Becoming Professional through Reflective Practice

The following thoughts on professionalism and reflection were circulated at a day conference for acupuncture and herbal medicine teachers held at the Northern College of Acupuncture (NCA) on June 24, 2006. They may be of wider interest? Like all BAABaccredited institutions, NCA prepares undergraduate students for the 'profession' of acupuncture. We believe reflective practice to be a crucially important aspect of that preparation.

Each student's learning journey has to include a deep, and a deeply personal, understanding of what it means to be a 'professional practitioner' in their chosen profession. We also believe that reflective practice is of continuing value throughout a professional career. It does not end when a student graduates with their first degree. For teachers of a practice profession like acupuncture, reflective practice becomes doubly important. Each teacher of acupuncture has to be a reflective 'professional practitioner' twice over, because teaching is a separate professional practice that is also enhanced by deep reflection.

In an ideal world, all experienced practitioners in teaching institutions would be consciously seeking to 'role model' reflections on teaching practice for their less experienced teaching colleagues, as well as role modelling reflection on acupuncture practice for their students. The following notes illustrate a chain of thought that links the concepts of a profession and professional knowledge to those of professional education and reflective practice itself.

What is a 'profession'?

  • Paid Work (not amateur)
  • Specialised Work (not unskilled)
  • Complex Work (not predictable)
  • Good Work (not inconsequential)

The relationship between the 'professions' and the rest of society is complex. On the positive side, the professions are known to serve important social 'goods' like justice, knowledge and, of course, health. Professionals still have some status in society. But in the public arena there are many negative perceptions around the level of autonomy and the amount of trust that the professions used to expect and enjoy. We live in a less trusting, more cynical age. Are all professions 'a conspiracy against the laity', as Bernard Shaw suggested? How should they be regulated? What is professional knowledge? Professional practitioners deal with a particular type of knowledge over and above their specialist expertise and specific skills. Much of this cannot be listed in a syllabus: it needs to be teased out and experienced personally by each new practitioner; hence the significance of reflective practice.

The following list is merely suggestive of the complexity and problematic nature of professional knowledge. It does not attempt to define it. Professional knowledge is:

  • Shared and collaborative, part of a 'tradition of conduct'.
  • Never complete, often uncertain, sometimes a mystery.
  • 'Situated' in a particular, if not unique context.
  • Ethically informed, works 'with' not 'on' clients.
  • Practical above all, but relies on theory and creates new theory.

Professional knowledge in this deep perspective is derived from what professional practitioners actually do. It has to be acquired, as if for the first time, by each new practitioner. It cannot be comprehensively covered in any list of occupational skills and competences. Such knowledge is not, therefore, what most of the public believe or what governments would like it to be. It is not evidencebased; it is not easily transferable; it is not based on solid and dependable factual knowledge. If they are to learn from each experience of practice, professionals must be able to theorise from their own practice. This means deep reflection in order to create a personal theory.

All professionals frequently have to make judgements about what to do for the good of a client without knowing all the facts of the case. Because they are fallible, mistakes will be made, but these are often the source of further learning and theorising. Reflection never stops. Professional knowledge also embraces a form of artistry, i.e. intuitive, tacit and sometimes inexpressible knowings. This personal artistry of practice can develop over time, as a result of the right kind of reflection. It may become what we mean by wisdom? What are the characteristics of professional education, underlying all formal syllabuses and assessments?

  • Professional education is essentially practical Whilst theorists may know something, practitioners must do something. The curriculum for a profession needs therefore to be grounded in professional practice itself. Theory is essential, but it is always in the service of practice. It is practice that determines the value of any theory, rather than theory that determines the value of any practice.
  • Professional learning is multifaceted Knowledge and understanding of practice are acquired in a variety of interactive ways within complex traditions and institutions. A practice is learned first and foremost by engaging in that practice: "learning by doing and making sense of what you did". Imitation, trial and error, apprenticeship, mentorship, classroom teaching, supervision, scholarship and research all play a part.
  • Professional education, like practice, is a moral endeavour Because professions serve human interests having consequences that are open to debate as to ends and means, professional education, like professional practice, is bound up in questions about what ought to be done as well as how to do it.
  • Professional educators as role models of personal reflection Professionals working in the practice of their profession and in the education of the next generation of practitioners need to be selfcritical, independent learners developing knowledge for themselves, as well as helping student practitioners to do so. How is knowledge for practice developed through reflective activities? Becoming deeply reflective can be compared to becoming literate in a new language. Literacy, or meaningmaking, in any language is achieved through listening, speaking, reading and writing. A language for individual practice can be honed by talking about your own practice and listening to other practitioners talking about their practice, in relationships like mentorship and supervision. Reading about other people's practice and research of practice, and writing about your own practice, are also part of the process. When you have tried these things for yourself it is easier to encourage students to do the same. Some Do's of good reflective speaking and writing
  • Discuss concrete situations and reallife persons and issues.
  • Use the first person singular, because thirdperson accounts do not engage people as whole persons. Ø Adopt a narrative style, because stories do engage and involve people as whole persons
  • Stay "in the moment" and include the intentions you, as practitioner, had during each significant "moment" Ø Demonstrate an ethical awareness and commitment to professional ideals
  • Describe your actions and the context or situation in which some action needs (or needed) to be taken Ø Illustrate how knowledge and new understandings are embedded in action, and how they can arise from reflection on action Ø Attempt to get below the surface of what has previously been taken for granted
  • Show evidence of any learning/deeper understanding that has occurred as a result of reflection

Ann Hopper and Allen Parrott
Accreditation Officers, BAAB

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