that can be derived from the experience. Specific conclusions relate to our own personal experiences, practice and development. Examples of questions that may be asked at this stage include:

• What have I learned from this experience?
• How might I have performed better?
• What would I do differently if a similar situation occurred in the future?
• What learning and development opportunities may strengthen this area of my practice?

Stage 6: Action Plan

Finally, we develop an action plan for addressing areas of our practice that we may wish to develop, based on our findings from the reflective process. This could be undergoing further training, gaining additional knowledge, practising a procedure or another similar activity. The action plan should contain objectives and timescales (SMART targets are useful here). Pertinent questions include:

• What will I do differently next time?
• What training will I undergo?
• How will I gain further knowledge or experience?

Gibbs advocated for his reflective cycle to be used in situations practitioners find themselves in often. This is primarily because practitioners who reflect on the same set of experiences are more likely to build up a bank of knowledge and expertise pertaining to that situation. 

However, the stages of the Gibbs model can be used in single, isolated experiences. This means that elements of the reflective cycle, the action plan aspect, for example, will likely be more generalised and ultimately less practical when considering the applications of the reflective cycle process. 

Advantages And Disadvantages Of Gibbs Reflective Cycle

As with all reflective practices, there are advantages and disadvantages of using Gibbs’ reflective cycle. 

These advantages and disadvantages are somewhat subjective, as not every method of reflective practice works for all practitioners in every situation. 

• Gibbs’ reflective cycle underpins many other models of reflective practice
• It provides a structured approach to experiential learning
• It is a relatively simple model that is a good introduction for individuals that are new to self-reflection

Disadvantages

• It was developed as a generalised approach to reflective practice within a teaching setting and so does not focus on specialised practice, such as nursing or social care

Alternatives To Gibbs Reflective Cycle

Kolb’s (1984) model is a more simplified model based on a set of theories around how people learn – in fact, Gibbs’ model was based on Kolb’s research. It revolves around four key stages: Concrete Experience, Reflective Observation, Abstract Conceptualization, and Active Experimentation.  

Schon’s model of reflection builds on the idea that reflection can be performed both after an experience (reflection-on-action) as well as during an experience (reflection-in-action).

There are also models of reflection that are designed to be used by specific vocations – for example, Johns model and Atkins & Murphy’s model were developed for the nursing profession.

A list of other models of reflective practice can be found here.

An Example Of Gibbs Reflective Cycle

Now that we have established the stages of Gibbs’ Reflective Cycle, we’ll now walk through an example. Following is a self-reflection from a care worker.

Description – Stage One

I was working with two individuals with learning disabilities in a supported living environment. Each of the individuals was supposed to be receiving one-on-one support but due to staff absences, I was supporting them both. We all had an enjoyable day but when I came to administer one of the individual’s medication (1mg Risperidone) at 6PM, I realised that I’d forgotten to give him his morning dose earlier in the day.

I called the pharmacy for advice. They advised that I should continue with the evening medication as usual and to call NHS 111 if the individual experienced any side effects or changes in behaviour. I informed the client of what had happened and apologised as well as wrote up the appropriate medication administration error form, made a record on the MAR sheet and informed my manager.

My manager thanked me for letting her know and said not to worry about it too much as it can happen from time to time. She also recommended that I reflect upon the experience when I had time.

Feelings – Stage Two

When I first came onto shift I was feeling a little nervous about working on my own with two clients and a bit overwhelmed by all the information that I was being given during the handover. As I’d only worked with the clients a few times, when the previous shift worker left I felt my priority was to get to know them and make them feel at ease with me. It was during this time that I should have administered the medication but completely forgot.

When I realised my mistake in the evening I felt instant dread and was worried about my error causing harm to the individual as well as getting into trouble with my manager and organisation. I also felt guilty and disappointed in myself. After a few moments, I regained my composure and followed company protocols by calling for advice from a medical professional.

When the pharmacy told me that the missed medication shouldn’t affect the individual’s health very much, I felt relieved but still felt a little scared that my employer would be angry or disappointed. However, I did feel better about it once I had spoken to my manager.

Evaluation – Stage Three

The thing that did not go well in this experience was that I forgot to administer an individual’s medication. However, there were also positive elements such as knowing what to do when a medication error occurs and owning up to the mistake. I fulfilled my duty of care by seeking immediate support from a medical professional and my duty of candour by apologising to the individual and being transparent in my explanation of what had happened.

Analysis – Stage Four 

Although the missed medication was not a major issue on this occasion, I work with individuals that could have much more serious consequences if they miss a dose of their medication – for example, individuals that have epilepsy and heart conditions.

In addition, being overloaded with information about two different clients, it was perhaps inevitable that something would be forgotten.

Conclusions – Stage Five 

Through this experience, I have learned that I can keep a level head in unexpected situations and that I have a thorough understanding of my responsibilities as a care worker and the standards that I must meet as well as my employer’s policies and procedures.

However, I think that I need to have a system in place to remember medication administration because it is so important to my role – although other aspects of my job role are important, medication administration can quite literally be life-or-death.

Action Plan – Stage Six

Going forward, I want to ensure that I do not forget to administer medication to my clients. I will do this by ensuring that I check the medication schedules for all the individuals that I am responsible for as soon as I come on to shift and setting a reminder on my phone.

• Gibbs: Learning by Doing (1988)

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Critical Exploration and Analysis of an Incident that Occurred in Clinical Practice

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Introduction

Throughout this piece, I will use Gibbs’ (1988) reflective cycle to critically explore and analyse an incident that occurred within clinical practice that has had an impact on my learning and development. The use of Gibbs’ cycle will facilitate reflection by identifying feelings which could have influenced my practice, recognising strengths and weaknesses of my performance and exploring what impact this had within practice.

Reflection is an integral aspect of Nursing as it promotes ongoing professional development by exploring the impact of personal practice on quality of care delivery (Kiron et.al., 2017). The focus of this reflection will be how communication was adapted when caring for a patient with Dementia. This area of practice has been selected as the focus of this piece as Handley et.al. (2017) highlight that an ageing population and reduction in social care services have resulted in a higher prevalence of patients with Dementia being treated in hospital. It is essential that practitioners adapt their practice to facilitate effective communication as this is one of the fundamental principles of delivering high quality care - particularly for patients with diverse needs (Murphy and Maidens, 2016).

In concordance with the Nursing and Midwifery Council’s (NMC, 2015: The Code), all of the names of the people involved have been changed and the location of the placement has been omitted. The patients name has been changed to Margaret and my mentors name has also been changed to Helen.

Description

I received a handover at the beginning of my shift and was informed that a new patient was due to be admitted from the community following a fall with a suspected urinary tract infection (UTI). Upon arrival, Margaret appeared confused and was not orientated to space or time. She was verbally angry towards staff who were transferring her and was visibly distressed. We were informed in the handover that seven months ago, she had been diagnosed with Alzheimer’s Disease and that they believed the current presentation of signs and symptoms of Dementia were being worsened by a untreated UTI. To ensure all staff within the multi-disciplinary team (MDT) were aware of Margaret’s condition, the ‘Butterfly Scheme’ was implemented whereby a logo was situated at her bed station to identify that Margaret had Dementia. This is designed to highlight to other staff that Margaret may need care adapting due to her condition.

If you need assistance with writing your reflective practice, our professional Reflective Practice is here to help!

Effectively communicating with patients is a fundamental part of the Nurses role and Fakr-Movahedi et.al. (2016) highlight that when there are barriers to communication, it is essential that practitioners adapt and overcome this to ensure quality of care isn’t diminished. How myself and Helen adapted communication will be one of the main focus points of this piece as this was instrumental to delivering person-centred care.

