Reflective Narratives by Student Physical Therapists on Their Early Clinical Experiences: An Inductive and Deductive Analysis—The Use of a Reflective Framework

Abstract

Introduction. Written narratives are used to develop reflective skills in health care students during clinical education. The purpose of this study was to explore the effectiveness of using a framework in narrative writing to facilitate reflection in physical therapy students during their initial short-term clinical experiences. Subjects. Each of 20 written narratives by physical therapy students was explored during their first clinical short-term experience. Methods. Data analysis was an iterative process consisting of eight individual researchers and cross-group researcher analyses for the development of themes and levels of reflection. Descriptive statistics, percent agreement between pairs of researchers, was calculated based on the number of times the identical rating was assigned to a narrative by pairs of raters. The strength of agreement between researchers was measured using inferential statistics. Results. Five themes emerged; these were patient-centered care, professional role, ethical issues, critical thinking, and student and clinical instructor relationship. Researchers determined that all 20 narratives contained reflection compared with a previous study in which only 64% of the narratives examined contained reflective writing. Analysis showed percent agreement between eight researchers ranged from 60% to 85%, with a mean of 73%. The weighted Kappa scores ranged from fair to substantial agreement, with the exception of one rater who demonstrated poor agreement relative to the consensus. Conclusion. The results of this study support the use of a framework in narrative writing to foster reflection in physical therapy students during their initial clinical experiences. Consistent levels of reflection occur through the use of a model that helps students connect specific experiences with their thoughts and feelings about those experiences. There was moderate agreement among researchers in choosing levels of reflection across narratives.

Facilitating the development and maintenance of reflection in speech pathology students

“…Recent research in physiotherapy (e.g., Greenfield et al 2017) and pharmacy (e.g., Deslandes et al 2018) has provided evidence of student reflection outcomes across longer durations. For example, Greenfield et al (2017) compared an historical databank of student reflective narratives written without the support of a framework or specific teaching strategy to those generated from a pilot study that used the Gibbs model of reflection to support reflection narratives. The comparison of these two datasets found improved demonstration of reflection in the cohort that used the Gibbs (1988) model of reflection.…”

Development of professional identity and professional socialisation in allied health students: A scoping review

“…A range of student experiences was reported, most often concerning the whole course or program (36, 48.6%) or a component (28, 37.8%) and less frequently (10, 13.5%) about student perceptions and values, shown in Table 2. Commitment by students to engage in their own learning was determined to be essential in PI development (Trede et al, 2012), with reflection (Bartlett et al, 2009;Greenfield et al, 2015), self-authorship (Johnson & Chauvin, 2016) and agency (Clouder, 2003) potentially beneficial strategies. Professional self-confidence affected students' clinical decision making, development of competency and professional identity, and improved with experience (Greenfield et al, 2015;Holland et al, 2012;Swanepoel et al, 2016;Tryssenaar & Perkins, 2001).…”

“…Commitment by students to engage in their own learning was determined to be essential in PI development (Trede et al, 2012), with reflection (Bartlett et al, 2009;Greenfield et al, 2015), self-authorship (Johnson & Chauvin, 2016) and agency (Clouder, 2003) potentially beneficial strategies. Professional self-confidence affected students' clinical decision making, development of competency and professional identity, and improved with experience (Greenfield et al, 2015;Holland et al, 2012;Swanepoel et al, 2016;Tryssenaar & Perkins, 2001). Students acknowledged ownership of their role in development of PI (Davis, 2006), in contrast with several authors who considered that lecturers and clinical educators should lead the process and give support to the student (Paterson et al, 2002;Taylor & Harding, 2007).…”