Teaching and Learning Forum 97 [ Contents ]

Using critical incidents in professional education to
develop skills of reflection and critical thinking

Michel Burgum
Catherine Bridge
School of Nursing
Curtin University of Technology
Critical incidents can help senior students extend to skills of reflection and critical analysis. Curtin midwifery students use a process developed by Tripp (1993) to work through events which occur in every day clinical practice. This process requires the students to describe and incident together with the social context in which it occurred. It might be an interaction between a colleague and client which made the student feel uncomfortable, upset or even very positive. Next, the student must explain the meaning of the incident within that social context, then provide a more general meaning. This forces the student to go beyond their personal response and consider the "bigger picture". Through reflecting on and analysing the components of the incident, the student increases their ability to withhold judgement until all aspects of a situation have been considered. This presentation will show you how to use critical incidents. In addition it identifies benefits and common pitfalls when using them in professional education programs.

Introduction

Increasingly university programs, with clinical or field components that require paid supervisors, are being asked to find ways to reduce expensive practicum time. This means that students can expect to receive much less exposure to real world situations during their program of study. How can we help students make the most of their experiences - and move beyond the egocentric focus of task completion and manual skills to develop the skill of professional judgement?

Critical incident work is one way we can assist the student to extend to cognitive skills of reflection and critical analysis. It is not always an easy process. In fact you can probably expect that the most needy students will be those who experience the greatest difficulty in making this conceptual leap!

What is a critical incident?

My use of critical incidents stemmed from reading about Tripp's (1993:42) contention that any event could be analysed to create a critical incident. This was important for me because; within the discipline I teach, much of what the student must learn involves working effectively and cooperatively as part of a team, comprising not only health professionals but a birthing family. I reasoned that if students could be taught to apply a simple technique to analyse events in clinical experience, it might facilitate their appreciation of the multiple variables to consider, the interaction between those variables and how this can affect the resulting outcomes.

The idea that any event in professional practice can be treated as a critical incident cannot be overemphasised. Tripp (1993:24-25) wrote that:

Teaching critical incident analysis

Midwifery students report that critical incidents have helped them in a variety of ways. These include: 'becoming more analytical'; helping me identify my position in ethical dilemmas', and 'helping me think about all the things that go on in clinical and where I fit in'. One of the methods advocated by Tripp (1993:26) involves the steps of a) describing an incident b) providing a contextual explanation of the incident c) finding a more general meaning, and d) articulating a position . These steps are outlined as follows together with some of the printed instructions I usually provide for the students.
  1. Describe an incident and the social context in which it occurred:

  2. Explain the meaning of the incident within that social context:

  3. Provide a more general meaning. Ask yourself:

  4. Identify your position

As part of the assessment requirements for the midwifery program, students are invited (it is an optional item) to compile a critical incident file. Over a period of 14 weeks the students are required to create at least 12 critical incidents by analysing events which occur during their clinical experience. These events may involve an interaction between a colleague and client which made the student feel uncomfortable, upset or even very positive. By analysing the event to produce a critical incident the student is forced to go beyond their personal response and consider the "bigger picture". Through reflecting on and analysing the components of the incident, the student increases their ability to withhold judgement until all aspects of a situation have been considered.

A student's perspective

An actual incident

Why use critical incidents in professional education?

It is evident from the example provided here that situations may be complex and varied. Furthermore that there is a potential for students to misinterpret the meaning of an event in a particular social context - especially in the initial phases of the educational program. Tripp (1993:43) informs that although we may use critical incidents in an attempt to confirm what we already suspect is correct, as happened in Catherine's example, the analysis can in fact reveal something new entirely. Tripp (1993:125) goes on to say that broadly speaking the aim is to improve professional judgement. He quotes Schon (1983) who emphasised that "members of a profession are valued for their ability to act in situations where a lack of knowledge (there not being a 'the right answer') demands sound judgement". This is because professional judgement is less about memorising facts and correct answers, and more to do with "reflection, interpretation, opinion and wisdom".

Today's demonstration will further explore the process of developing critical incidents and highlight for you some of the benefits and pitfalls of using them in professional education programs. We look forward to you participation in our session.

Reference

Tripp, D. (1993). Critical incidents in teaching. Developing professional judgement. London: Routledge.

Please cite as: Burgum, M. and Bridge, C. (1997). Using critical incidents in professional education to develop skills of reflection and critical thinking. In Pospisil, R. and Willcoxson, L. (Eds), Learning Through Teaching, p58-61. Proceedings of the 6th Annual Teaching Learning Forum, Murdoch University, February 1997. Perth: Murdoch University. http://lsn.curtin.edu.au/tlf/tlf1997/burgum.html


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