Admittedly, I was somewhat apprehensive when witnessing how disorientated Margaret was when she was admitted onto the ward. I was aware that staffing on the ward that day had been reduced due to sickness so was concerned that she would not receive care in a timely or safe manner as she was visibly distressed upon admission and would require additional support to meet her individual needs.

However, I was reassured by Helen’s calm approach and felt confident that I could learn from her experience of nursing patients with Dementia before, as I was aware she had a specialist interest in this area. I was also determined to provide person-centred care for Margaret and was eager to learn different ways of adapting communication to facilitate care delivery and meet her specific needs.

A strength of this incident was that throughout Margaret’s stay in hospital, staff were made aware using the Butterfly Scheme on her name board that she was exhibiting signs of Dementia and that communication and care may need to be adapted. This improved awareness and communication between staff and it was visible to see that in most cases, Margaret’s care was adapted to suit her needs because of this transparency.

Another strength of this situation was that Helen had a lot of experience and skills already in adapting care for people with communication difficulties. This meant that I was learning Nursing skills that were consistent with evidence-based, best practice guidelines that would enhance care. I was grateful to have the opportunity to observe how Helen interacted with Margaret as I recognise that I learn effectively from a vicarious approach – particularly as Helen was a role model for me within practice.

However, I did notice that at times due to staffing, communication appeared rushed when on the ward round and this negatively impacted Margaret. Witnessing the distress this caused her emphasised the importance of adapting communication more so and also reminded me of the importance of using nonverbal communication to convey warmth and empathy. When Helen and I communicated with Margaret, we ensured that our nonverbal cues emulated Egan’s ‘SOLER’ principles which are designed to convey active listening and open-ness. We found that using non-verbal cues like maintaining eye contact and touch helped us convey warmth and care to Margaret which also seemed to soothe and reassure her.

I also noticed that Margaret became particularly distressed when she was asked questions with medical jargon. Despite alerting all staff on the ward round of Margaret’s condition, it was disappointing that not everyone adapted their practice to make Margaret feel more comfortable and settled as the use of medical terminology clearly exacerbated Margaret’s sense of unease.

Overall, communication was adapted to meet Margaret’s needs the majority of the time. The use of nonverbal cues when conveying information certainly enhanced the therapeutic relationship and reduced Margaret’s anxiety whilst staying on the ward. However, observing others communicating with her, typically on the ward round highlighted that the use of medical terminology was detrimental to her care delivery and that this approach caused considerable distress.

As a nationwide initiative, the Butterfly Scheme was implemented in accordance with the NHS Improvement guidelines for Dementia assessment and improvement framework (2017) and in this instance was recognised most of the time. Early recognition and transparency amongst staff aware of the Butterfly Scheme meant that Margaret was given more time to communicate by people who recognised her as experiencing Dementia. In these instances, her care dramatically improved and she was more involved in making decisions about her care and exhibited less anxiety and stress. However, as not all staff recognised this scheme and didn’t adapt their communication or practice to suit Margaret’s needs, this highlights the need for further training with staff and improved communication on the ward. Fetherstonhaugh, Tarzia and Nay (2013) emphasise that patients with dementia often report feeling excluded from making decisions about their care which contradicts the vision outlined in the NHS Constitution (Department of Health and Social Care, 2015) to provide safe and inclusive care to all patients.

Consistent with Bandura’s (1977) social learning theory, I identified early on that I learn most effectively through vicarious reinforcement so it was an incredibly useful experience to observe how Helen interacted with Margaret in practice. As I also identify similar personality traits to Helen, I believe this strengthened my learning as I noticed myself modelling my behaviour on her practice that I had witnessed. This is something I will ensure I remember for future placements as a student but it is also an aspect of teaching I will be aware of when mentoring staff in the future as my career progresses.

Using Egan’s (1975) ‘SOLER’ principles proved to be effective when conveying information to Margaret as it complimented a warm approach that was used by myself and Helen. Use of therapeutic touch put Margaret at ease and Stonehouse (2017) highlights that this can be a very useful approach to enhance trust and rapport in the therapeutic relationship – particularly for patients with dementia as there sensory perception can be altered.

Macdonald (2016) highlights that use of medical jargon can impede the therapeutic relationship which was observed in Margaret’s case. It is essential that patients are involved in making choices about their care to promote empowerment, dignity and respect (Truglio-Londrigan and Slyer, 2018). Farrington (2011) states that the use of medical terminology can intimidate a patient and prevent them from feeling included in care provision; diminishing empowerment and reducing the quality of their care. Whilst Helen and I ensured that our terminology was appropriate for Margaret’s needs, not every member of staff did which caused her considerable distress at times. Furthermore, as Margaret had dementia, it was essential that communication was adapted to suit her needs as Ellis and Astell (2017) emphasise that this will enhance quality of patient care and promote safety and transparency between staff and patients by ensuring that staff continue to act within her best interests.

Action Plan

To increase my understanding of Dementia, I will complete online training to learn more about the condition and what the best practice guidelines are when caring for someone with dementia. I think this will benefit my practice by allowing me to become more aware of how to deliver safe and effective, person-centred care for an individual with complex needs. To ensure this can be achieved by my next placement, I will complete the online training within the next four week and submit the completed certification as proof of Continuing Professional Development.

To further enhance my Nursing skills when caring for patients with Dementia, I will shadow a Specialist Alzheimer’s Disease Nurse to learn more about the condition and how best to adapt care to the individual needs of a patient. I intend to complete this within three weeks of my next placement as this will also contribute to my Continuous Assessment of Practice (CAP) document and help me achieve one of the Specialist Nurse professional learning logs.

Using Gibbs’ (1988) reflective cycle, I have explored my experience of adapting communication for a patient admitted onto the ward with Dementia. It has been essential to evaluate this incident as effective communication is a core principle of the Nurses role. Furthermore, adapting communication to suit the patients’ needs is an integral part of compassionate, person-centred care and can enhance the individuals’ experience of receiving care.

Due to an ageing population, nurses are caring for more people with Dementia on busy hospital wards. This piece has shown how essential it is that the approach to care is adapted to the individuals’ need to reduce distress and enhance their quality of care. Implementation of the butterfly scheme was helpful to a degree in this particular scenario but I also recognise that not all staff adapted their practice because of this. This piece has demonstrated the complexity of delivering care for a person with a communication difficulty and highlights that provision of care is largely influenced by personal attitudes and beliefs towards care delivery.

This piece has illustrated the importance of not using medical jargon when communicating with patients, particularly those with Dementia as this could exacerbate confusion and cause distress. It also highlighted how essential non-verbal communication cues were when conveying information but also when reassuring the patient.

Overall, I feel as though my initial reluctance and apprehension of taking responsibility for Margaret’s care provision soon diminished with the support of Helen. I recognise from this experience that I learn most effectively through vicarious learning and will be sure to replicate this in future placements and later in my career when I become a mentor to other staff.  Reflecting on this experience has been incredibly valuable to my learning as I have recognised areas of work that require development as well as elements of practice I feel more confident in. I believe that this incident demonstrates that I can practise safely and effectively, whilst ensuring that the patient remains at the heart of care delivery and that their care is enhanced through adapting practice to suit their needs.

Reference List

Bandura, A. (1977). Social Learning Theory. New York: General Learning Press.

Department of Health and Social Care (2015). The NHS Constitution. [Date accessed: October 2019] Available at: https://www.gov.uk/government/publications/the-nhs-constitution-for-england/the-nhs-constitution-for-england

Egan, G. (1975). The skilled helper: a systematic approach to effective helping. California: Brooks/Cole.

