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The MSR is used worldwide, especially in healthcare professions, for example, NovelestskyRosenthal and Solomon (2001). It is designed to enable practitioners to access the depth and breadth of experience necessary to gain insight. It moves through a reflective spiral from significance to insight. Significance lies on the surface of experience, whereas insights lay deep within. Insights are learning that change the practitioner in some way towards realising their vision of practice as a reality. Insights may be expressed as ‘what I learn from reflecting on this experience?’

The first version of the MSR was constructed in 1991 through analysing the pattern of dialogue in guided reflection, framed within Strauss and Corbin’s grounded theory paradigm model (Johns 1998). Since then, it has evolved through reflection on its efficacy. Table 4.1 sets out the 18th edition. It is structured through six distinct phases that mirror the six dialogical movements: preparatory and descriptive [1], reflection and drawing insight [2], deepening insights through dialogue with literature and guides [3 and 4], presentation [5], and communication [6]. For users acquainted with the previous edition note that the ‘influences grid’ has been replaced by four key questions for the practitioner to consider whether they could respond differently in future experiences. In deleting the ‘influences grid’ I reinstated specific cues for ethics, feelings, and past experiences.

The MSR cues and their sequencing are not prescriptive. However, the novice reflective practitioner will benefit from systematically applying them until they become second nature. With experience of using them, the practitioner naturally internalises them so that they become embodied and used more intuitively. The descriptive and reflection phases (first and second dialogical movements) will inevitably merge. The cues will naturally shape the practitioner’s gaze in clinical practice, nurturing the development of reflection within practice, not just after the event.

TABLE 4.1 Model for Structured Reflection (18th Edition)

Source: Christopher Johns/18 edition – December 2019.

Preparatory phase – Bring the mind home

Descriptive phase – Write a description of an experience (Dialogical movement 1)

Reflective phase cues (Dialogical movement 2)

What is significant to reflect on?

Why did I respond as I did?

Did I respond in tune with my vision?

Did I respond effectively in terms of consequences?

Did my feelings and attitudes influence me?

Did past experiences influence me?

Did I respond ethically for the best?

Anticipatory phase –

Given a similar situation, how could I respond more effectively, for the best and in tune with my vision?

Am I able to respond as envisaged? Consider: Am I skilful and knowledgeable enough to respond differently? Am I powerful enough to respond differently? Do I have the right attitude? Am I poised enough to respond differently?

Insightful phase – What tentative insights do I draw from this experience?

Deepening insights phase

How has extant theory/ideas inform and deepen my insights? [Dialogical level 3]

How has guidance deepen my insights? (Dialogical movement 4)

How do I now feel about the experience?

Representation phase (Dialogical movement 5)

How can I communicate my insights most effectively in written/performance format?