A structured approach to reflective practice training in a clinical practicum.

Abstract

Reflective practice is considered to be the key component for achieving greater self-awareness, professional expertise, critical thinking, integration of theory-practice links, and enhanced patient care. While reflective practice is considered a key component in supervision in terms of skill development and increase in clinical competence, it is unknown whether or not reflection is a workable and meaningful training activity that results in a positive outcome. The purpose of this project was to conduct an initial evaluation of the feasibility and acceptability of a reflective practice exercise within a practicum setting. Participants included 22 graduate students (13 females, 9 males) in a Clinical Science doctoral degree program that completed a reflective practice exercise which utilized a series of guiding questions, while receiving training and supervision from a licensed clinical psychologist. Results highlight positive outcomes of the reflective practice in terms of clinician growth and associated client outcomes, following the reflective practice. In addition, the results show that the structured reflective practice is a meaningful exercise as well as an acceptable approach to developing reflective practice as part of clinical practice training and lifelong learning. These findings highlight the potential use of the structured approach to reflective practice in a clinical practicum setting. Recommendations for improving the reflective practice process in a clinical practicum are discussed.

Reflective practice in clinical psychology: Reflections from basic psychological science.

“…Fueling our concerns is the marked dearth of evidence that reflective practice techniques yield more reflective practitioners, better patient outcomes, or more accurate clinical judgments and predictions (Mann et al., 2009). Although reflective practice exercises appear to be well‐received by most psychology trainees (Cooper & Wieckowski, 2017; Knight et al., 2010), evidence of satisfaction should not be confused with evidence of effectiveness. In fairness, the gap here is more one of absence of evidence than of evidence of absence given the lack of controlled trials examining the impact of reflective practice techniques on clinically relevant outcomes.…”

“…To more explicitly guide the process of reflective practice, other authors (e.g., Johns, 1994; Kolb, 1984) have proposed various multistage “cycles” of reflective practice, some of which have been recommended for use in psychological training (Anderson et al., 2004; Cooper & Wieckowski, 2017; Sheikh, Milne, & MacGregor, 2007). Gibbs (1988) advanced an influential six‐stage process of reflective practice comprising of (a) a description of the clinical interaction; (b) examination of one's thoughts and feelings; (c) evaluation of what went right and what went wrong; (d) analysis of the interaction; (e) conclusions, including what one might have done differently; and (f) a formulation of an action plan for what to do in similar clinical interactions.…”

“…Furthermore, reflective practice has increasingly been recognized as a valued goal, if not a formal core clinical competency, in numerous clinical psychology and clinical neuropsychology graduate programs in the United States, the United Kingdom, Australia, New Zealand, South Africa, among other nations (Cooper & Wieckowski, 2017; Gates & Senediak, 2017; Knoetze & McCulloch, 2017). Numerous American doctoral (Ph.D. and Psy.D.)…”

“…In aggregate, these considerations appear to have received scant attention in the reflective practice literature. A core assumption of reflective practice is that this approach “enables experiential learning (learning‐by‐doing) in which students draw on their experiences to continually learn and reapply their learning to a new experience” (Cooper & Wieckowski, 2017, p. 253). For example, most reflective practice techniques are premised implicitly or explicitly on the cyclical models of Gibbs (1988) and other theorists, which posit that we can retrospectively appraise clinical situations to discover what we could have done better and formulate corrective action plans accordingly.…”

Narratives of Expert Speech-Language Pathologists: Defining Clinical Expertise and Supporting Knowledge Transfer

“…Indeed, selfreflection is correlated with clinical expertise in other professions and training SLPs to self-reflect should be incorporated into clinical training programs. Clinical psychology, for example, provides a structured framework for embedding reflective practice into training programs (Cooper & Wieckowski, 2017).…”