Self-reflection is paramount to the development of professionalism and serves as the foundation of adult education and lifelong learning. Pedagogical approaches in health sciences programs that promote selfreflection are growing in popularity. Current literature identifies a gap in what and how students conceive selfreflection and whether self-reflection is creating professionals that meet the challenges of today's healthcare climate. This qualitative study explores the conceptions of self-reflection for occupational therapy students in Level II Fieldwork. The use of phenomenographic methodology guided the collection of information-rich data through semi-structured interviews. Twenty-one occupational therapy graduates volunteered to participate in the interviews. Verbatim transcripts were coded to identify categories and patterns in the data. A focused discussion was employed as a member-checking method to ensure accuracy of study outcomes. Participants identified that self-reflection may serve to inform personal and professional practices during occupational therapy student clinical rotations. Although universally defined, student self-reflection occurred in countless ways and took many forms. Participants valued its function in expanded decision making, selfawareness, and competence in fieldwork and everyday occupations. These findings facilitate further research and the creation of new self-reflection educational methods or interventions designed to build or remediate self-reflective capacity of health sciences students during academic and clinical programming.