Overview

Christopher Johns in the year 1994 developed reflective writing specifically for the nursing sector at the Burford Nursing Development Unit. This model was inspired by Gibbs' and Rolfe's model and soon after its wide popularity, the application of the model got popular in other varieties of disciplines as well in which the education sector was also involved. The framework developed by Christopher Johns had a total of 5 sets of questions that further had other sets of questions for writing effective and advanced reflection.

The idea of this reflective model hit the researcher during his one research and that’s when he realized that for an effective reflection, there should be both internal and external factors included. As per the model, the internal factors of the model included an individual’s own emotions, thoughts, and ideas (Cox, 2005). On the other hand, the external factors consisted of factual occurrences of the experiences. To carry out the information, Johns prepared 5 sets of questions.

Furthermore, Johns utilized Barbara Crapper's pattern of knowing which she developed in 1978 included 4 phases of naming, aesthetics, personal, ethics, empirics and additionally johns added the fifth phase named reflexivity.

Five different phases of Johns' model of reflection

Phase 1: Describe the experience (Aesthetics Questions)

The first phase is all about describing the experience in detail on what you want to reflect upon. This is the reason questions under the category of aesthetics are mainly concerned with factual description. Questions under the category of aesthetics are mentioned below

  • What, where, and when did happen?
    In this, we will highlight the background context of the situation. For example, the location, your role, time and the other necessary background information that will help readers understand the context of the situation.
  • What was my reaction?
    While answering this, you will highlight your reaction to the occurrence of the incident you are reflecting upon.
  • What was the reaction of others involved in the situation?
    In this, you will focus on the reaction of other people involved in the situation.
  • What actions did I take?
    At this stage, you will state the actions taken by you when the incident occurred.
  • What was the result?
    Lastly, you will highlight the result of your actions and the ways in which it impacted on the whole situation.

Johns model of reflection stages

Phase 2: Reflection (Personal Questions)

The second phase is for self-reflection and all the questions asked in this phase were personal and related to the feelings oneself. This section is all about connecting the dots of factual and situational contact with feelings and how the emotional aspect contributed to the situation you are reflecting on. Some assisting questions that lie under the category of personal questions are

  • What were you feeling and why were you feeling the way you did?
    In this, you will highlight the ways in which you felt during the occurrence of the event you are reflecting on and the major reasons behind those feelings.
  • How are you feeling right now about the incident you are reflecting upon?
    In this, you will highlight your current feelings about the incident you are writing the reflection about.

Phase 3: Influencing factors (Ethical Questions)

In this section, you will minutely express how the internal and external factors impacted the way you acted in certain situations you are reflecting on. Moreover, you will also relate to this section with your values and ethics to support or oppose your actions. Some assisting questions that might help you with the same area -

  • What were the internal factors that reflected influence in your actions?
    Here you will highlight the internal factors such as your feelings, thoughts or assumptions about the situation that might have influenced your actions in one way or another.
  • What were the external factors that influenced your actions?
    While answering this, you will shed light on the various external factors such as other people’s opinion, actions, or body movements that might have impacted your actions in different ways.
  • Were your actions aligned with your ethics?
    In this, you will highlight the fact that whether your actions were aligned with your action in any way or not.
  • Did you do anything unethical? If yes? Did any external factors have an impact on that?
    In this, you will focus on explaining the relationship between your actions and general ethics. If the answer is yes, you will highlight if the external factors had any impact on your unethical actions.

Phase 4: Contextual (Empirics Questions)

Moving ahead, this section contains where you will explain the other alternative actions that you could have taken instead of what you did in reality. Alongside this, you will also discuss the impact of your actions on yourself or on other elements or people that were involved in the situation you are reflecting upon. Some empirical questions that will help you in the reflective writing of this section are

  • What other options did you have?
    In this question, you will focus on exploring all the alternatives that you could have opted for in terms of acting in the situation you are reflecting on.
  • Did you consider all the options before reacting?
    In this, you will highlight the fact that you considered options before reacting or not.
  • Did you choose the best possible options?
    In this, you will underline the fact that whether you chose the best option of all or you had a better alternative but did not choose because of some reason.
  • What was the impact of your actions on others involved in the situation?
    While answering this, you will highlight the impact of the actions you took on the other people that were involved in the situation.

