Introduction
This essay applies the Gibbs Reflective Cycle (Gibbs, 1988) to examine an episode in which a nursing student taught a colleague how to complete a dietitian referral. The purpose is to demonstrate professional development in interprofessional communication and nutritional care within a UK hospital setting. The reflection follows the six stages of the model—description, feelings, evaluation, analysis, conclusion and action plan—while meeting the academic expectations of a lower-second-class honours submission.
Description
During a routine ward round on an acute medical ward, a healthcare assistant asked for guidance on referring an older patient with unintentional weight loss to the dietitian. The student nurse explained the electronic referral form, highlighted the key data required (body-mass index, recent weight trend, MUST score and relevant medical history) and observed the assistant complete the task under supervision. The process lasted approximately fifteen minutes and concluded with the referral being accepted by the dietetic team within two hours.
Feelings
Initially, the student felt confident because the referral procedure had been covered in university sessions. As the interaction progressed, a degree of uncertainty emerged regarding the precise threshold for urgent versus routine referral. After the form was submitted successfully, a sense of professional satisfaction was evident, tempered by recognition that further reading on local referral criteria would strengthen future guidance.
Evaluation
The session achieved its immediate goal: the referral was accurate and timely. Strengths included clear, step-by-step language and the use of the ward’s computer terminal to demonstrate live data entry. Limitations were also apparent; the explanation assumed prior knowledge of the Malnutrition Universal Screening Tool (MUST) that the healthcare assistant had not yet acquired. Consequently, the teaching was only partially effective for learners at an earlier stage of competence.
Analysis
Effective teaching in clinical settings requires assessment of the learner’s existing knowledge before instruction begins (Hattie, 2012). In this instance, the student omitted a brief knowledge check, which is a recognised feature of adult-learning principles. Furthermore, National Institute for Health and Care Excellence (2017) guidance emphasises that timely dietetic referral can reduce length of stay; therefore, accurate referral practice constitutes both a patient-safety and resource-efficiency issue. The episode illustrates how small gaps in preparatory assessment can compromise the quality of interprofessional education.
Conclusion
The experience reinforced the importance of structured preparation when teaching practical skills. While the referral itself was completed correctly, a more thorough exploration of the learner’s baseline understanding would have produced a more robust learning outcome. The episode also highlighted the need for ongoing familiarity with local policies that may evolve between academic modules and placement rotations.
Action Plan
Future teaching encounters will begin with a short knowledge quiz or targeted questions. In addition, the student intends to review the current trust nutrition policy document at the start of each placement and to practise explaining the MUST tool using simple visual aids. These steps should enhance both the accuracy of referral guidance and the student’s own confidence in supporting colleagues.
References
- Gibbs, G. (1988) Learning by Doing: A Guide to Teaching and Learning Methods. Further Education Unit, Oxford Polytechnic.
- Hattie, J. (2012) Visible Learning for Teachers: Maximizing Impact on Learning. Routledge.
- National Institute for Health and Care Excellence (2017) Nutrition Support for Adults: Oral Nutrition Support, Enteral Tube Feeding and Parenteral Nutrition. Clinical guideline CG32. NICE.
