The Reflective Clinician: Specific Reflection Techniques to Enhance Student Learning in the Clinical Setting


Developing decision making skills in the clinical setting requires students to learn from each patient experience. Learning to make a good decision is a process by which the student (and the novice clinician) take information from each patient to build a collection of successes and failures from which to choose techniques to use with the future patients.
The reflective process is a technique that allows for a consistent process between patients and therefore more standard and progressive learning from each situation. This helps the new clinician use his/her knowledge base to assess the positive and negative aspects of the patient interaction and develop a plan based on these reflections.

Methods and/or Description of Project

Donald Schon developed a model of reflection to organize skills around practice. Using this model in the clinical setting affords both the student and the clinician an opportunity to recognize and address conflicts, ambiguity, and the uniqueness of each patient case. This is done by reflecting in action and reflecting on action to construct and reconstruct knowledge, and then acting on the results.
The model is presented in detail and then demonstrated on a variety of case studies.


Schon’s model has direct correlation to clinical practice. It is a process by which clinical instructors help the students understand the clinical decision making process as it is happening, with targeted questions and then experimentation with techniques. The reflection process is also used by students to consider patient cases in journal exercises to make appropriate and thorough plans.
The reflective model allows clinicians to grow and develop in their practice as they learn from both the simple and complex cases. This is an ideal process for lifelong learning.

Conclusions/Relevance to the conference theme: Through the Looking Glass: Transforming Physical Therapy Education

Given today’s fast paced and complicated clinical environment, it is critical that the student take full advantage of the clinical education experiences to develop a model of clinical decision making. The clinical instructor and the student can use the reflective model together to work through complex patients in the clinic with targeted questioning. The student can then use the model to journal and develop plans for patients. Most importantly, the student now has a process by which he/she can problem solve patients in the future to promote lifelong learning.


Argyris M. Schon DA. Theory in Practice: increasing Professional Effectiveness. San Francisco: Jossey-Bass, 1974.
Crandall S. How expert clinical educators teach what they know. Journal of Continuing Education in the Health Professions. 1993; 13:85-98.
Hargreaves K. Reflection in medical education. Journal of University Teaching and Learning Practice. 2016; 13 (2): 1-19.
Huhn K, Black L, Jensen G, Deutsch J. Tracking change in critical thinking skills. Journal of Physical Therapy Education. 2013; 27 (3):26-31.
Schon DA. The Reflective Practitioner: How Professionals Think in Action. San Francisco: Jossey-Bass, 1983.
Schon DA. Educating the Reflective Practitioner. San Francisco: Jossey-Bass, 1987.
Sanders J. Use of reflection in medical education: AMEE Guide No.44. Medical Teacher. 2009; 31:685-695.
Wainwright SF, Shepard KF, Harman LB, Stephens J. Novice and experience physical therapist clinicians; a comparison of how reflection is used to inform the clinical decision making process. Physical Therapy. 2010; 90(1): 75-88.
Wainwright SF, Shepard KF, Harman LB, Stephens J. Factors that influence the clinical decision making of novice and experienced physical therapists. Physical Therapy. 2011; 91(1):87-101.

Course Objectives

The participant will understand the basic student skills needed to participate in reflective practice in the clinic
The participant will understand the role of the clinical instructor in teaching and demonstrating reflective practice in the clinic
The participant will understand Schon’s reflective model and how it relates to clinical practice
The participant will identify questions that trigger reflection in the clinic
The participant will use Schon’s reflective model on the case studies presented
The particiant will understand how to use the model in daily practice with clinical students (and novice clinicians)

Instructional Methods

Powerpoint Presentation
Case Studies

Tentative Outline/Schedule

I. Introduction to reflective practice - 10 min
II. Student skills needed for clinical practice - 10 min
III. Overview of general decision making process - 10 min
IV. The reflective practitioner model - 10 min
V. Student process for using the reflective model - 15 min
VI. The role of the clinical instructor - 15 min
V. Case studies - 20 min

BACK to Abstract Results

  • Control #: 2750701
  • Type: Educational Session
  • Event/Year: ELC2017
  • Authors: Ms. Lisa Giallonardo
  • Keywords:

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