Ellis, M. & Astell, A. (2017). Communicating with people living with dementia who are nonverbal: the creation of adaptive interaction. PLOS One. 12(8): 35-39.

Fakr-Movahedi, A., Rahnavard, Z., Salsali, M. & Negarandeh, R. (2016). Exploring nurse’s communicative role in nurse-patient relations: a qualitative study. Journal of Caring Sciences. 5(4): 267-276.

Farrington, C. (2011). Reconciling managers, doctors and patients: the role of clear communication. Journal of the Royal Society of Medicine. 104(6): 231-236.

Fetherstonhaugh, D., Tarzia, L. & Nay, R. (2013). Being central to decision making means I am still here: the essence of decision making for people with dementia. Journal of Aging Studies. 27(2): 143-150.

Gibbs, G. (1988). Learning by doing: a guide to teaching and learning methods. Oxford: Further Education Unit.

Handley, M., Bunn, F. & Goodman, C. (2017). Dementia friendly interventions to improve the care of people living with dementia admitted into hospital: a realist review. BMJ Open. 7(7): 15-25.

Kiron, K., Lamb, C., Gundogan, B., Whitehurst, K. & Jafree, D. (2017). Reflective practice in healthcare and how to reflect effectively. International Journal of Surgery: Oncology. 2(6): 20-21.

Macdonald, L.M. (2016). Expertise in everyday Nurse-Patient conversations: the importance of small talk. Global Qualitative Nursing Research. 10(11): 32-36.

Murphy, J & Maidens, G. (2016). Improving communication in dementia care. Nursing Times. 112(29): 18-21.

NHS Improvement (2017). Dementia assessment and improvement framework. [Date accessed: October 2019] Available at: https://improvement.nhs.uk/documents/1857/Improving_dementia_care_FINAL_v5_111017.pdf

Nursing and Midwifery Council (NMC, 2015). The Code. [Date accessed: October 2019] Available at: https://www.nmc.org.uk/standards/code/read-the-code-online/

Stonehouse, D. (2017). The use of touch in developing a therapeutic relationship. British Journal of Healthcare Assistants. 11(1): 11-15.

Truglio-Londrigan, M. & Slyer, J.T. (2018). Shared decision making for nursing practice: an integrative review. Open Nursing Journal. 12(1): 1-14.

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Gibbs’ Reflective Cycle

What is the gibbs' reflective cycle.

The Gibbs’ Reflective Cycle is a Tool that helps professionals Grow and Learn from their past Experiences .

To do this, it proposes to analyze the Situations in which someone wants to Improve.

• Drawing Conclusions that allow us to do things better in the future.

It consists of  6 Repetitive Steps (a cycle):

• Description .
• Evaluation .
• Conclusion .
• Action Plan .

This cycle must be repeated until Obtaining the Desired Results .

The Six Steps of Gibbs' Reflective Cycle

1. Description : Describe in detail the Situation in which you want to improve .

• A Negotiation, A Decision you made, a Discussion with your employees, etc.

2. Feelings : Reflect on How you Felt in that Situation, How you Coped with it.

• Did you feel Insecure? Did you feel Determined? Did you Hesitate?

3. Evaluation : Evaluate the Experience and its Outcome , Objectively.

• What Consequences did it have, What worked, What did not, etc.

4. Analysis : Analyze the Reasons that explain the Result of this Situation.

• Why something worked or didn’t work. Why you Made that Decision, etc.

5. Conclusion : Get the Lessons from this Analysis; How to do things better.

• What could have been done better? What could be done in a different way?

6. Action Plan : Develop and Implement a Plan to do things better.

• Applying the Conclusions obtained in this Cycle.

Repeat the Cycle until Reaching the Desired Results .

Gibbs’ Reflective Cycle Template

Now, before sharing some examples , we want to explain one important thing:

• How to use this Cycle .

We know that it can get a bit Confusing (Feelings, Action Plan, etc).

That is why we’ll offer you a Guideline that you can Follow .

• It can be used for your Personal Analysis or, in Coaching Situations.

How to use the Gibbs Reflective Cycle

Description : Details are important, as is the Context of any Situation.

• The Place and People Involved.
• What Interactions happened.

Feelings : They Can give us a Clue as to what we need to Improve .

• If we feel Insecure, it is usually because we do not know the Subject well enough.
• What made you feel Uncomfortable?
• What made you feel Determined?

Evaluation : Here, you should not try to find Reasons , only Facts .

• What worked, What didn’t work, and under What Circumstances.
• The Outcome: What happened After the Situation?

Analysis : Now it is the time to find the Whys .

• Why is the Reason something Worked? The Root Cause.
• Potential Root causes causing you a Problem.

Conclusions : Time to “Connect the Dots” and obtain Solid Conclusions .

• What Solid Conclusions have you Obtained?
• What Could have been done better?

Action Plan : Now, you have to put things into Practice .

• Set Specific, Measurable, Realistic and Time-Related Goals.
• Use Objective Metrics.

Let’s see some examples:

Gibbs Reflective Cycle examples

Now, let’s Imagine that you have recently been Promoted to Manager .

You are very happy about it, but you do not feel very Comfortable when you face your employees .

• Sometimes you have to impose yourself, so that what you say is done.

Also, it is something you would like to Improve on .

That is Why you decided to use Gibbs’ Reflective Cycle .

Let’s see How you use it:

Description - Gibbs Reflective Cycle example

The Situation in which you want to Improve :

• It is You and your Employees (no matter Who).
• You are In front of them alone or in a collective meeting.
• You Want things to be done in a New way.
• You Tell them how they have to do things from now on .

Feelings - Gibbs Reflective Cycle example

After thinking Carefully about it, you Discover that you Felt :

• Anxious about Compelling People to do Something.
• Insecure about you Authority.
• Determined about the Need of doing the Things in a New Way.

Evaluation - Gibbs Reflective Cycle example

You then Evaluate what happens in these Situations :

• You Compel your employees to do what you say.
• They obey you.
• Those who know you best Respond much better to your Commands .
• Those who don’t know you are more Reluctant to change .

Analysis - Gibbs Reflective Cycle example

Now, you start thinking about the Whys :

• This makes you Feel Insecure.
• They don’t make you Feel Anxious or Insecure .
• That and , the fact that you are New in the Position .

Conclusion - Gibbs Reflective Cycle example

You Obtain important Conclusions from this Analysis :

• Or People that don’t know your Skills when making decisions.

This People are Reluctant to “obey” you, and make you Feel Insecure and Anxious.

• So they will Trust you more.
• And they will Trust your Authority more.

Action Plan - Gibbs Reflective Cycle example

Finally, you decide to Develop an Action Plan :

• Starting with those who know you least.
• Comparing the Previous Results with the Current ones.

You Estimate that you will need 2 months to have met with all your employees.

• And decide if you need to repeat this Cycle again.

The Gibbs’ Reflective Cycle is a Tool that helps professionals Grow and Learn from their past Experiences.

Consists of 6 Repetitive Steps that must be repeated until getting the desired Results:

• Description : Describe in detail the Situation in which you want to improve.
• Feelings : Reflect on How you Felt in that Situation, How you Coped with it.
• Evaluation : Evaluate the Experience and its Outcome, Objectively.
• Analysis : Analyze the Reasons that explain the Result of this Situation.
• Conclusion : Get the Lessons from this Analysis; How to do things better.
• Action Plan : Develop and Implement a Plan to do things better.
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What? So What? Now What? Critical Reflection Model

Saul McLeod, PhD

Editor-in-Chief for Simply Psychology

BSc (Hons) Psychology, MRes, PhD, University of Manchester

Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.

