Johns, Christopher 　著

内容

目次

Preface xiii Acknowledgements xx 1 What is reflective practice? 1 Describing reflection 2 Reflection on experience 2 Mindfulness 3 Prerequisites of reflection 4 Reflexivity 5 Practical wisdom and praxis 5 Contradiction 5 Empowerment 8 Development of voice 9 Silence 9 Received voice 10 The subjective voice 10 The procedural voice 11 The constructed voice 11 Whole brain stuff 12 Knowing reflection 13 Bimadisiwin 14 Critical reflection 14 Transgression 15 Being in place 15 The significance of reflective practices for professional practice 16 Expertise 18 The six dialogical movements 19 The hermeneutic circle 19 Dialogue 20 Evaluating reflection 21 Journal entry 23 Conclusion 23 Notes 24 2 Writing self: the first dialogical movement 25 Mimesis 25 Creative writing 26 Bringing the mind home 27 Dividing the page 28 Commentary 30 Writing rather than telling 30 Tapping the tacit 31 Opening the reflective space through the humanities 32 The therapeutic benefit of writing 33 Notes 34 3 Engaging the reflective spiral: the second dialogical movement 35 Models of reflection 36 Guarding against a prescriptive legacy 36 The model for structured reflection (MSR) 37 What issues are significant to pay attention to? 42 How were others feeling and what made them feel that way? 42 How was I feeling and what made me feel that way? 43 What was I trying to achieve and did I respond effectively? 45 What are the broader consequences of my actions on the patient, others and myself? 46 What knowledge did or might have informed me? 47 To what extent did I act for the best and in tune with my values and beliefs? 47 How does this situation connect with previous experiences? 50 What assumptions govern my practice and what factors influence the way I feel, think and respond within the particular experience? 51 Warshield 53 Stress, anxiety, and coping with work 54 Feeling fluffy???feeling drained scale 54 Water butt theory of stress 56 The risk of burnout 57 The looking forward cues 57 Janet writes 57 How might I respond more effectively given this situation again? 59 What would be the consequences of alternative actions for the patient, others and myself? 60 What factors might stop me from responding differently? 60 How do I NOW feel about this experience? 60 Am I now more able to support myself and others better as a consequence? 61 Conclusion 61 Notes 61 4 Framing insights 62 Single lines 63 Framing insights 64 Carper???s fundamental ways of knowing 64 The framing perspectives 65 Developmental framing: the being available template 65 The being available template (BAT) 66 Conclusion 68 Note 68 5 The dance with Sophia: the third dialogical movement 69 The dance with Sophia 70 Dialogue as creative play 71 Mapping 71 Narratives of health illness 71 Michael???s wife 72 Michael???s wife 72 Passing people by 73 Waiting 74 Loneliness 74 Caring 75 Buddhist influence 75 Lifting 75 As if she might shatter 76 Sylvia 76 Sylvia 77 Lorna 79 Conclusion 79 6 Guiding reflection: the fourth dialogical movement 80 Dialogue 80 Why reflection needs to be guided 81 Co–creation of insights 81 The reality wall 82 Contracting 83 What issues need to be contracted? 83 Finding the path 84 The nature of guidance 84 Remoralisation 86 Pulling free 86 Conclusion 87 7 Weaving and performing narrative: the fifth and sixth dialogical movements 88 Fifth dialogical movement 88 Methodology 88 Narrative form 89 Creativity 90 Fiction 91 Coherence 91 Sixth dialogical movement 92 Change value of narrative 93 Conclusion 94 Note 94 8 The reflective curriculum 95 The community of inquiry 96 Collaboration 96 Peers 96 Potential benefits of a reflective curriculum 97 Potential constraints to the reflective curriculum 98 Theory???practice gap 98 Imagining the shape of a reflective curriculum 99 Guided reflection groups 101 Dialogue 102 The talking stick 102 Skilled guides 103 Storytelling 103 Art workshops 104 Performance 104 Jane???s rap 104 Imagine 105 The rub 105 Journal entry 1 106 Journal entry 2 107 Honour thy mother 107 Journal entry 3 110 Journal entry 4 111 Judging reflective writing 115 Programmes 115 