Reflection in Public Health Practice
Topic outline
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What is reflection?
Reflection is a process we go through when we step back and critically think about experiences, decisions and actions and the wider system we work in. As healthcare workers, we are increasingly being encouraged to reflect on our practice more to learn from it and improve our future practice.
In public health it is more than just remembering what happened with individual patient care, public health reflections often deal with complex systems, communities and policies as well.
In this course, we will:
- Learn using case studies
- Use clear tools and frameworks for reflection
- Support you building a regular reflection habit
- Consider how you might apply your learning to ethical decisions and leadership
How to get the most from the course:
- Take notes as you go.
- Capture key points and questions.
- Add actions to your Personal Development Plan (PDP).
- Discuss and review your PDP with your mentor.
Certificate of Completion
Linked to demonstration of WHO Essential Public Health Competencies when completed as part of a Peoples Praxis learning pathway.
- Complete the end-of-course quiz.
- Score over 70%.
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Module 1: Introduction to Reflective Practice
The course starts with some background, and an introduction to reflective practice and later it describes the key elements of reflection.
There are two exercises in this module for you to practice your learning.
Estimated time to complete: ~30 minutes (self-paced).
What you’ll cover
- Introduction to reflection in public health—its relevance and importance.
- Different types of reflection.
- How reflection is embedded in the WHO Essential Public Health global competency frameworks.
My reflective journey – a personal example
Whilst visiting a Primary Healthcare Centre in North Nigeria, I was asked to teach an impromptu class to a group of hospital attendants about basic life support. These hospital helpers were often the first people who ushered in sick patients and had no previous medical background. They also had never received any formal teaching about similar topics though they were very keen.
I started my teaching session in a group with 15 ladies sitting around me and with an interpreter relayed the information they needed to know about basic life support. There were many blank faces and no questions at all.
I quickly realised I had not taught them this concept in a way that made it easy for them to retain the information or use it practically!
With the help of a senior colleague and mentor, we quickly changed our delivery method and made the session interactive and we even practiced by creating a local song to remember the steps by.
The end result was fantastic! They had a memorable interactive session, and I learned that I must take time to understand my audience and adapt my delivery methods to suit them wherever possible.
Teaching basic life support at a PHC — adapting my delivery after reflection.
Exercise 1 — Spot the reflection moments 📝
Using my example above:
- Note what happened initially (approach and outcome).
- Identify the trigger for reflection (what signalled a change was needed?).
- Describe what changed and why.
- Write one key learning you would carry forward.
Tip: Add your notes to your reflection log or Personal Development Plan (PDP).
Exercise 2 — A written note or a voice note
Choose one: write 5–8 sentences or record a 1–2 minute voice note.
- What is reflection to you? How do you practice it now?
- Why learn more? What’s your motivation?
- What might get in the way? Write 2–3 steps you’ll take to overcome these (your plan).
Tip: add your notes to your Personal Development Plan (PDP) and discuss them with your mentor.
Learning Pathways (Optional): Share your reflection with your mentor at your next meeting.
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Module 2: The basis of reflection
This module introduces the foundations of reflection in a changing world. It links pedagogy and andragogy to public-health practice, showing how adult, problem-centred learning strengthens reflective habits and aligns with WHO Essential Public Health competencies.
Estimated time to complete: ~15 minutes (self-paced)
What you’ll cover
- Why reflection matters in a changing world (healthcare, technology, society).
- Pedagogy vs andragogy — what they mean and why it matters for public health.
- How adult learning (andragogy) strengthens reflective, problem-centred practice.
- Applying the idea to practice (lecture → interactive, needs-based teaching).
- Where reflection fits within WHO Essential Public Health competency frameworks.
“The only constant in life is change” — Heraclitus
“No condition dey permanent” — Nigerian pidgin English proverb
Why this matters
- Things change—healthcare, technology, society and culture.
- We must keep our knowledge up to date, and review our practice in its changing context (professional, political, economic, social).
- Reflection supports lifelong learning and adapting to new situations.
How adults learn best
There are two commonly described methods of learning;
The old traditional methods of learning, often referred to as pedagogy, and the new more modern approaches known as andragogy.
Pedagogy reflects child-focused education, where learners depend on the teacher, follow a set curriculum, and are motivated by external rewards.
Whilst andragogy, by contrast, describes adult learning, where learners are self-directed, draw on their own experiences, and engage with problems that have immediate real-world relevance.
In public health, reflective practice works best with andragogy (adult learning) rather than purely pedagogy (child-focused teaching), as our reflections are most effective when they are self directed and engaging.
Aspect Pedagogy (Child Learning) Andragogy (Adult Learning) The learner Dependent on teacher Self-directed, responsible Learner experiences Limited; teacher’s knowledge Rich experiences used as a resource Readiness to learn Set by age/curriculum Driven by real tasks or problems Orientation Subject-centred Problem-centred; real-world focus Motivation External (grades, approval) Internal (growth, career, curiosity) In the earlier personal example from module 1: pedagogy = lecture; whilst andragogy = interactive, needs-based and memorable.
Learning Pathway Mentee — Optional exercise
Think of a time you experienced either pedagogy or andragogy. Share a short written or voice note with your mentor.
