4.
Analysis (Expanded Using Prompts from the
Guide)
Reconsider the things that went badly and why
they went badly (causes of action):
One key issue was that I did not verify the
timing or adequacy of analgesia before
initiating the physiotherapy session. This
oversight likely contributed to the patient's
discomfort during deep breathing and
coughing. I was so focused on performing the
techniques correctly that I neglected pre-
session planning, which is critical in post-op
care where pain is a major limiting factor.
Another issue was forgetting to bring
supportive aids like an extra pillow or a small
stool, which could have helped in splinting the
incision and improving positioning.
What did this lead to (consequences of action):
The patient experienced increased discomfort,
which may have led to reduced participation,
especially in coughing and deep breathing
activities. This could potentially affect the
effectiveness of the physiotherapy, increasing
the risk of postoperative pulmonary
complications. Additionally, the session was
slightly delayed and less efficient because I
had to improvise with available materials,
disrupting the flow and focus.
What could have been done to avoid these
negative consequences?
I could have:
Checked with the nurse or patient records if
analgesics were given recently.
Asked the patient about her current pain level.
Gathered all necessary equipment (pillows,
stool, towel) before entering.
Created a simple pre-session checklist for
surgical ward sessions to guide my
preparation.
---
Reconsider the things that went well and why
they went well (causes of action):
Despite the challenges, I maintained clear
communication, which helped the patient trust
the process. I also explained each step before
performing it, reducing anxiety. I positioned
myself well to manage the drain and lines,
ensuring patient safety. These actions went
well because of my theoretical preparation and
previous simulation training on line and drain
management.
What did this lead to (consequences of action):
The patient successfully tolerated early
mobilization to sitting, and performed
diaphragmatic breathing and supported
coughing despite mild discomfort. This was
important in preventing postoperative
respiratory complications. It also helped the
patient feel encouraged and actively involved
in her recovery.
How could these positive actions be further
improved?
These actions could be improved by
incorporating even more structured
communication with the nursing staff, including
a quick pre-treatment briefing about pain,
vitals, and line status. My explanation could
also be paired with simple visual cues or
demonstration if the patient had language
barriers or confusion. Additionally, I could use
documentation templates to note patient
response, helping future sessions be more
consistent and progressive.
---
My contribution to the experience and how
useful it was:
My contribution was central to the session’s
success. I led the entire intervention under
supervision, managed the lines and the
environment safely, and guided the patient
through her first postoperative physiotherapy
session. This was useful not only for the
patient's physical recovery but also for building
my confidence and competence. A previous
classroom role-play on postoperative chest
physiotherapy helped me apply techniques like
supported coughing and positioning.
Comparison to previous experience:
Compared to earlier sessions in medical
wards, this was more complex due to the
presence of invasive lines, pain, and the risk of
wound stress. It showed me the added caution
needed in surgical settings and the importance
of interdisciplinary teamwork.
---
Other people present during the experience:
The nurse assisted with monitoring vitals and
supporting the patient’s posture during
mobilization. Her calm and supportive
demeanor was different from mine—I was
initially tense. Her confidence reassured the
patient and reminded me how valuable team
dynamics are. If I had communicated better
with her beforehand, we could have
coordinated analgesia and preparation more
effectively.
Using the "Conclusion" section from the
Gibbs Reflective Cycle (as shown in your
image), here's a detailed conclusion for your
memorable encounter in the surgical ward:
5. Conclusion (Detailed
Explanation)
What should or could I have done
differently?
I should have taken a moment before the
session to confirm the patient's pain status
and assess her comfort level before
beginning chest physiotherapy. I also could
have prepared all necessary equipment in
advance—such as a small pillow for splinting, a
towel for support, and a footstool for better
sitting posture. Additionally, I could have
coordinated more closely with the nursing
staff beforehand to ensure optimal timing
around analgesia.
What stopped me from doing this?
The main factor was nervousness and
eagerness to perform. I was focused on
applying my practical skills and following what I
had learned, but in doing so, I underestimated
how much preparation and interprofessional
communication contribute to a smooth session.
I also lacked a structured pre-session
checklist, which would have reminded me of
these important steps.
What did I learn about myself during the
experience?
I learned that while I am capable of applying
techniques under supervision, I need to
slow down and think more holistically—not
just about what I'm doing, but how the patient
is experiencing it. I also discovered that I
naturally communicate clearly with patients
and can maintain calm during clinical
challenges, which helps build trust.
What did I learn about my current
knowledge or level of practice (strengths
and weaknesses)?
My strength lies in my basic clinical
reasoning, line and drain safety awareness,
and patient interaction. However, I
recognized a weakness in session
preparation, particularly around pain
management timing and equipment
readiness. I also need to improve my
interprofessional collaboration, especially
when working in fast-paced wards like surgical
units.
Did the experience achieve any of my
learning goals or meet any of my required
competencies?
Yes, this experience helped me meet
competencies related to acute care
physiotherapy, including safe mobilization of
a post-op patient, awareness of post-surgical
complications, and early respiratory
intervention. It also supported my goal of
becoming more confident in clinical decision-
making and teamwork in complex settings.
Would you like help summarizing all parts of
the reflection into one full document?