Reflections on Reflective Practice among Pre-Hospital Emergency Care Practitioners in Ireland.

Abstract

Background

This paper examines the level of engagement of Irish pre-hospital emergency care practitioners with reflection and reflective practice.  It also explores the attitudes of practitioners to reflection and to methodologies designed to support reflective practice such as reflective discussion and video-assisted structured reflection.  Finally it outlines the main barriers to reflection, both individually and collaboratively, and reflective practice gaining widespread acceptance as key learning strategies among pre-hospital emergency care practitioners and educators in Ireland.

Methodologies

This paper is part of a larger project which consisted of three cycles of action research.  Data was collected via an online survey questionnaire, and by conducting a series of semi-structured interviews with various stakeholders.  These included all three clinical levels of pre-hospital emergency care practitioners and educators from emergency service providers, private ambulance services, and voluntary organisations.

Findings

Many practitioners consider themselves to be reflective practitioners.  However, very few of them use a structured model of reflection. Reflection, and reflective practice are not part of the education standards for practitioners in Ireland, and consequently receive very little attention in most education programmes. Practitioners within voluntary organisations perceived that reflective practice was encouraged by their organisation in greater numbers than those from other organisations. Collaborative forums were perceived to be beneficial, although concerns were raised about their potential for abuse and misuse.  These concerns appear to emanate from a lack of trust within certain organisations.

Recommendations

Reflective practice to be included in the education standards for all levels of practitioners in Ireland. Develop and roll-out an education programme for existing practitioners regarding reflection, reflective learning, reflective practice, and structured models of reflection, as part of their CPC requirements. Provide education for all EMS course faculty regarding reflection, reflective learning, reflective practice, and structured models of reflection. A learning contract for all participants and faculty, including a confidentiality agreement, must be in place prior to the establishment of any collaborative forums. Further research to explore the reasons for lack of trust within organisations should be undertaken. Further research is recommended to explore the reasons for the disparity of opinion between volunteer and professional organisations regarding the encouragement of reflective practice.