Learn about our Editorial Process

Olivia Guy-Evans, MSc

Associate Editor for Simply Psychology

BSc (Hons) Psychology, MSc Psychology of Education

Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.

The “What? So What? Now What?” model offers a practical framework for incorporating reflection into various aspects of our lives, leading to continuous learning, growth, and improved decision-making.

The “What? So What? Now What?” reflective model, originating from Terry Borton and further developed by Rolfe et al. for healthcare practice, emphasizes a cyclical progression of understanding and action.

The stages are interconnected, with each one building upon the insights gained from the previous stage.

• “What?” establishes the foundation by focusing on objective description. It prompts the individual to gather the facts and details of the experience without immediate interpretation or judgment.
• “So What?” transitions from observation to analysis. It encourages the individual to make sense of the “What?” by exploring their emotional responses, connecting the experience to prior knowledge, identifying patterns, and uncovering potential implications. This stage helps individuals move beyond merely recounting events to understanding their significance.
• “Now What?” propels reflection into action. Drawing upon the insights from the “What?” and “So What?” stages, this stage focuses on developing concrete steps for improvement, future application of learning, and personal or professional growth. It transforms reflection from a passive process of thinking to an active process of planning and doing.

The connection between these stages is crucial as it allows for a deeper level of understanding and more effective action.

By regularly reflecting on our experiences, we can identify areas for improvement and make more informed decisions in the future.

Who are the authors of the Reflective Model?

Originally developed by Terry Borton for teachers and educational settings, it gained popularity as a reflective tool in clinical healthcare settings in the 1980s. Its enduring appeal lies in its simplicity and efficacy.

Rolfe et al.’s reflective model, based on Borton’s “What? So What? Now What?” model, is a framework tailored for healthcare practitioners, particularly in nursing.

While sharing the same three-stage structure, Rolfe et al.’s adaptation emphasizes clinical practice, focusing on developing clinical judgment, communication skills, and patient-centered care.

This model is often integrated into nursing education to help students connect theory and practice.

Stage 1. What? – Describing the Experience

The “What?” stage focuses on objectively describing the experience or event. This involves detailing the facts without interpretation or judgment.

The “What” stage establishes a clear, factual account of the experience, laying the foundation for deeper analysis in the subsequent stages.

It encourages individuals or groups to slow down, step back, and articulate the concrete details of what transpired, without immediately jumping to interpretations, judgments, or emotional responses.

It’s crucial to be as comprehensive and objective as possible during this stage to ensure a solid basis for reflection.

Here’s a breakdown of the key aspects of the “What?” stage:

• Focus on Facts: The emphasis is on providing a neutral and impartial account of the event, sticking to observable and verifiable information.
• Sensory recall : Participants are encouraged to replay the event in their mind as if watching it on a movie screen, focusing on what they saw, heard, or felt.
• Objectivity Over Subjectivity: While personal experiences are acknowledged, the goal is to describe them in a way that minimizes personal biases and interpretations.
• Inclusivity : If reflecting as a group, it’s important to hear from different perspectives, as people may have noticed different things
• Setting the Stage for Deeper Analysis: The “What?” stage provides the necessary context and factual basis for the subsequent “So What?” and “Now What?” stages, which explore the meaning and implications of the experience.

Examples of questions that can guide the “What?” stage, prompting individuals to consider specific details, actions, and observations related to the experience:

• What happened? – This encourages a concise and chronological account of the events.
• What did you observe? – This prompts focus on sensory details and specific observations.
• What was your experience? – This invites reflection on personal involvement in the event.
• What worked well, and what didn’t? – This prompts an initial, surface-level assessment of successes and challenges.
• Who else was involved? – This encourages consideration of the social context and the roles of others.
• What did you do? – This focuses on specific actions taken during the experience.

By thoroughly addressing these “What?” questions and establishing a clear, factual understanding of the experience, individuals and groups can lay a strong foundation for meaningful analysis and the identification of valuable insights in the later stages of the reflection model.

Example of a “What?” Stage Reflection

Let’s imagine a scenario where a first-year nursing student is reflecting on their first experience assisting a registered nurse in providing wound care to a patient. Here’s how the student might approach the “What?” stage of reflection, focusing on objective description:

• What happened? I assisted a registered nurse in providing wound care to an elderly patient with a diabetic ulcer on their foot. We gathered the necessary supplies, including sterile gloves, saline solution, gauze, and bandages. The nurse explained each step of the procedure to me and allowed me to observe before I helped. I assisted in holding the patient’s leg steady while the nurse cleaned the wound and applied a new dressing.
• What did you observe? The wound was about two inches in diameter and had a yellowish discharge. The patient appeared to be in some discomfort, grimacing slightly when the wound was being cleaned. The nurse was very gentle and patient with the patient, explaining each step clearly and providing reassurance.
• What was your experience? I was initially nervous about participating in wound care, as I had never done anything like it before. However, the nurse made me feel more at ease by explaining the procedure thoroughly and allowing me to observe first. I was surprised by how much care and attention to detail was required.
• What worked well? The nurse’s calm and reassuring demeanor helped to put the patient at ease. I felt that my assistance in holding the patient’s leg steady was helpful in allowing the nurse to focus on the wound care.
• What didn’t work well? I felt a bit awkward and unsure of myself at times, as I was still unfamiliar with the procedure and the supplies. I think I could have benefited from reviewing the steps involved in wound care beforehand.
• Who else was involved? The registered nurse, the patient, and myself were directly involved in the wound care procedure.
• What did you do? I helped gather supplies, observed the nurse, held the patient’s leg steady, and assisted in disposing of the used materials.

This detailed, objective account of the experience provides the foundation for the student to move on to the “So What?” stage, where they can begin to analyze their feelings, reactions, and the significance of the experience.

Stage 2. So What? – Analyzing and Sense-Making

The “So What?” stage delves into analysis and sense-making. This stage encourages you to examine your feelings, thoughts, and interpretations of the experience.

The goal is to uncover insights and identify what difference the event made. This stage is where analysis, critical thinking, and sense-making take center stage.

Here’s a breakdown of what the “So What?” stage entails:

• Connecting the Dots: It involves identifying patterns, relationships, and potential causes and effects related to the experience described in the “What?” stage. Relate the experience to relevant theories, course concepts, or broader ideas
• Exploring Emotions and Reactions: It encourages individuals to examine their feelings, thoughts, and initial interpretations of the experience. Why did they react in a certain way? What assumptions or prior experiences might have influenced their perceptions?
• Evaluating impact : Assess the consequences of the event for yourself and others.
• Identifying Learning Points: The goal is to uncover insights, lessons learned, and areas for potential growth based on the experience.
• Generating Hypotheses: It can involve developing initial explanations or interpretations of why things happened the way they did, which can later be explored further.

Some guiding questions for this stage include:

• What was important about this situation?
• How did you feel when it happened?
• Did anything in particular trigger these emotions in you?
• What might have been behind your response?
• Did you learn a new skill or clarify an interest?
• Are there any implications for you personally or professionally?
• Who might you have forgotten to consider in that encounter?
• What might impact the recipient’s views or experience of the project?
• What caused this event?
• Why might have other people acted the way they did?
• Was this event part of a broader pattern?
• How does this experience connect to course concepts?
• What other insights or hypotheses could be drawn from the experience?
• What is the importance of this?
• So what more do I need to know about this?
• What are some of the most pressing needs/issues in the community? How does this project address those needs?
• What contributes to the success of projects like this? What hinders success?

