Reflective Practice in Radiation Therapy

Reflective Practice

• Reflective practice is a process initiated consciously or subconsciously in response to positive or negative events, requiring analysis for answers or insights (Chapman et al., 2009).
• Benefits include structured expression of radiation therapy knowledge
• Reflective Practice enables knowledge sharing among therapists, benefiting both the profession and patient outcomes
• Facilitates verification and examination of clinical actions, optimizing work practice and inter-professional relationships
• Enables constant evaluation and adaptation of techniques and developments
• Radiation therapists constantly evaluate clinical parameters for accuracy in complex situations.
• Improves decision-making abilities and explores areas of advanced practice
• Reflective Practice allows realisation of career desires and aspirations for career mapping or planning

Dimensions of Reflective Practice

• Iterative dimension involves continuous repetition such as identifying a problem, finding a solution, and implementing a change
• Vertical dimension refers to the depth of reflection

Simple Models of Reflection

• Driscoll's model: Asks 'What?', 'Now What?', and 'So What?'
• ERA cycle model: Focuses on Experience, Action, and Reflection
• Gibbs' reflective cycle is a more complex model incorporating Description, Feeling, Evaluation, Analysis, Conclusion, and Action Plan

What's Important in Reflective Practice

• Understand the situation
• Reflect on the situation
• Propose future behaviour or action

Burnout Definition

• It's an individual response to chronic work stress that can progressively lead to health alterations (Montero-Marin, 2016)
• A psychological syndrome causing damage at cognitive, emotional, and attitudinal levels which translates into negative behavior towards work, peers, users, and professional roles (Maslach, 2006)

Dimensions of Burnout

• Emotional exhaustion involves feelings of being depleted due to work, leading to fatigue and difficulty coping with tasks
• Cynicism or depersonalisation is detachment and indifference towards work and/or those receiving it
• Reduced personal achievement involves negative self-evaluation and doubts about performance, leading to decreased productivity and low coping skills

Subtypes of Burnout

• Frenetic burnout is typical of individuals working intensely until exhaustion by working many shifts, temporary contracts, overtime, high motivation, high effort, and high energy
• Underchallenged burnout stems from under-stimulating work environments, causing monotonous work with limited change and routine which leads to cynicism
• Worn-out burnout involves hopelessness and a lack of control or recognition, resulting in insufficient support or appreciation, neglect of responsibilities, and disconnection

Sources of Burnout

• Include intrapersonal, interpersonal, organisational, and structural sources
• Stem from lack of peer support and supervision
• May be caused by emotional labour and organisational factors
• Can result from poor working hours and work overload
• Occurs from a lack of influence and autonomy
• Is impacted by role ambiguity and role conflict

Burnout in Medical Radiations

• In medical radiations can be caused by high workload and negative patient interactions
• Increased overtime hours contribute to occupational burnout
• Work-related musculoskeletal disorders can lead to burnout
• Lack of administrative support increases burnout
• Compassion fatigue can lead to job burnout

Enhancers and Protectors of Burnout

• Protectors: Agreeableness, Conscientiousness, Extraversion, Openness to experience, and Problem-focused coping with self compassion
• Enhancers: Neuroticism, External locus of control, Emotion-focused coping, and Type A personality

Important Terms

• Problem-focused Coping includes problem-orientation and fixing the issue, taking action
• Internal Locus of Control: individuals believe they control outcomes
• Emotion-focused Coping focuses on feelings and involves venting.
• External Locus of Control: individuals believe the world controls outcomes

Emotional Intelligence

• Includes self-regulation, self-awareness and motivation

Resilience

• Resilience is adapting, or 'bouncing back
• Ability to successfully adapt to difficult or life experiences through mental, emotional, and behavioral flexibility, adjusting to external and internal demands (APA, n.d.)

Resilience Models

• Compensatory model: Resilience factors offset risk factors
• Protective model: Protective factors shield individuals from risk factors
• Challenge model: Exposure to risk yields an optimal outcome

Protective Factors

• Broad and can change based on the individual and context
• Considers personal traits, contextual resources, and strategies

Protective and Risk Factors

• Internal traits/states: Emotional intelligence, distress tolerance, self-esteem, motivation, conscientiousness
• Contextual resources: Social support, family support, financial support, job satisfaction, peer/mentor support
• Strategies: Coping strategies, reflection, work-life balance, mindfulness

Emotional Intelligence and Resilience

• Encompasses emotional awareness and emotional regulation