Reflective writing is a core skill in nursing and healthcare education. Programmes accredited by the Nursing and Midwifery Council (NMC) require students to demonstrate that they can learn from clinical experience, critically examine their own practice, and identify areas for professional development. Gibbs' Reflective Cycle (1988) is the most widely used framework for structuring this process. This guide explains how to apply it effectively.
What Is Gibbs' Reflective Cycle?
Developed by Professor Graham Gibbs in his 1988 work Learning by Doing, Gibbs' Reflective Cycle is a six-stage framework for structured reflection:
- Description — What happened?
- Feelings — What were you thinking and feeling?
- Evaluation — What was good and bad about the experience?
- Analysis — What sense can you make of the situation?
- Conclusion — What else could you have done?
- Action Plan — If it arose again, what would you do?
The cycle is designed to be iterative — reflection leads to changed practice, which generates new experiences to reflect upon. In a written essay, you move through each stage in sequence.
Choosing an Experience to Reflect On
Choose a real clinical experience from your placement that was genuinely challenging, unexpected, or significant to you. This might be a difficult patient interaction, a clinical error, a situation where you felt out of your depth, or a moment of professional growth. Avoid trivial incidents that generate little reflective depth. The best reflective essays engage honestly with discomfort and uncertainty.
For confidentiality reasons, always anonymise all patients, staff, and placement locations. Use pseudonyms ("Mrs J," "the ward manager") and remove any identifying details, in accordance with NMC guidance on confidentiality.
Stage 1: Description
Describe the experience factually and concisely. Set the scene: where were you, what were you doing, who else was involved? State what happened. Do not include your feelings or analysis at this stage — that comes later.
Example: "During my second placement on a medical ward, I was asked by my mentor to assist with a medication administration round. When documenting the medication given to a patient (referred to as Mr A for confidentiality), I noticed that the dose recorded on the Medication Administration Record differed from the prescription in the patient's notes. I informed my mentor immediately."
The description should be brief — roughly 10–15% of the total word count. The analysis is where you earn your marks, not the description.
Stage 2: Feelings
Reflective writing is unusual in academic nursing in that you are explicitly invited to write about your emotional response. Be honest and specific. Avoid vague statements like "I felt nervous." Instead, explore why you felt that way and how those feelings affected your behaviour.
Example: "Initially, I felt a surge of anxiety when I noticed the discrepancy. I was uncertain whether I had misread the record, and I was aware that challenging a senior clinician, even indirectly, felt uncomfortable. I was also conscious of a sense of responsibility towards Mr A's safety, which overrode my hesitation."
Stage 3: Evaluation
Evaluate the experience honestly: what went well and what did not? This is where you begin to move beyond pure description towards critical thinking.
In the medication example: what went well was the prompt identification and reporting of the discrepancy. What did not go well might be the fact that the anxiety almost prevented reporting, or that documentation practices on the ward were not consistent enough to prevent the error in the first place.
Stage 4: Analysis
This is the most academically demanding stage, and the one that attracts the most marks. Here, you draw on theoretical frameworks, research literature, professional guidelines, and nursing theory to make sense of what happened. You are not simply describing your experience — you are explaining it in the context of broader knowledge.
For a medication error scenario, relevant literature might include: NMC (2018) The Code, research on medication safety culture in NHS settings, literature on psychological safety and speaking up in clinical teams, and evidence-based frameworks for error prevention. Reference all sources correctly using Harvard or APA, as required.
Stage 5: Conclusion
What could you have done differently? What have you learned? This is a personal and honest assessment — not self-criticism for its own sake, but a genuine identification of what the experience has taught you about your practice. Consider both what you would do the same and what you would do differently.
Stage 6: Action Plan
The action plan should be specific and forward-looking. What concrete steps will you take as a result of this reflection? These might include completing additional training, reading specific guidelines, practising a clinical skill, or changing how you communicate in a particular type of situation.
Example: "As a result of this experience, I plan to review the NMC (2018) guidelines on medication management and complete the Trust's mandatory e-learning module on medication safety. I will also discuss with my mentor strategies for building confidence in raising concerns in clinical settings."
Writing Style for Reflective Essays
Nursing reflective essays are written in the first person ("I felt," "I observed," "I concluded"). This is explicitly required for reflective writing and is an exception to the usual academic convention of writing in the third person. Write in a clear, professional, and honest voice. Avoid overly emotional language, but do not hide genuine feeling behind clinical detachment.
Other Reflective Models
While Gibbs is the most widely used model in UK nursing programmes, others include:
- Schon's Reflection-in-Action and Reflection-on-Action (1983) — focuses on real-time and post-hoc reflection in professional practice.
- Johns' Model of Structured Reflection (1994) — uses guided cue questions to prompt deeper analysis.
- Driscoll's WHAT? Model (1994) — a simplified three-stage framework (What? So What? Now What?).
Always check your module handbook to confirm which model your assignment requires.
Key Points to Remember
- Anonymise all patients, staff, and locations.
- Use academic literature in the analysis stage — this is where the essay demonstrates critical thinking.
- Write in the first person.
- Ensure your action plan is specific and realistic.
- The description stage should be brief; the analysis should be the longest section.
- Reference all sources using the required citation style.