Phase 5: Learning (Reflexivity Questions)

In the additional questions, Johns added some reflective questions that will assist you in effectively underlining the learning model. So, in this section, you will briefly describe all your learning from this experience and how you will use those learnings in the future if similar situations occur. For this, Johns underlined some assisting reflexivity questions that will assist you in writing your reflective process using the model.

  • What were the main learning outcomes of this experience?
    In this, you will highlight the different learning outcomes you got from this learning experience.
  • How will you use your learning outcomes in future similar situations?
    Here you will outline the ways in which you will utilize your learning outcomes from this situation to the future similar situations.
  • How has this experience changed the perspective of your existing knowledge?
    In this, you will highlight the ways in which you got additional knowledge

Moving forward, after meticulously reviewing the model, below is an example of reflective writing using Johns’ model of reflection that will assist you in understanding the model more comprehensively.

Johns' model of reflection example in nursing

Case assessment - This reflective example will focus on highlighting a nurse’s experience working at a residential care center. This reflection will highlight her experience of dealing with a patient named Mary Lou suffering from paralysis due to a damaged spinal cord.

Phase 1: Describe the experience

I have been working with the residential care center for over months and this time I was placed at the house of 32-year-old Mary Lou who was paralyzed due to a damaged spinal cord that was caused by an accident in 2020. We both tuned in well until one day I experienced that Mary Lou was shivering. I instantly panicked and thought that I made some mistake that caused a temperature rise in Mary Lou's body. Mary Lou was also feeling feverish but she said her body cannot feel anything below the level of injury. Listening to this, I became a little more anxious than I was. However, I remember that during my placement I was reading a book called, “Nursing Spinal Cord Injuries”. I read that automatic regulation of temperature occurs but it only occurs at a level of injury because the connection between brain cells gets disrupted below the level of injury. In order to obtain a stable bodily self, the brain generates moment-to-moment representations by integrating and weighting different sensory inputs according to their reliability and presumably integrating them into offline body representations (Lenggenhager, Pazzaglia, Scivoletto, Molinari & Aglioti, 2012).As soon as I remembered that, I calmed myself down and gave paracetamol to Mary Lou. Soon after Mary Lou was perfectly fine.

 

Phase 2: Reflection

As soon I realized that her body temperature was rising but it was only happening above the level of injury, I panicked and felt nervous. I felt this way because earlier that day, although Mary Lou was not allowed to, we had ice cream together and I thought that due to that something went wrong and she was experiencing this. I now feel that I shouldn't have just assumed things and should have thought about it thoroughly before reacting to the situation anxiously.

 

Phase 3: Influencing factors

If I look back at the situation, I feel that Mary Lou getting tense was one major external factor that impacted my behavior or feelings in a certain way.Besides, I also feel that I shouldn't have just assumed that it happened because of my carelessness and this internal factor made me anxious in the first place. Moreover, I know that my actions are directly linked to my ethics which I did not adhere to. I feel that my action of feeding Mary Lou was completely unethical because I was not allowed to do so but I felt doing so Mary Lou’s connection formed in such a short time. This was a major external factor that led me to my unethical action as I could not say no to Mary Lou.

 

Phase 5: Contextual

Elaborating contextually, other than what I did, I could have chosen not to give the ice cream to Mary Lou which was the ethical and right thing to do.Even when I was giving her the ice cream, I knew it was not the wise and best thing to do but I did it anyway. The impact of my decision led to trouble for both of us.

 

Phase 6: Learnings

Through this whole experience, I learned that it is never good to react to a situation based on assumptions before knowing the reality.Besides, it is essential to use your existing knowledge and take help if necessary to keep you and the patient calm during the situation of crisis. If a similar situation occurs again, I will ensure that I take deep breaths and calm myself down before getting to a conclusion.

References

Lenggenhager, B., Pazzaglia, M., Scivoletto, G., Molinari, M., & Aglioti, S. (2012). The Sense of the Body in Individuals with Spinal Cord Injury. Plos ONE, 7(11), e50757. doi: 10.1371/journal.pone.0050757

Cox, E. (2005) “Adult learners learning from experience: Using a reflective practice model to support work‐based learning,” Reflective Practice, 6(4), pp. 459–472. Available at: https://doi.org/10.1080/14623940500300517.