By the same token, Reflection may include a physical element, and may refer to discussion as well as to contemplation. In group work a task orientated group session may be seen as Activity and a subsequent discussion or support group as Reflection. The reason for describing this as a cycle is that it is impossible to perform both functions at the same time. In IT terms new data cannot be recieved and processed at the same time. An experienced practitioner working on familiar ground is able to alternate the two so quickly that they may appear to be simultaneous.
Activity provides an opportunity to compare existing models with the outside world.
Reflection is the process whereby existing models are changed, ie new knowledge is created and learning takes place. A busy practitioner has a life full of Activity, but little time for Reflection. One possible outcome of this is that existing models of disease and treatment are used but not modified by experience. Unless time for reflection is included in day to day work, then the practitioner's knowledge and practice will stagnate. For the patient Consultations often include the presentation of new information to the patient.