Reflective Practice: A Model for Facilitating Critical Thinking Skills Within an Integrative Case Study Classroom Experience

Abstract

Background and Purpose. Reflection is the hallmark of professional practice. Professionals reflect in action, assess outcomes, and seek continuous improvement. This article presents a model by which all aspects of reflective practice can be facilitated within an integrative case study classroom experience. Description and Evaluation. Physical therapy students from Stony Brook University participated in a week-long integrative case study course following their first semester of professional studies. This course served to enhance critical thinking skills as students integrated and applied course material in preparation for clinical practice. Paper patients, video patients, and interactions with residents from a local nursing home provided the experiential bases for reflective activities. Students worked through the patient/client management model in developing apian of care and providing interventions for a number of residents. Each experiential component was followed by a reflective activity. Students worked independently and in small faculty-mentored groups, and participated in large group discussions. Faculty mentors encouraged questioning and the exploration of assumptions and alternative perspectives. Problem lists, evaluations, care plans, student-generated metaphors, group presentations, and summative reflective essays confirmed the types and levels of reflection that occurred throughout the week and provided evidence of critical thinking, integration, and professional development. Outcomes. This model demonstrated how the reflective process can he incorporated into an integrative classroom experience to prepare students to meet the demands of practice as they begin to take on the role of a reflective practitioner and lifelong learner. It demonstrated the ease of facilitating integration, critical thinking skills, and professional behaviors in a classroom setting. Discussion and Conclusions. Professional practice requires physical therapists (PTs) to function efficiently and effectively within a dynamic environment. Literature suggests that reflective practice is valuable in the development of a practitioner who can engage in ongoing learning and professional development, and continually reassess and modify care. This model offers a mechanism in which theory meets practice in the classroom setting in preparation for clinical practice. Key Words: Reflective practice, Critical thinking, Integration, Professional behaviors. INTRODUCTION Physical therapists (PTs) are integral members of a broader category of health care providers that includes all members of the health care team. PTs are continually faced with a complex patient population in a rapidly evolving health care system. New information is being generated daily and patients, as consumers, are becoming increasingly more educated about their own health care needs. Information production, global economics, and an increased emphasis on quality assurance, productivity, and efficiency require greater skill in integration and critical thinking. Furthermore, PTs no longer have the luxury of time in the clinical setting. Productivity, efficiency, and accountability have become increasingly manifest as patients are being discharged from hospitals sooner and PTs are receiving reimbursement for fewer treatment sessions.1 This has moved PTs into positions of greater responsibility, requiring more complex decision-making and clinical-reasoning skills.1 A tremendous burden is being placed on clinicians as they work to maintain productivity while simultaneously striving for quality care. As a result, students are expected to arrive in the clinic well prepared to work collaboratively and perhaps even add to the productivity of the department-not to become an added burden on clinicians. The responsibility to prepare these students for this level of function resides with the education programs, whose task it is to develop active learners and critical thinkers who are able to function professionally and deliver effective, quality care to an increasingly diverse patient/client population. …