With placement blocks looming last year, I knew that the world of reflection and reflective practices were going to become important to me very soon. The benefits of reflection have been widely discussed and its importance is sewed into the tapestry of healthcare education and the professions.
However, with little experience of the process, I was keen to devise a method to make it as simple as possible. I decided I would keep a placement diary and note down some thoughts each day. I wanted a condensed and simple method so it would be something I would maintain daily. Being an avid user of social media, it occurred to me that these diary entries could be similar length to tweets. Thus, I decided to tweet them out.
I am interested in the notion of group reflection, of which there is a scarcity of research, particularly within a healthcare context (Sørensen, 2020). A study published in Nursing Times found that facilitated reflective practice groups were advantageous and these were particularly useful in roles with high emotional cost, such as nursing (Knight 2015).
In business practices, team shared reflection has been found to lead to quality improvement by removing the barriers to effective change (Løvaas and Vråle, 2020; Shaw et al., 2012). The HCPC and other health regulators advocate reflecting in groups stating that, when all views are respected and listened to, there are benefits such as creating collective wisdom, improvement in services and care, and the safe exploration of thoughts and feelings (HCPC, 2019). Social media can be used to foster a form of effective team reflection. The beauty of it is the group participants can be anywhere in the world.
What’s in the tweets?
I started without a formal structure but I’m now working to this loose formula: the hashtag #RadDiary; the date; the modality/area I’m working in; how I felt about the day; what went well; what to improve on; a photo that captured the day.
What are the benefits?
1. Transparency
Transparency and authenticity are very important to me. They are a vital quality of healthcare professionalism, and being honest when mistakes are made is vital for effective service progression. There is also a more personal angle. As someone with a past of mental health issues, I’m very aware of the sinister consequences of not communicating and addressing one’s feelings. Recent statistics state that two in five men admit regularly feeling worried or low (Mind, 2020). Evidence suggests that suppressing emotions is not only a danger to one’s emotional and cognitive wellbeing but to one’s physical health (Patel and Patel, 2019). The act of avoiding the expression of negative emotions may escalate the frequency of the negative emotions one is trying to avoid (Tran and Rimes, 2017).
2. Reassurance
First, there is a personal benefit for the person posting. I have received much encouragement and reassurance from the radiography Twitter community. There is always someone who has been through what you are going through or has done what you have done (or even worse). Addressing worries with a wide, knowledgeable and understanding community is vastly beneficial.
Second, other students will see the posts and know they are not alone in the things they have done or feel. It’s the effect of someone being the first to raise their hand and ask the question that everyone was secretly worrying about. Hopefully I am helping to create a community or team of students who are open to sharing their thoughts and supporting one another. Creating that environment of trust is very important in team reflection (Shaw et al., 2012).
3. Being concise
I am terrible at staying on topic when I’m writing. By limiting each post to one tweet, I only have 280 characters and need to edit down my thoughts to what really matters. What did I do today? What went well? What should I improve on? It’s an enforced method of concise reflection.
What have I learned from the process so far?
1. Developing a daily practice
Some days I don’t feel like sharing because I’ve a bad day and just want to go to bed. However, I’ve managed to push myself and not miss a day. This is a practice in self-discipline that gives me a huge sense of accomplishment.
If I feel that the day has not gone to plan, I can always accomplish something by adding a diary entry. Cultivating this level of self-discipline can also be useful in other areas of life, such as following an exercise plan.
2. Mood enhancement
As I mentioned above, some days I do not feel in the mood to write a diary about my day. However, I know those are the days when I should express myself the most. I’ve found that the act of analysing and formally considering my day can make me aware of what I actually accomplished. There is never a day that is void of all merit and by appreciating the good things I did, I feel better.
3. Building self-confidence
What if no one comments or likes? Social media is an often unpredictable medium. Sometimes tweets get lost in the ether or sometimes they are seen but they get no traction. Therefore, I have learned not to feel hurt by lack of engagement. The core reason for doing it has to be for me. Sometimes social media can feel like you are talking in an empty room but that is fine if the act of talking is rewarding.
4. True authenticity
Social media has the reputation of being fake and it would be very easy to airbrush my experience and portray myself as the perfect student. I believe too strongly in the benefits of being honest and authentic to do that. However, there have been some occasions when I have struggled to post, such as on 28 April (see #RadDiary).
I pride myself on being patient-centred and focused on patient dignity and confidentiality. This was a relatively small event and the patient and I laughed about it, but the shame of my error of judgment stayed with me after the shift.
When I was about to post about it, I thought: What will people think of me? What if potential future employers see it? However, my belief in being honest and transparent outweighed those worries and I Tweeted about it. As you might imagine, I had people commenting/messaging that they had done or heard the same thing. The rest of that week was much more successful, and those successes felt much more deserved. It was a practical example of how embracing low feelings can create fulfilling highs.
5. Take the initiative
Of course, I don’t think I invented ‘sharing your day’ on Twitter. However, I do think I have formalised the practice of sharing your day on placement. By doing it every day, I hope I have helped popularise it and have inspired other students. I believe that if you have an idea and it’s not currently happening, take the initiative to make it happen.
What about the future?
I’ve seen approximately 12 other students using the hashtag as well as others doing something similar that has possibly been influenced by the project. I hope to see this community continue to grow and the mutual benefit continue to increase. Personally, I’m planning on continuing it throughout my degree and seeing where it goes. It’s an ongoing process but I feel it’s been very beneficial to me and, hopefully, to the student radiography Twitter community.
Ben Potts is a first-year diagnostic radiography student at Birmingham City University. Follow Ben on Twitter @ben_imaging #RadDiary
References
- HCPC. (2019) Benefits of becoming a reflective practitioner: A joint statement of support from Chief Executives of statutory regulators of health and care professionals. [joint statement] 18 June. Available at: https://www.hcpc-uk.org/globalassets/news-and-events/benefits-of-becoming-a-reflective-practitioner----joint-statement-2019.pdf [Accessed 31 May 2021]
- Knight, S. (2015) Realising the benefits of reflective practice. Nursing Times; 111(23/24). Available at: https://www.nursingtimes.net/roles/nurse-managers/realising-the-benefits-of-reflective-practice-01-06-2015/ [Accessed 31 May 2021].
- Mind (2020). Get it off your chest Men’s mental health 10 years on [pdf] Available at: https://www.mind.org.uk/media/6771/get-it-off-your-chest_a4_final.pdf [Accessed 31 May 2021].
- Patel J. and Patel, P. (2019) Consequences of Repression of Emotion: Physical Health, Mental Health and General Well Being. International Journal of Psychotherapy Practice and Research, 1(3). Available at: https://doi.org/10.14302/issn.2574-612X.ijpr-18-2564
- Sørensen, M., Groven, K. S., Gjelsvik, B., Almendingen, K., and Garnweidner-Holme, L. (2020). The roles of healthcare professionals in diabetes care: a qualitative study in Norwegian general practice. Scandinavian journal of primary health care, 38(1). Available at: https://doi.org/10.1080/02813432.2020.1714145
- Shaw, E. K., Howard, J., Etz, R. S., Hudson, S. V., and Crabtree, B. F. (2012). How team-based reflection affects quality improvement implementation: a qualitative study. Quality management in health care, 21(2). Available at: https://doi.org/10.1097/QMH.0b013e31824d4984
- Tran, L., & Rimes, K. A. (2017). Unhealthy perfectionism, negative beliefs about emotions, emotional suppression, and depression in students: A mediational analysis. Personality and Individual Differences, 110. Available at: https://doi.org/10.1016/j.paid.2017.01.042
