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  • Title: Reflections on clinical learning in novice speech-language therapy students.
    Author: Hill AE, Davidson BJ, Theodoros DG.
    Journal: Int J Lang Commun Disord; 2012; 47(4):413-26. PubMed ID: 22788227.
    Abstract:
    BACKGROUND: Reflective practice is reported to enhance clinical reasoning and therefore to maximize client outcomes. The inclusion of targeted reflective practice in academic programmes in speech-language therapy has not been consistent, although providing opportunities for speech-language therapy students to reflect during their clinical practice has been reported. Indeed, there has been limited investigation of the nature of speech-language therapy students' reflections. AIMS: (1) To describe the breadth and depth of reflection skills of novice speech-language therapy students by utilizing structured reflective learning journals. (2) To evaluate the use of a coding system to determine its reliability and relevance in identifying reflection skills. METHODS & PROCEDURES: Participants were 52 students in their second year of a 4-year undergraduate speech-language therapy programme. Mean participant age was 20.5 years; all students were female. Participants completed guided written reflections following three interviews with a standardized patient (an actor portraying a parent of a child with delayed speech development). Reflections were coded by two raters. Nine participants' reflections were recoded by raters A and B to establish intra-rater reliability. Inter-rater reliability between these two raters was calculated and a third rater completed coding of 20% of students' reflections to further establish inter-rater reliability. OUTCOMES & RESULTS: Results indicated that the majority of students were categorized as 'reflectors'. All students demonstrated at least one element of reflection. Their reflective writing primarily focused on a discussion of the content of and strategies used within the interviews, and reflection on and for action. Results also indicated that the coding system used within the study was reliable in determining both the breadth and depth of student reflections. CONCLUSIONS & IMPLICATIONS: This study found that novice speech-language therapy students can reflect on their clinical learning experiences within a structured clinical environment involving standardized patients. Only a small number of novice students were found to be critical reflectors who were able to analyse the content of clinical interviews, view the interaction from the perspective of the patient, and record changes to their own perspective which occurred as a result. The coding system was established as reliable and thus relevant for use in furthering research on reflective practice within speech-language therapy and other disciplines. Further investigation of reflective skills within other clinical environments and with additional clinical experience is recommended.
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