Additional learning
- Watch this short video on reflective practice
- Write a brief reflection When did you learn best through experience/problem-solving? What made it effective? How will you apply this to future public health challenges? Share with your mentee/mentor.
Learning Pathway - Mentor notes
Invite your mentee to share reflections and discuss how their understanding has evolved.
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Module 3: Frameworks for Reflection
In this module:
- You’ll meet four reflection models—Gibbs, Schön, Rolfe, and Triple-Loop Learning.
- Learn how to apply them to public-health scenarios.
- Learn how to choose the right one for your context.
Estimated time to complete: ~45 minutes
What you’ll cover
- What reflection is (and what makes it effective).
- Quick guides to Gibbs, Schön, Rolfe, and Triple-Loop Learning.
- How to pick a framework for your situation.
- Apply a model to a short public-health case.
What is reflection?
Reflection = thinking about experiences to gain new understanding and improve practice.
Critical reflection = going deeper—questioning assumptions, values, policies, and systems to learn and improve.Ineffective vs effective reflection (quick view)
Ineffective- Just describes what happened.
- Blames time/others; no ownership.
- No lessons or plan.
Effective- Describes and explains decisions.
- Surfaces assumptions, values, policies, context.
- Includes other perspectives/evidence.
- States lessons learned and a specific action plan.
How to practise reflection (3 simple steps)
- Description — What happened?
- Analysis — Why? Feelings, decisions, other perspectives, context.
- Action — What did you learn? What will you do differently?
🔄 Gibbs’ Model (6 stages) - Encourages structured reflection through six stages
Description • Feelings • Evaluation • Analysis • Conclusion • Action plan.
Use Gibbs when: you need a structured, step-by-step review and a clear plan.
⚡ Schön’s Model
Reflection-in-action (during) and reflection-on-action (after).
Use when: you must adapt in real time and then debrief.
❓ Rolfe et al.
What? • So what? • Now what?
Use when: you need a fast, practical check-in.
🎯 Triple-Loop Learning
Single: doing things right • Double: doing the right things • Triple: how we decide what’s right.
Use when: work involves policy, systems, and values.
Lived example (used for all models):
During a mobile vaccination clinic in a remote village, many mothers were hesitant to bring their children forward for measles immunisation. Uptake was lower than expected.🔄 Reflection Using Gibbs’ Model (6 stages)
- Description: Low uptake; visible hesitation among mothers.
- Feelings: Concerned, frustrated; assumptions challenged.
- Evaluation: + logistics OK; − weak community engagement.
- Analysis: Language/cultural barriers; limited trust; no prior leader involvement.
- Conclusion: Relationships/context as critical as supply.
- Action plan: Co-plan with local leaders/volunteers, use translators and culturally relevant messaging, add pre-visit dialogue and feedback loop.
⚡ Reflection using Schön’s Model
Reflection-in-action (during): On noticing hesitancy, invite a respected health volunteer to translate, switch to brief one-to-one chats, and show a simple pictorial explainer.
Reflection-on-action (after): Recognise lack of pre-engagement and tailored messaging; plan co-designed materials in local language and a leader briefing before the next clinic.
❓ Reflection using Rolfe et als model.
What? Mothers hesitant; measles uptake lower than planned.
So what? Trust and understanding not established; language/culture gaps; no prior leader involvement.
Now what? Partner with leaders/volunteers, run a pre-clinic Q&A, use local-language audio/visuals, and review uptake + feedback within 48 hours.
🎯 Reflection using Triple-Loop Learning
Single-loop (doing things right): Add weekend hours and reminder messages to raise attendance.
Double-loop (doing the right things): Reframe strategy to include co-created messages, community translators, and engagement with trusted figures.
Triple-loop (how we decide what’s right): Redefine success with the community (trust, informed choice, satisfaction), and share decision-making on future outreach.
Learning activities
- Compare and contrast the four models (1–2 bullets each).
- Apply one model to a short case (e.g., clinic outreach).
- Group discussion: Which model fits your context best—and why?
Mentor notes
Use lived examples for each model and coach mentees to apply them to real-world contexts. Focus on assumptions, alternatives, and a concrete action plan.
Optional: further reading & guides
- Intro to reflective writing
- Tips for effective reflective notes
- Facilitating reflection — a guide for mentors
- Examples of good-quality reflective notes
Estimated time to complete: ~45 minutes (core); 60–75 minutes with activities.
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We hope that you wrote the two exercises as well as you could have. Unlike most certificates which require some sort of 'test' and assessment, we do not feel such an approach is relevant to a subject like reflection. You can be your own examiner here and decide whether you have done enough and if you have then congratulations and go ahead and download the certificate by clicking on the link below.
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Finally, although what you have done is personal to you, it can be important to share and learn from others. So if you feel able to - it is entirely voluntary - then you can upload your work with a short note about you, your motivations for posting it and if you want any specific feedback from others. Do not be discouraged if you do not hear back - but also note that these feedback loops only work when everyone participates, and so do consider sending in your work.
If you want to upload your blog, go to the Blog Menu on the side panel or via Add an entry about this course. You will see that you can publish your blog privately, or so that others can see.
