‘He has a life, a soul, a meaning that extends far deeper than his medical assessment … .’: The role of reflective diaries in enhancing reflective practice during a rural community physiotherapy placement

Abstract

Background. The Department of Physiotherapy at the University of the Witwatersrand, Johannesburg, South Africa has a programme that allows 4th-year physiotherapy students to experience learning about public health in a rural setting. This experience is assessed using a portfolio. To date, the portfolios have only been assessed in terms of the students achieving the learning objectives. The process has not been evaluated for its effectiveness in promoting a reflective learner. A reflective learner is considered as one who will develop critical thinking and better accountability for their own learning.

Objective. To analyse the level of reflective practice attained by the students.

Methods. A qualitative approach was used to analyse evidence of reflective practice in student reflective diaries. Guided content analysis, using a framework compiled from the literature, was used to code the data. The coding framework outlined the levels of reflective practice – from the lowest level, identifying learning outcomes, to the highest level, i.e. abstract concept formation.

Results. Forty-eight portfolios with reflective diaries were available for analysis. Data saturation was obtained after eight reflective diaries were analysed. The majority of the student diaries (6 of 8) reflected a low level of reflective practice, with only a few attaining a high level.

Conclusion. This study showed that physiotherapy students who experienced learning in a rural setting achieved low levels of reflective practice. A minority of students were able to progress in their reflection to reveal elements of critical thought, reflective thinking and, further still, abstract concept formation.