By thoughtfully engaging with these “So What?” questions, individuals and groups can extract valuable lessons from their experiences, gain self-awareness, and prepare for more informed and effective actions in the “Now What?” stage.

Asking “So What?” questions can also challenge your existing mental models and promote Double Loop Learning.

The “So What?” stage is crucial for moving beyond simple description to critical analysis. It helps you extract meaning from the experience and understand its broader significance.

This deeper understanding then forms the basis for the final “Now What?” stage, where you consider future actions and applications of your insights.

Example of a “So What?” Stage Reflection

Building on the “What?” stage example of a first-year nursing student assisting with wound care, let’s explore how they might approach the “So What?” stage:

• How did you feel when it happened? I initially felt nervous and inadequate because I lacked experience. However, observing the nurse’s expertise and seeing the impact of our actions on the patient’s well-being instilled a sense of purpose and motivated me to learn more.
• What might have been behind your response? My nervousness likely stemmed from a lack of confidence and fear of making a mistake that could negatively impact the patient. Witnessing the nurse’s composure and expertise reassured me and highlighted the importance of experience in building confidence.
• Did you learn a new skill or clarify an interest? I gained practical experience in wound care, which I had only read about in textbooks. This experience also reinforced my interest in pursuing a career where I can make a tangible difference in patients’ lives.
• Who might you have forgotten to consider in that encounter? I was primarily focused on assisting the nurse and the patient. However, reflecting on the experience, I realize that I could have also considered the patient’s family members or caregivers, who might also be affected by the patient’s condition and the care being provided.
• Was this event part of a broader pattern? This experience highlighted the importance of hands-on experience in nursing education. It also illustrated the value of clear communication and a supportive learning environment in developing clinical skills and confidence.
• What is the importance of this? This experience demonstrated that nursing practice requires not only technical skills but also empathy, communication, and the ability to establish trust with patients. It also highlighted the importance of lifelong learning and continuous professional development in providing competent and compassionate care.

This analysis demonstrates how the “So What?” stage encourages the nursing student to examine their emotional responses, identify knowledge gaps, and relate their experience to broader themes in nursing practice.

This sets the stage for the “Now What?” stage, where they can develop action steps for improvement and future learning.

Stage 3. Now What? – Determining Next Steps

“Now What?” focuses on applying your analysis to determine effective next steps. This involves identifying what you can take away from the experience and how you can use those insights in the future.

It focuses on translating insights and learning from the “What?” and “So What?” stages into concrete plans and actions.

This stage also promotes continuous learning and growth by encouraging individuals to:

• Applying Lessons Learned: It encourages individuals to consider how they can use their newfound understanding to make changes in their thinking, behavior, or approach to similar situations. Consider how to share insights or lessons learned with others.
• Identify Knowledge gaps : Recognize areas where further learning or skill development is needed.
• Developing Actionable Strategies: The goal is to create specific, measurable, achievable, relevant, and time-bound (SMART) goals and plans to address the identified learning needs or areas for improvement.
• Experimentation and Testing: It might involve designing small experiments or tests to try out new approaches or validate hypotheses that emerged during the reflection process.
• Continual Improvement: The “Now What?” stage emphasizes that reflection and learning are ongoing processes, and it encourages a cycle of planning, action, observation, and further reflection.
• What would you do differently if a similar situation arose?
• What follow-up is needed to address any challenges or difficulties?
• How might you prevent negative outcomes or problems in a similar situation?
• What do you need to gain more competence [in], and how will you make this happen?
• What specific steps you need to take to address this identified deficiency?
• What lessons can you take forward in similar and other contexts?
• How might you better prepare and resource yourself for a similar situation?
• What information can you share with your peers or community volunteers?
• If you were in charge of the project, what would you do to improve it?
• How will it affect your future as a pharmacist/midwife, etc.?
• This process requires reflection on practice, assessing and identifying learning needs and available opportunities, developing and implementing a personal learning plan, and evaluating the outcomes.

By thoroughly exploring these “Now What?” questions and formulating actionable steps, individuals and groups can transform reflection into meaningful change and continuous growth.

They can then apply these insights to similar experiences in the future, ultimately leading to improved decision-making, skill development, and personal and professional effectiveness.

Example of a “Now What?” Stage Reflection

Scenario: A nursing student encounters resistance from a patient while attempting to administer medication. The patient, anxious and in pain, refuses the medication, stating it doesn’t work. The student, feeling flustered, seeks assistance from a senior nurse who skillfully calms the patient and successfully administers the medication.

• Identify Knowledge and Skill Gaps: The student acknowledges that their initial approach lacked the empathy and communication skills needed to effectively de-escalate the situation. They recognize the senior nurse’s expertise in building rapport, active listening, and clear explanation, leading to a positive outcome.
• Seeking further training: Enrolling in workshops or courses on therapeutic communication or conflict resolution techniques.
• Shadowing experienced nurses: Observing how they interact with resistant or anxious patients, paying close attention to their verbal and non-verbal communication strategies.
• Role-playing scenarios: Practicing communication techniques with peers or instructors in a safe environment, seeking feedback to refine their approach.
• Reviewing relevant literature: Consulting nursing textbooks or journals for evidence-based strategies for managing challenging patient interactions.
• Anticipating potential challenges: Proactively considering potential barriers to care, particularly with patients exhibiting anxiety or pain.
• Employing active listening: Focusing on understanding the patient’s perspective, validating their concerns, and addressing their fears before proceeding with medication administration.
• Explaining procedures clearly: Using clear, concise language to explain the medication’s purpose, potential side effects, and expected benefits.
• Seeking support when needed: Recognizing that it’s okay to ask for assistance from colleagues, particularly in challenging situations.

By working through the “Now What?” stage, the nursing student transitions from simply reflecting on the experience to actively shaping their future practice.

This stage highlights the importance of continuous learning, self-improvement, and a commitment to providing compassionate, patient-centered care.

Comparing Rolfe et al.’s Reflective Model and Gibbs’ Reflective Cycle

While both Rolfe et al.’s model, adapted from Borton’s “What? So What? Now What?” framework, and Gibbs’ Reflective Cycle are popular reflective models, they differ in their structure and emphasis.

Understanding these differences can help you choose the most appropriate model for your reflective needs.

Structural Differences:

• Linear vs. Cyclical: Gibbs’ Reflective Cycle follows a more structured, cyclical format, guiding the reflector through six distinct stages: Description, Feelings, Evaluation, Analysis, Conclusion, and Action Plan. This cyclical structure emphasizes the iterative nature of reflection, encouraging repeated cycles of reflection and action. In contrast, Rolfe et al.’s model, while inherently encouraging ongoing reflection, presents a more linear, three-stage process.
• Number of Stages: The six stages of Gibbs’ Cycle allow for a more comprehensive and in-depth exploration of the experience. Each stage prompts the reflector to consider different facets of the situation, fostering a holistic understanding. Rolfe et al.’s three-stage model, while concise, might not provide the same level of detailed guidance.

Emphasis and Focus:

• Emotional Exploration: Gibbs’ Cycle explicitly includes a stage dedicated to exploring “Feelings.” This encourages individuals to acknowledge and process their emotions related to the experience, which can be crucial for personal growth and self-awareness, particularly in emotionally charged professions like healthcare. Rolfe et al.’s model, while not explicitly excluding emotions, places less direct emphasis on their exploration.
• Evaluation and Learning: Gibbs’ Cycle incorporates dedicated stages for “Evaluation” and “Conclusion,” promoting critical analysis of the experience’s successes, challenges, and potential areas for improvement. This structured approach can lead to more concrete learning points and action plans. While Rolfe et al.’s model encourages analysis and action planning, it doesn’t delineate these steps as distinct stages.

