The Gibbs reflective cycle: the six stages, with a worked clinical example

Most clinicians have sat down to write a reflection and stared at a blank page. You know something happened on shift that mattered. You are just not sure how to turn it into a written account that shows learning rather than a diary entry. The Gibbs reflective cycle is the tool most people reach for, and for good reason. It gives you six clear questions to answer, in order, so the writing almost structures itself.

This guide explains the six stages in plain English, shows a full worked example you can adapt, and covers the two things people get wrong most often: staying stuck in description, and failing to anonymise properly. It applies whether you are building HCPC CPD evidence or writing an NMC reflective account.

Where the Gibbs cycle comes from

The model was published by Graham Gibbs in 1988 in his book "Learning by Doing: A Guide to Teaching and Learning Methods". It was designed for education, and it has since become one of the most widely used reflective frameworks in healthcare. It is cyclical rather than linear, which is the whole point. You are not writing a one-off report. You reflect, you change something, and the next similar event feeds back into the cycle.

Neither the HCPC nor the NMC requires you to use Gibbs, or any named model. The HCPC states plainly that there is no set way to record your reflection. The NMC asks you to answer a fixed set of questions on its reflective account form rather than follow a particular model. Gibbs is popular precisely because its six stages map neatly onto what both regulators want to see: what happened, what you made of it, and what you changed.

The six stages

Work through them in order. Each one is a question.

1. Description. What happened? Give a short, factual account. No opinion and no analysis yet. Just enough for a reader to understand the situation.
2. Feelings. What were you thinking and feeling at the time, and afterwards? Be honest. This is not self-indulgence. Your emotional response often points to what you actually learned.
3. Evaluation. What was good and bad about the experience? What went well, and what did not?
4. Analysis. Why did it happen that way? This is the heart of the reflection. Bring in your knowledge, relevant guidance, or a conversation with a colleague to make sense of it.
5. Conclusion. What did you learn, and what else could you have done?
6. Action plan. If it happened again, what would you do differently? Be specific. A vague "I will be more careful" is not an action. "I will use a structured handover tool every time I escalate" is.

A worked example

Here is a compact reflection that moves through all six stages. It is deliberately anonymised, with no names, no dates, no location, and roles only.

Description: During a busy shift, a patient in my care began to deteriorate. Their observations were drifting, but no single reading crossed an alarm threshold. I mentioned it to a colleague in passing but did not formally escalate for around an hour, by which point the patient needed more urgent input. Feelings: I felt uneasy early on but told myself I was being overcautious. When the patient deteriorated further, I felt responsible and worried that I had missed something obvious. Evaluation: I did recognise the early signs, which was good. What went badly was that I did not act on my own instinct, and I did not communicate the concern in a way that prompted a response. Analysis: Looking back, I was pattern matching to a stable patient and discounting a slow trend because no single number looked alarming. An informal comment to a colleague carried none of the urgency I actually felt. The gap was not knowledge. It was escalation and communication. Conclusion: I learned that a trend matters as much as a threshold, and that a concern only counts if it is communicated clearly. I could have escalated in a structured way much sooner. Action plan: I will treat a persistent trend as a trigger to escalate, even when individual readings are within range. I will use a structured handover format (for example situation, background, assessment, recommendation) whenever I raise a concern, so the urgency is unmistakable.

Notice how short each stage is. The value sits in the analysis and the action plan, not in a long description.

The trap: description instead of reflection

The single most common mistake is spending most of the account on stage one. A page describing what happened, followed by a sentence at the end saying you learned a lot, is not a reflection. It is a report, and assessors and confirmers can spot it instantly.

A simple test: if a colleague could have written the same account by watching you on shift, it is description. Reflection is the part only you can write, because it is about your reasoning, your feelings, and what you will change. Aim to spend the majority of your words on stages four to six.

Anonymise as you write, not afterwards

Both regulators require you to protect confidentiality in anything you submit. The safest habit is to anonymise as you write, rather than scrubbing a finished draft. Remove anything that could identify a patient or colleague:

• Names, initials, and job titles unusual enough to identify someone
• Dates, shift patterns, and locations
• Record numbers or case references
• Distinctive clinical details that, combined, could point to one person

Refer to everyone by role. "A patient in my care" and "a senior colleague" are enough. If a detail is not needed for the learning, leave it out.

Mapping Gibbs to your regulator

For HCPC registrants, a Gibbs reflection sits comfortably as a piece of CPD evidence. The HCPC treats reflection as an example of work based learning, and there is no set format, so the six stage structure is perfectly acceptable.

For NMC registrants, the reflective account form asks three things: the nature of the activity, feedback or event; what you learned; and how you changed or improved your practice. You then link it to one or more themes of the Code. Gibbs feeds this directly. Your description covers the nature of the event, your conclusion answers what you learned, and your action plan answers how you improved. The link to the Code is a short extra step at the end.

A word on difficult shifts

Reflection works best on events that unsettled you, which is exactly why it can tip into rumination. Reflection is structured and forward looking, and it ends with an action plan. Rumination is circular and goes nowhere. If writing about an event leaves you feeling worse rather than clearer, treat that as a signal to pause and seek support rather than push through. Your occupational health service and your union are there for this. The Samaritans are also available on 116 123, free at any time.

Let Reflectory do the structuring

If the blank page is the problem, Reflectory can help. It interviews you about the event, one question at a time, and turns your answers into a structured reflective account in your own words. Identifiable details are screened out, and every document carries a built in note that AI was used to support your reflection rather than write it. You stay the author. It simply makes the six stages easier to reach.