The Preferred Method of Reflection for Occupational Therapy Students During and After Clinical Placements: Video, Written or Artistic?

Abstract

Health care students, including occupational therapy students, are required to use reflective practice in many coursework assignments, during their mandated clinical placements, and when practicing as health care professionals. The catalyst for this investigation was that university students are frequently required to complete these reflections in a written format. This is surprising, and contrary to clinical placements and practice, where the majority of reflection is undertaken either verbally with other health care professionals or via internal thought mechanisms (i.e. thinking about their thinking and decision making). After graduation from university, the use of written reflections is almost non-existent for health care practitioners. This chapter will argue that the commonly used written reflections do not mimic how reflection takes place during clinical placements and when working as a health care professional. The investigation described in this chapter aimed to identify the preferred method of reflection that third-year undergraduate occupational therapy students chose when offered a choice of reflective medium and to understand why they preferred the chosen format. Students who participated in our investigation could choose either a written, video or an artistic format to complete five reflective practice tasks. Students undertook a mandatory clinical placement where they spent a minimum of 75 h onsite at an aged care residential facility. During and after the placement, the students selected five topics from a list of 30+ topics that focussed their reflections on their effectiveness as an occupational therapist. For each topic, they were free to choose either of the three reflective medium formats. A total of 68 students completed an online survey, which collected quantitative and qualitative data. The 68 students completed a total of 340 reflective pieces with 81% preferring the video format, 18% selecting the written format, and only two students choosing an artistic format. Students reported that the video format was preferred because video required them to use verbal communication, which was the same method of reflection used during clinical placements. Video was also preferred because it allowed the full array of emotions to be expressed. The most commonly selected topics were “Critique your interpersonal, communication, and assertive skills” (57%) and “Critique your emotional resilience and coping skills” (43%). From the findings, the chapter, recommends that university educators shift from using written reflective assignments to verbal formats. The verbal format is both the preferred and most commonly used format of reflective practice used during clinical placement and in practice. Our results provide overwhelming evidence that students prefer the verbal format because they know that this is how reflection is completed in healthcare settings. Even those who preferred the written format agreed that the written expression of emotions is difficult and lacks sophistication when compared to the video format where the full set of emotional communication tools are available – words, facial gestures, body language, and voice pitch and intonation. University educators are encouraged to offer a choice of verbal and written reflective formats to students, with a requirement to complete most reflective tasks in the verbal format before commencing clinical placements. Our findings indicate that health care students prefer assignments to replicate the formats that they will encounter during clinical placements and when working as health care professionals.

Appendix A

The 33 topics that students could select from:

• 1. Critique your use of evidence-based practice.

• 2. Critique your emotional resilience and coping skills.

• 3. Critique your interpersonal, communication, and assertive skills.

• 4. Critique your initial interview skills.

• 5. Critique your ability to explain occupational therapy to your residents.

• 6. Critique your first two days on the placement.

• 7. Critique an assessment that you completed.

• 8. Critique your ability to interpret information from assessments.

• 9. Critique your ability to assess occupational performance.

• 10. Critique a set of progress notes

• 11. Critique the occupation-based goals that were set

• 12. Reflect on how you coped when receiving feedback.

• 13. Critique a clinical decision you made.

• 14. Critique your clinical reasoning skills.

• 15. Critique a group activity/session you facilitated.

• 16. Critique an intervention you implemented with a resident.

• 17. Critique your ability to deal with stress.

• 18. Critique why you became frustrated or annoyed during the placement?

• 19. Critique your time management and organisational skills.

• 20. Critique your teamwork skills.

• 21. Critique your confidence in making decisions.

• 22. Critique how you dealt with an ethical issue.

• 23. Critique how you dealt with elder abuse – if you observed it.

• 24. Did one of the residents pass away during your time in the facility? How did you react?

• 25. Did you have a strong emotional reaction to something that occurred?

• 26. Critique your ability to deal with workplace politics.

• 27. Critique how you evaluated the outcome of the OT program.

• 28. Critique how you concluded the therapeutic relationships at the end of the placement?

• 29. If you worked on a project, critique the outcome.

• 30. Select any item or set of items on the SPEF-R. Critique your skills in this area.

• 31. Critique how you used OT theory during the placement, e.g. OT model, CPPF, occupation as core to occupational therapy etc.

• 32. Reflect on your preparedness for your 4th-year full-time clinical placements.

• 33. Other topic was chosen – use free text.