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An aspect of ‘why did I respond as I did?’ is to respond in tune with one’s vision. Vision is a background to all experience necessary to establish creative tension. This cue lifts vision into scrutiny – ‘did I act in tune with my vision?’ bringing vision into focus. It challenges the practitioner as to what their vision is and what it means as something lived beyond the words used to express it. Thus reflection is always an inquiry into vision.

TABLE 4.2 Model for Clinical Judgment

Effective action

How did I assess the situation?

What was my rationale for clinical decisions to meet perceived outcome?

What actual actions did I take to meet perceived outcomes?

Evaluation: what were the consequences of my actions?

Did I meet perceived need?