Can Student Self-Reflection Improve? Exploring the Implementation of a Guided Self-Reflective Intervention
Purpose/Hypothesis: The ability of learners to self-reflect has been associated with the highest level of learning and it is a necessary part of the clinical reasoning process for health profession students. Measurement of the ability to self-reflect has not been standardized in health science education despite self-reflection’s association with other non-cognitive traits contributing to academic and professional success. The purposes of this study were to determine if self-reflection improves among DPT students following intentional, guided, reflective clinical reasoning activities and to explore potential mechanisms responsible for change. Number of Subjects: 41 2nd year DPT students Materials and Methods: An explanatory sequential mixed methods design was utilized to investigate self-reflection change following a semester of self-guided clinical reasoning and reflective practice. Video recordings of individual student performance during lab practicals were shared with learners, followed by reflective narrative guided by questions in clinical reasoning were completed at midterm and final time periods. Change in self-reflection was measured by the Self Reflection and Insight Scale (SRIS), with established internal consistency among health professional students. Constant comparative analysis process of open and axial coding leading to midterm and final timepoint theme development was also employed utilizing student’s reflective narratives. Paired t-test with an alpha level correction was completed using SPSS™, Version 25 and Atlas Ti8™n software for qualitative data. Results: A significant change in SRIS total scores (p = 0.009) as well as Engagement subscale (p <0.001) was found following educational intervention. Unique themes emerged at mid-point and final timeframes from guided reflective narratives. Mid-semester themes included; self-awareness, struggle in clinical decision making, reflection on action, need for adaptability and importance of therapeutic alliance. Final emerged themes included; increased confidence, comfort with uncertainty, improved self-awareness, deep reflective practice and growth mindset. Conclusions: Learner-centeredness has been identified as an essential component contributing to excellence in physical therapy education. Growth in reflective abilities was evident both quantitatively and qualitatively. Guided learner-centered reflection within didactic curriculum may assist in development of life-long learning and creating adaptive expertise in DPT students. Clinical Relevance: Engagement in self-reflection prior to clinical practice is essential to foster development of clinical reasoning skills necessary for today’s complex health care environment. The results of this study show a potential method for improving a student’s ability to self-reflect on performance and make adaptations for future learning situations.