Application in Nursing and Healthcare:

• Rolfe et al.’s Model in Nursing Education: Rolfe et al.’s model is frequently integrated into nursing curricula. Its emphasis on connecting theory and practice, developing clinical judgment, and fostering patient-centered care aligns well with the goals of nursing education.
• Gibbs’ Cycle in Healthcare Practice: Gibbs’ Reflective Cycle, with its focus on detailed description, emotional processing, and structured analysis, can be particularly beneficial for healthcare practitioners reflecting on complex or challenging clinical encounters.

Choosing the Right Model:

The choice between these models depends on the specific context and the reflector’s goals.

• Reflecting on complex experiences.
• Individuals seeking a deeper understanding of their emotional responses.
• Situations requiring detailed analysis and evaluation.
• Quick reflections on everyday experiences.
• Individuals seeking a straightforward framework to guide their learning.
• Promoting rapid integration of theory and practice, as often seen in nursing education.

Ultimately, the most effective reflective model is the one that best suits the individual’s learning style and the specific demands of the situation.

Borton, T. (1970). Reach touch and teach: Student concerns and process education. New York, NY: McGraw-Hill.

Gibbs, G. (1988). Learning by doing: A guide to teaching and learning methods.  Further Education Unit .

Rolfe, G. (2014). Big ideas: Reach touch and teach: Terry Borton. Nurse Education Today, 34 (488-489).

Rolfe, G., Freshwater, D., & Jasper, M. (2001). Critical Reflection for Nursing and the Helping Professions: A user’s guide . London: Palgrave Macmillan.

Rolfe, G., & Jasper, M. (1993). Some strategies for curriculum development in nurse education.  Journal of further and higher education ,  17 (3), 105-111.

Gibbs Reflective Cycle - 6 Stage Model Comprehensive Guide

Reflective practice involves engaging in a thoughtful examination of your actions, feelings, and responses to experiences. This process enhances self-awareness and promotes continuous personal and professional growth. Reflective practice encourages critical thinking, improving decision-making and problem-solving abilities. Here’s a comprehensive guide to the Gibbs reflective cycle and how you can use it for personal and professional reflection and development.

What is the Gibbs Reflective Cycle?

Professor Graham Gibbs introduced this model in his 1988 book, ‘Learning by Doing: A Guide to Teaching and Learning Methods.' The Gibbs Reflective Cycle provides a systematic method for reflecting on experiences and drawing valuable lessons. It comprises six stages: Description, Feelings, Evaluation, Analysis, Conclusion, and Action Plan, giving individuals a structured approach to reflect, analyze, and learn from their past experiences. Each stage aims to delve deeply into different aspects of an experience, from the initial description to devising actionable strategies based on the reflection.

The Six Stages of Gibbs’ Reflective Cycle

The Gibbs Reflective Cycle provides a step-by-step, structured approach to reflective practice, ensuring valuable lessons are drawn from past experiences. Reflecting through the six stages—Description, Feelings, Evaluation, Analysis, Conclusion, and Action Plan—facilitates personal and professional growth.

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1. Description: The First Step in Reflection

The description stage is crucial as it sets the foundation for the entire reflective process. Here, the focus is on objectively recounting the experience without any judgments or analysis. Key questions to ask include:

What happened?

When and where did it happen?

Who was involved?

What was the outcome?

This step ensures a clear, unbiased account of the event, making it easier to delve deeper into the following stages.

2. Feelings: Dive into Your Emotional Response

The feelings stage allows you to explore your emotional reactions to the experience. Consider both your initial and subsequent emotional responses, as well as those of others involved. Reflect on:

What were your thoughts during the event?

How did you feel before, during, and after the event?

How might others have felt?

Acknowledging these emotions provides a deeper understanding of your responses and helps maintain emotional awareness in similar future scenarios.

3. Evaluation: Objectively Assessing the Situation

During the evaluation stage, objectively analyze the positives and negatives of the experience. Useful questions include:

What went well during the experience?

What did not go well?

What was your role, and how did you contribute?

This stage encourages a balanced view, acknowledging both achievements and areas needing improvement.

4. Analysis: Delving Deeper into the Experience

The analysis stage involves understanding why things happened the way they did. It requires connecting theories or professional knowledge to the event. Key questions and activities include:

Why did the outcomes occur as they did?

What influenced the positive and negative aspects?

Refer to relevant academic literature or other resources to gain deeper insight.

This comprehensive analysis helps identify the underlying factors affecting the experience, fostering a deeper understanding.

5. Conclusion: Drawing Learnings from Your Experience

In the Conclusion stage, summarize the lessons learned from the experience. Reflect on:

What did you learn about yourself?

What skills or knowledge did you gain?

What could have been done differently?

This stage is about crystallizing the insights gleaned from the previous stages, preparing you for future situations.

6. Action Plan: Preparing for Future Application

The final stage is the action plan , where you outline specific steps and strategies for applying what you’ve learned to future scenarios. Consider the following:

What will you do differently next time?

How will you develop the skills you need?

What preventive strategies can you implement to avoid past mistakes?

You can use an action plan template to develop an action plan during this stage.

By methodically tracing through these six stages, the Gibbs Reflective Cycle ensures a thorough and productive reflective practice process, applicable across various industries such as healthcare, education, and business.

Application of Gibbs' Reflective Cycle in Real-World Scenarios

Gibbs Reflective Cycle offers a structured approach to reflection, which can be immensely beneficial across various professions. By evaluating past experiences, professionals can derive actionable insights and foster continuous improvement. Below, we explore the application of the Gibbs Reflective Cycle in healthcare, education, and business sectors to showcase its versatility and effectiveness.

Healthcare professionals deal with a myriad of challenging situations on a daily basis. Reflecting on these experiences using the Gibbs Reflective Cycle can enhance patient care and professional development. For instance, a nurse could use the cycle to reflect on a case where a patient’s condition deteriorated unexpectedly.

Teachers can also benefit from integrating the Gibbs Reflective Cycle into their practice. For example, reflecting on a challenging classroom experience can help improve teaching strategies.

HR professionals can usethe Gibbs Reflective Cycle to enhance their training and development programs. Consider an HR manager reflecting on a recently conducted leadership development workshop.

By applying this reflective process, HR professionals can continuously refine their training and development initiatives, ensuring they meet the evolving needs of employees and align with organizational goals.

Integrating visual tools like Creately can further enhance the application of the Gibbs Reflective Cycle. Using collaborative mind maps can make the reflection process more organized and effective.

Embracing Gibbs Cycle in Your Organization

Integrating reflective practices.

Integrating the Gibbs reflective cycle into your organization can enhance team development and organizational growth. By encouraging employees to use this cycle, you foster a culture of continuous improvement and learning. Start by providing training sessions that explain the six stages: Description, Feelings, Evaluation, Analysis, Conclusion, and Action Plan. Use tools like Creately’s visual workspace to create templates and diagrams that aid in understanding and implementing each stage. Regularly scheduled reflection meetings can also help reinforce the practice.

Benefits for Team Development

The Gibbs reflective cycle offers numerous benefits for team development. Firstly, it encourages a structured approach to critical thinking and problem-solving. Teams can systematically analyze their actions and decisions, leading to more informed and effective outcomes. Additionally, it promotes open communication and emotional intelligence as team members share their feelings and thoughts about various experiences.

Fostering Continuous Learning

Creating a culture of reflective practice with Gibbs reflective cycle helps in fostering continuous learning within your organization. This model not only improves personal and professional growth by systematically analyzing past events but also assists in identifying areas for improvement.

