The Use of Reflective Summary Writing as a Method of Obtaining Student Feedback About Entering Physical Therapy Practice

Abstract

ABSTRACT: The purposes of this qualitative study were to obtain feedback from students as to how prepared they were prior to graduation from a problem-based program to enter physical therapy practice and to promote reflective think ing. Forty-eight students, during final academic semester of a 2 year post-baccalaureate physical therapy program with a problem-based curriculum, completed a reflective summary (a short essay) their perceptions of entering physical therapy The reflective summary assignments were transcribed into Ethnograph computer software program, and specific phenomena related to students feedback were identified, coded, and grouped into themes. The following themes were identified: 1) general preparation to enter clinical practice, 2) skills in problem solving, self-directed learning, small-group learning, and critical appraisal of literature, 3) hands-on skills, 4) ability to work in a variety of groups, and 5) link between academic and clinical components of program. Reflective summary writing is a useful educational strategy to obtain students' feedback how prepared they are to enter clinical practice and to promote reflective thinking skills. It also assists in identifying areas of knowledge and skills that students feel are necessary to enter practice and may be helpful in designing curricula in problem-based education programs. Key Words: Physical therapy, Problem-based curriculum, Reflective practice, Reflective thinking INTRODUCTION Shepard and Jensen* have suggested that there are two types of knowledge that must be conveyed to physical therapist students. One kind of knowledge is technical knowledge or know-how, which includes facts, principles, examples, and rules of thumb that constitute basis for hands-on patient care(P571) Technical knowledge is necessary for clinical practice and is used to assess and treat client conditions for which there are known beneficial interventions. The second type of knowledge is known as reflective or knowledge and is part of intuitive performance of everyday clinical Reflective knowledge is part of every professional's spontaneous actions but may not follow specific rules or theories.' This type of knowledge is used for what Schon2 called the indeterminate zones of practice. Indeterminate zones of practice include uncertainty, instability, uniqueness, and value conflict and do not encompass technical knowledge.2 For instance, a practitioner may not be able to handle a unique situation solely by applying techniques or theories that have been previously learned, but also may need to apply intuitive or reflective knowledge. That is, a competent physical therapist must master not only physiological and pathological knowledge, as well as psychomotor hands on skills, but also other processes, often implied, that rarely appear in formal curriculum. The reflective practitioner uses both technical knowledge and reflective knowledge to solve day-to-day clinical problems. Schon23 argued that professional practice can be improved if practitioners were encouraged to reflect more their actions rather than simply to rely their acquired technical knowledge. He suggested that successful practitioners' ability to reflect-in-action enables them to deal with uncertainty and complexity of clinical Physical therapists continuously come upon indeterminate zones of practice in their daily clinical As physical therapy educators, we must assist our students to become reflective thinkers so that they will be better prepared to deal with indeterminate zones of There are several definitions of reflection. Houston4 stated that reflection is an ancient concept based knowledge, as well as ability to analyze situations to recognize nuances of problems, to be able to think divergently, and to propose solutions to problems. Fellows and Zimpher5 asserted that within concept of reflection, past experience and understandings are linked with present experience and understandings. …