Learning to be surprised: how to foster reflective practice in a high-reliability context

Reflection-in-action is often emphasized as a critical ingredient of professional practice, especially in complex and novel situations that call for high situational awareness. Relatively little is known, however, about how organizations can actively foster such a reflective attitude and about the challenges that may be encountered when trying to do so. This article investigates how an anaesthesiology department uses organizational practices to help novice nurses become reflective practitioners. Different practices foster reflection-in-action in different ways, addressing different dimensions of the reflective attitude. The study also provides evidence on factors that are likely to impede this learning process, most notably the mediation by goal conflicts and power relations. Overall, the paper contributes to a deeper understanding of how organizations can go about fostering reflection-in-action.