Change in reflections of physiotherapy students over time in clinical placements

Abstract

Physiotherapy programmes are expected to develop reflective practitioners. Research has indicated that the reflections of senior students and clinicians are different from students beginning their clinical experience. However, most of these studies are cross-sectional in nature. The purpose of this qualitative study was to describe the changes in the reflections of a group of physiotherapy students from their first to their third clinical placements. Subjects were 15 female students (mean age: 20.1 years) in an undergraduate physiotherapy programme in the United Arab Emirates. They wrote weekly entries in a journal during their first and third clinical placements. They described an event, their reaction to it and how it might affect their future behaviour. Two evaluators independently read and coded the content of all journals, and then worked together to categorize the data, rate the level of reflection of each weekly entry and develop themes. The levels of reflection and the themes from the two time periods were compared. Quotes from individual students from both time periods illustrated the changes in reflections. Students’ highest level of reflection for each entry ranged from level 1 (only described the event) to level 4 (gained a new understanding), with a slightly higher mean level of reflection during the third clinical placement. Themes derived from the journals were Professional behaviour, Learning, Self-development, and Ethical issues, in the first placement, and Communication, Ethics, Learning, and Scope of practice, in the third placement. In the latter placement, students were more confident and more focused on the client compared with their first placement. Although the overall themes were somewhat similar in the first and third clinical placements, students broadened their perception of the roles and responsibilities of physiotherapists and of the ultimate impact of their actions on the patient.