Teams that regularly reflect on their experiences are more likely to adapt and evolve, maintaining a competitive edge in their industry. The structured approach guarantees that valuable lessons are captured and utilized to enhance future performance.

Incorporating the Gibbs reflective cycle into your organization offers a structured and disciplined method for analyzing past experiences, planning future actions, and fostering a culture of continuous learning and improvement.

What is the Difference Between Kolb’s and Gibbs' Reflective Cycle?

Overview of kolb’s reflective cycle.

Kolb’s Reflective Cycle, conceptualized by David Kolb in 1984, emphasizes experiential learning and follows a four-stage model: Concrete Experience, Reflective Observation, Abstract Conceptualization, and Active Experimentation. The cycle advocates that learning through experience is a continuous process where immediate or concrete experiences provide the basis for observations and reflections. Through this reflection, individuals can conceptualize new ideas and apply them in future situations, thus perpetuating a cycle of learning and growth.

Comparing Kolb and Gibbs Reflective Cycle

While both Kolb’s and Gibbs' reflective cycles are rooted in reflective practice and aim to leverage experiences for learning, they differ in their approaches and applications:

Stage Differences: Kolb’s model comprises four stages, whereas Gibbs' model includes six detailed stages: Description, Feelings, Evaluation, Analysis, Conclusion, and Action Plan. Gibbs' structure provides a more granular approach to reflection.

Focus: Kolb emphasizes the experiential learning process, fostering continuous improvement based on hands-on experiences. In contrast, Gibbs offers a more structured reflection, ideal for critical analysis and deriving actionable insights.

Applicability: Kolb’s model is widely used in academic settings and training environments to promote hands-on learning. Gibbs' framework is versatile across sectors like healthcare, education, and corporate environments, providing a robust structure for in-depth reflection.

When to Use Each Model

Choosing between Kolb’s and Gibbs' reflective cycles depends on the context and objectives of the reflective practice:

If the goal is to integrate experiences with theoretical concepts and enhance hands-on skills, Kolb’s Reflective Cycle is preferable. It works well in educational and training settings where experiential learning is crucial.

For a more detailed, structured reflection that dissects emotional and cognitive responses, making it suitable for professional development and complex problem-solving scenarios, Gibbs' Reflective Cycle is the better choice.

Gibbs Reflective Cycle Pros and Cons

Advantages of gibbs reflective cycle.

The Gibbs Reflective Cycle offers numerous advantages that make it an invaluable tool for personal and professional growth:

Structured Framework: The clear, step-by-step process helps individuals systematically reflect on their experiences, ensuring no crucial aspect is overlooked.

Versatility: This model is adaptable across various fields, including healthcare, education, and business, making it a go-to framework for diverse professionals.

Emotional Resilience: By facilitating the exploration of both positive and negative emotions, the Gibbs Reflective Cycle enhances emotional intelligence and resilience.

Actionable Insights: It aids in deriving concrete action plans from reflections, leading to continual improvements in practices and behaviors.

Development of Critical Thinking: The focus on analysis and evaluation promotes critical thinking skills and encourages deeper insights.

Enhanced Communication: Reflective practice using this model can improve interpersonal communication by fostering empathy and better self-awareness.

Limitations and Challenges

Despite its advantages, the Gibbs Reflective Cycle is not without its limitations:

Time-Consuming: Conducting a thorough reflection process can be time-intensive, which may pose a challenge for busy professionals.

Requires Honest Self-Assessment: Effective reflection necessitates a high degree of honesty and self-awareness, which can be difficult to achieve without external feedback.

Limited External Input: The cycle primarily relies on self-assessment, potentially overlooking external perspectives that could provide additional insights.

Necessitates Self-Motivation: Individuals must remain self-motivated and disciplined to consistently engage in reflective practice.

Potential for Over-Analysis: There is a risk of over-analyzing situations, leading to unnecessary complexity and stress.

Tips to Use the Gibbs Reflective Cycle Effectively

To harness the full potential of the Gibbs Reflective Cycle while mitigating its challenges, consider these strategies:

Set Aside Dedicated Time: Allocate specific times for reflection to ensure it becomes a regular part of your routine rather than an afterthought.

Seek External Feedback: Complement your reflections with external input from mentors, peers, or supervisors to gain a well-rounded view of your experiences.

Utilize Digital Tools: Platforms like Creately offer visual tools that can help map out each stage of the Gibbs Reflective Cycle, making the process more organized and engaging.

Maintain a Reflection Journal: Document your reflections regularly, which can help track your progress and identify recurring patterns or areas for improvement.

Break Down the Cycle: Instead of attempting the entire cycle in one sitting, break it down into manageable parts to avoid overwhelming yourself.

By implementing these strategies, you can maximize the benefits of the Gibbs Reflective Cycle while navigating its inherent challenges, ultimately fostering a more reflective and growth-oriented mindset.

The Value of Reflective Practice

Reflective practice is an essential component of both personal and professional development. By systematically analyzing past experiences, individuals can derive valuable insights, make informed decisions, and foster continuous improvement. Adopting structured reflection models like the Gibbs Reflective Cycle enables a disciplined approach that enhances learning and growth.

The Gibbs Reflective Cycle plays a key role in transforming everyday experiences into opportunities for self-improvement. It encourages users to dissect their experiences through a structured six-stage process, leading to actionable insights and concrete plans for the future. Whether you are a student, educator, healthcare professional, or business strategist, implementing the Gibbs Reflective Cycle can significantly improve your reflective practice.

Adopting this cycle in an organizational setting can also promote a culture of continuous learning and development. Tools like Creately’s visual workspace can be particularly beneficial in this context. Creately offers templates to navigate each stage of the Gibbs Reflective Cycle comprehensively, from Description to Action Plan, making the reflection process more visual and organized.

Ultimately, embracing the principles of the Gibbs Reflective Cycle can lead to enriched personal growth, enhanced professional effectiveness, and a robust framework for lifelong learning. By cultivating reflective practices using structured models, individuals and organizations can unlock their full potential and achieve more informed and thoughtful outcomes in their respective fields.

Join over thousands of organizations that use Creately to brainstorm, plan, analyze, and execute their projects successfully.

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Hansani has a background in journalism and marketing communications. She loves reading and writing about tech innovations. She enjoys writing poetry, travelling and photography.

Reflective Essay

Learning tips, tricks and hints

Reflective Essay Examples – How You Can Use the Gibb’s Model For Your Writing

The reflective essay examples using the Gibbs model have been discussed in some of my other articles, but I thought it was time to review this model in its entirety. It seems that most of the good reflective essay examples using the Gibb’s model use the Gibb’s model as a backdrop, and in order to really come up with an effective reflective essay you have to get rid of the backdrop, and then apply the model to your essay.

The key is to create your own background. There is nothing more inspiring for many writers than to have an outline and a structure to work from. However, many writers do not have any background in the composition of essays, and therefore they can have trouble coming up with an outline or structure of their own. As I have said, this is where the Gibb’s model shines, because once you have established the background for your reflective essay, you can move on to using the model itself.

The Gibb’s model is simply a tool that allows you to use different elements to represent a specific concept or theme. For instance, for your reflective essay on friendship, you would have to find the metaphor that best represents what you are trying to convey. For instance, if you were trying to express the idea that friendship is a virtue, you might use a tree, and a tree is an icon of friendship. If you were trying to explain that friendship is a virtue that is needed in every relationship, you could use another tree and another icon of friendship. You simply can’t talk about these concepts without using the metaphor and the concept.