Conclusion 116 Notes 116 9 Reflection on touch and the environment 117 Touch 117 Commentary 120 Environment (Jill) 121 Conclusion 124 10 The emotional cost of caring 125 Simon writes 125 Commentary 129 Note 130 11 Life begins at 40 131 Clare writes 131 Electrocardiographs (ECGs) 131 Insight 135 Reflection 136 12 Balancing the wind or a lot of hot air 138 Jim writes 138 Mary 139 The pain clinic referral 140 Mary???s family 140 Reflection 144 13 A reflective framework for clinical practice 146 The Burford NDU model: caring in practice 146 Vision 146 Valid vision 149 The nature of caring 149 Suffering 150 Nurturing growth 150 Knowing caring 150 The internal environment of practice 152 Social utility 152 From vision to reality 153 A structural view of a refl ective framework for clinical practice 154 A system to ensure the vision is realised within each clinical moment 154 Wavelength theory 156 The Burford NDU reflective cues 157 Tony 158 Who is this person? 159 What meaning does this health event have for the person? 160 How is this person feeling? 160 How has this event affected their usual life pattern and roles? 160 How do I feel about this person? 161 How can I help this person? 161 What is important for this person to make his stay in the hospice comfortable? 162 What support does this person have in life? 162 How does this person view the future? 162 Reflection on being available to Tony 163 A system to ensure effective communication 163 Narrative notes 164 Talk 164 Reflective handover 164 Bedside handover 165 Patient notes 166 Narrative 168 A reflective quality system to ensure effective practice 169 A system to ensure staff are enabled to realise the vision as a lived reality 169 Organisational culture 170 Conclusion 170 Notes 170 14 Reflective leadership 171 A little voice in a big arena 172 Reflection 175 Transformational leadership 178 Power 178 Journal entry ??? realising our power 179 Journal entry ??? self–deception 180 Refl ective leadership 181 The learning organisation 182 Vision 184 Vision, what vision? 184 Conclusion 184 Notes 185 15 Teetering on the edge of chaos 186 Lazell writes 187 Newtonian knowing: The machine in parts 187 Complexity learning and knowledge cycles 189 Choice 190 Maps, strange attractors and learning through leadership 192 Conclusions: Where chaos and leadership fuse 193 Commentary 195 Conclusion 196 Notes 196 16 Ensuring quality 197 Reflective approaches 198 Clinical audit 198 Project 199 Model for reflective inquiry (MRI) 199 Debriefing 200 Standards of care 201 Standards group 202 Nutrition 202 Sleep 204 Relatives 204 Confidentiality 206 The value of standards of care 207 Conclusion 209 Note 210 17 Clinical supervision 211 Sustaining practitioners 212 Bumping heads 213 Revealing woozles 213 Four variables of clinical supervision 213 Voluntary or mandatory 214 Group versus individual supervision 214 Single or multi–professional 215 Who should the supervisor be? 215 Peer supervision 217 Contracting 218 Emancipatory or technical supervision 219 John Heron 221 The nine–step model 222 Pragmatics of clinical supervision 223 Karen 224 Trudy 224 Session 1 225 Commentary 226 Session 2 226 Commentary 228 Session 3 228 Commentary 229 Session 4 229 Commentary 231 Session 5 231 Commentary 232 Session 6 232 Commentary 234 A quiet eddy 234 Notes 234 18 Tales of clinical supervision 235 Michelle 235 Commentary 237 Cathy and the GPs 238 Exploring perspectives 240 Hank???s complaint 248 Horizontal violence 251 Conclusion 252 Notes 252 19 Therapeutic journalling for patients 253 Moira Vass 253 My refl ection 253 Therapeutic benefit 257 Facilitating therapeutic writing 258 Conclusion 259 20 Nurse bully and the timid sheep: an adventure in storyboard 260 Conclusion 269 21 Reflective prose poetry 270 Notes 279 22 Through a glass darkly 280 Introduction 280 Performance design 280 Giving voice 280 Through a glass darkly preamble 281 Through a glass darkly 282 The first gate 283 The second gate 284 The third gate 285 The fourth gate 286 The fifth gate 287 The sixth gate 288 Notes 290 Appendix Clinical supervision evaluation tool 293 References 297 Index 311