Narrating practice: reflective accounts and the textual construction of reality

Background.  Two approaches dominate current thinking in health and welfare: evidence‐based practice and reflective practice. Whilst there is debate about the merits of evidence‐based practice, reflective practice is generally accepted with critical debate as an important educational tool. Where critique does exist it tends to adopt a Foucauldian approach, focusing on the surveillance and self‐regulatory aspects of reflective practice. Aim.  This article acknowledges the critical purchase on the concept of reflective practice offered by Foucauldian approaches but argues that microsociological and discourse analytic approaches can further illuminate the subject and thus serve as a complement to them. Methods.  The claims of proponents of reflective practice are explored, in opposition to the technical–rational approach of evidence‐based practice. Findings.  Reflective practice tends to adopt a naive or romantic realist position and fails to acknowledge the ways in which reflective accounts construct the world of practice. Conclusions.  Microsociological approaches can help us to understand reflective accounts as examples of case‐talk, constructed in a narrative form in the same way as case records and presentations.