Of course, the idea is to use as many different metaphors, images, and symbols as possible, and to use them in different positions within the essay. This way, even when you are just introducing different concepts or themes, you can make it easier to remember and easier to relate to those concepts.

One great reflective essay example is that of Henry David Thoreau’s book, which he wrote while on a visit to Paris. Thoreau wrote about the life of his friend, and in one of his reflections on nature, he makes the observation, “The most important thing in nature is the fact that we know the most about it.”

He goes on to state, “We must not forget that it is this truth which gives life its value; not its quantity. This truth is so self-evident that the less we know about it, the less we value it, and the less importance we give it.”

Now, I can easily relate to this simple statement. Although, in writing a reflection on friendship, it is easy to say that there is nothing more important than being a friend, I also realize that there are many other factors to consider, and I would not be able to stand up and write about friendship in the same way as Henry David Thoreau if I did not believe that friendship was important to me.

This is why I love the reflective essay model. It allows me to introduce many different elements of reflective writing, but I feel confident in writing about each of these different elements without it taking over the rest of my essay. When I am done with my reflective essay, I can simply move onto using the metaphors, and images that I have found to be most effective in expressing my ideas.

Another great reflective essay example is by Margaret Wise Brown. In this particular example, she uses a series of images and symbols to describe the emotions of loneliness and isolation, in order to create a reflection on the things that one can do to get over these feelings.

The first of her quotes, “There is nothing to be done about the loneliness, except to try to find out what it is inside of you that is giving you these feelings. “, is something that I cannot relate to. at all. But then she goes on to say, “We are only alone because we refuse to see ourselves in the mirror,” and in that last quote, she uses a series of metaphors and images to express her feelings.

These are just a few examples of how you can incorporate a reflective essay into your overall composition. If you are having trouble finding a good one, there are some great resources for you to check out.

Gibbs’ Reflective Cycle in Healthcare Essay

• To find inspiration for your paper and overcome writer’s block
• As a source of information (ensure proper referencing)
• As a template for you assignment

Introduction

Description, action plan.

Healthcare givers utilize Gibbs’ reflective cycle to develop a learning structure from experience. It was created in 1988 by Graham Gibbs and has been very critical in the field of medicine (Ezezika & Johnston, 2022). Repeated experiences and encounters with the patients in the hospital enable nurses to be familiar with different conditions and learn how to handle them better. Cases of emergencies are given priority to save lives and facilitate the healing process. This essay examines Gibb’s reflective cycle, specifically on the triaging system, with an explanation of the role of nursing leadership and education based on a reflective situation.

Leadership and education roles are essential in nursing emergencies and disasters. In case of emergencies, healthcare givers who have been educated on the need to respond immediately save the lives of many individuals by acting immediately. This includes administering first aid procedures and administering medications that relieve pain. Effective communication skills enable nurses bear in mind the differences in culture and preferences and respect them ( James et al., 2022). Being sensitive to beliefs and establishing boundaries enables each person to take their duties as assigned. Leadership role entails being a personal driver and taking duties without supervision. Workers must motivate each other on the need to collaborate to achieve the set goals and objectives.

Additionally, nurses must be aware of conflict resolution and problem-solving strategies and their application. Dealing with people from different cultures is complex and requires strategic approaches. The idea of resource management also can be associated with leadership. Facilities used in the hospital must be taken care of as they support patients in many ways. Since they are expensive to purchase, the available ones should be maintained regularly. The policies and guidelines of the set healthcare system must be obeyed to eliminate disagreements with the managers. These combined skills make the health professional complete socially and physically. Patient privacy is kept by keeping their data reports confidential. Strong passwords are used, and access to stored data must only be limited to authorized individuals.

I will explain an incident that I experienced when attending to a patient in the hospital’s emergency unit. It was during my internship, and I had not acquired so much competency in the profession. He had chest pains and had difficulties in breathing. Upon examining his medical history, it was highlighted that he had a lung infection resulting from smoking. He could barely communicate appropriately due to verbal problems making the diagnosis difficult. The specific areas of reflection focus on how other nurses and I utilized practical communication skills to show compassion to the client. His wife, who had accompanied him, was so stressed, and all she could cry was crying because of fear. However, we calmed the patient and addressed his individual needs appropriately.

Since it was my first time to handle a patient with such conditions, I was mindful of the patient’s condition and how to handle it effectively. Therefore, I allowed one of my colleagues to take the prominent role since she was more experienced. This resulted in a vulnerable state which required the most care for healing. However, the other nurse could not take the case as an emergency, increasing my anxiety about whether to act. She kept on shouting at the wife, who was in the patient’s company, telling her to be quiet. Despite the condition, the nurse felt that she could be more concerned about the remedy to be administered than causing unnecessary tension. As a nurse, treating all individuals with care is essential since it is difficult to understand the damage resulting from rude responses.

A deep examination of the incident illustrates both bad and good experiences, which are critical in my role as a nurse. As a healthcare practitioner, many roles have been assigned to me and must be attended to effectively. Performing physical examinations, prescription and administering medication, giving support to patients, and recommending of laboratory tests are some of my duties. However, from the incident that happened, I feel that I did not take my responsibilities as required. I could have talked to my other nurse about the need to handle patients and their families with care. On the positive side, I was able to apply effective communication cues to handle the patient. Failure to work as a team in the hospital can lead to death, especially when handling patients with critical conditions. The other nurse was concerned with the wife who accompanied the husband instead of focusing on the needs. To console her, words of encouragement could be used instead of harsh treatment. I learned that understanding a patient’s medical history is critical before undertaking a step aimed at healing. This is because some conditions are associated with past events or hereditary conditions, making them require special attention.

The nursing codes of ethics require that every healthcare giver must be well-equipped with practical communication skills. They play a role in facilitating the diagnosis process by creating a conducive environment in the hospital. Nurses must maintain eye contact and avoid the use of non-verbal cues of communication which suggest some intentions (Hwang & Chang, 2022). They should further learn how to interact with other people who accompany the patients by addressing them with respect and bearing in mind their emotions. The patient’s needs should be given first priority and care by bearing in mind their likes and dislikes.

From the above experience, the importance of being competent and assertive in my profession has been mastered appropriately. The position in my team should not act as a barrier to taking my roles. In the encounter with the patient, I was afraid to respond to the patient since my experience was insufficient. Since communication is vital, all healthcare professionals must learn how to effectively take control of any situation that occurs in the hospital, whether formal or informal. Creating a conducive environment will lead to the offering of quality services.

In the future, I will confidently respond to any emergencies by eliminating anxiety, as it can lead to worsening the situation. The interests of the patients must be given priority and action. A strong working relationship must be created with fellow workers such that if mistakes occur, they can be corrected in a friendly manner. Compassion is a crucial trait and nurses should consider the patient’s situation and handle it with caution. I will ensure the other nurses learn to be mindful of events that trigger fear and offer guidance and counseling to the target team.

Ezezika, O., & Johnston, N. (2022). Develop and implement a reflective writing assignment for undergraduate students in a large public health biology course . Pedagogy in Health Promotion , 237337992110699. Web.

Hwang, G.-J., & Chang, C.-Y. (2022). A reflective cycle-based virtual reality approach to promoting students’ learning achievement, sense of presence, and higher-order thinking in professional training . Interactive Learning Environments . 1–16. Web.

James, A. Hn., Watkins, D., & Carrier, J. (2022). Perceptions and experiences of leadership in undergraduate nurse education: A narrative inquiry . Nurse Education Today , 111 , 105313. Web.

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IvyPanda . "Gibbs' Reflective Cycle in Healthcare." February 3, 2024. https://ivypanda.com/essays/gibbs-reflective-cycle-in-healthcare/.