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 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.