Self-Reflection and its Relationship to Occupational Competence and Clinical Performance in Level II Fieldwork

Purpose: Reflective practitioners embody the ability to critique their own clinical thinking about the dilemmas that frequently arise in professional practice and everyday life. Conflicting evidence exists on whether or not self-reflective practices are effective in promoting academic, clinical, and personal success. This quantitative study investigated self-reflection as a predictor of increased occupational competence and clinical performance in Level II Fieldwork for entry-level Master\u27s degree occupational therapy students. Method: The study used convenience sampling to recruit participants and data were collected via a demographic survey and self-assessment questionnaires. Multiple linear regression analyses were conducted to determine the extent to which self-reflection predicts occupational competence and clinical performance. R2 values were examined to determine the importance of each dependent variable (occupational competence and clinical performance). Results: Findings revealed a statistically significant relationship between self-reflection and occupational competence (p = 0.0053) but not between self-reflection and clinical performance (p = 0.08). Self-reflection accounted for 14% of the variance in clinical performance (R2 = 0.14), and more than one third (R2 = 0.38) of the variance in occupational competence. Results suggest that students who self-reflect regularly during fieldwork may have a greater ability to maintain everyday life routines during the demands of Level II Fieldwork. Conclusions: Self-reflection strongly predicts occupational competence of occupational therapy students during Level II Fieldwork, but does not significantly predict students’ clinical performance. Recommendations: Occupational therapy educators should consider incorporating guided self-reflection activities into the academic program in order to support student occupational competence. Intentional coaching in self-reflection may better prepare students for a clinical setting by supporting healthy daily routines, which may help them to manage stress during Level II Fieldwork. Future research should explore the impact of self-reflection training during clinical rotations (provided by clinical educators) on student clinical performance. Revision of the measurement of clinical performance is warranted to include questions pertaining to soft skills such as self-reflection and awareness

Promoting Self-Management of Breast Cancer-Related Lymphedema Through the Remotivation Process

Background. Lymphedema affects a significant number of women with breast cancer. Self-Management Programs (SMP) are important in the long-term management of chronic conditions such as lymphedema. Motivation is crucial in the daily performance of the SMP. The study explored the effect of the Remotivation Process on the motivation of women with breast cancer-related lymphedema to incorporate an SMP into their daily routine. Methodology. The study was a within-subjects quasi-experimental design that used the Volitional Questionnaire, frequency count of the SMP, and circumferential measurement as outcome measures. Eleven participants (n = 11) with breast cancer-related lymphedema completed the study that used the Remotivation Process as the intervention for 4 weeks with a follow-up session during the 8th week. Results. The participants progressed to a higher state of motivation on the Volitional Questionnaire at the end of the study. There was an increase in the performance of the exercise component of the SMP in 7 days, and a significant decrease in the circumferential measurement of the affected arm. There was also a positive correlation between VQ and circumferential measurements. Conclusion. The study suggests the usefulness of the Remotivation Process in an occupational therapy intervention to promote self-management. It can possibly facilitate motivation, improvement in the manifestation of lymphedema, and the daily performance of the self-management program for lymphedema

Occupational Therapy Student Conceptions of Self-Reflection in Level II Fieldwork

Self-reflection is paramount to the development of professionalism and serves as the foundation of adult education and lifelong learning. Pedagogical approaches in health sciences programs that promote self-reflection are growing in popularity. Current literature identifies a gap in what and how students conceive self-reflection and whether self-reflection is creating professionals that meet the challenges of today’s healthcare climate. This qualitative study explores the conceptions of self-reflection for occupational therapy students in Level II Fieldwork. The use of phenomenographic methodology guided the collection of information-rich data through semi-structured interviews. Twenty-one occupational therapy graduates volunteered to participate in the interviews. Verbatim transcripts were coded to identify categories and patterns in the data. A focused discussion was employed as a member-checking method to ensure accuracy of study outcomes. Participants identified that self-reflection may serve to inform personal and professional practices during occupational therapy student clinical rotations. Although universally defined, student self-reflection occurred in countless ways and took many forms. Participants valued its function in expanded decision making, self-awareness, and competence in fieldwork and everyday occupations. These findings facilitate further research and the creation of new self-reflection educational methods or interventions designed to build or remediate self-reflective capacity of health sciences students during academic and clinical programming

Looking in the mirror for the first time after facial burns: a retrospective mixed methods study

Appearance-related concerns are common following burns. However, there is minimal research that has specifically investigated patients' reactions when they looked in the mirror for the first time following facial burns. The current study aimed to investigate patients' reactions and factors associated with distress. Burns patients (n=35) who had sustained facial injuries completed a questionnaire which examined their reactions when looking in the mirror for the first time. Data were collected between April and July 2013. Participants had sustained their burns 12 months prior to participating, on average (ranging from one to 24 months). Forty-seven percent (n=16) of patients were worried about looking for the first time, 55% (n=19) were concerned about what they would see, and 42% (n=14) held negative mental images about what their faces looked like before they looked. Twenty-seven percent (n=9) of patients initially avoided looking, 38% (n=13) tried to 'read' others' reactions to them to try to gauge what they looked like, and 73% (n=25) believed that it was important for them to look. Mean ratings suggested that patients found the experience moderately distressing. Patients most often found the experience less distressing compared to their expectations. Distress was related to feeling less prepared, more worried and increased negative mental images prior to looking. In conclusion, patients' reactions to looking in the mirror for the first time vary. Adequately preparing patients and investigating their expectations beforehand is crucial. The findings have a number of important implications for practice

Patient and service user engagement in research: a systematic review and synthesized framework

BackgroundThere is growing attention towards increasing patient and service user engagement (PSUE) in biomedical and health services research. Existing variations in language and design inhibit reporting and indexing, which are crucial to comparative effectiveness in determining best practices.ObjectiveThis paper utilizes a systematic review and environmental scan to derive an evidence‐based framework for PSUE.DesignA metanarrative systematic review and environmental scan/manual search using scientific databases and other search engines, along with feedback from a patient advisory group (PAG).Eligible sourcesEnglish‐language studies, commentaries, grey literature and other sources (including systematic and non‐systematic reviews) pertaining to patient and public involvement in biomedical and health services research.Data extractedStudy description (e.g. participant demographics, research setting) and design, if applicable; frameworks, conceptualizations or planning schemes for PSUE‐related endeavours; and methods for PSUE initiation and gathering patients'/service users' input or contributions.ResultsOverall, 202 sources were included and met eligibility criteria; 41 of these presented some framework or conceptualization of PSUE. Sources were synthesized into a two‐part framework for PSUE: (i) integral PSUE components include patient and service user initiation, reciprocal relationships, colearning and re‐assessment and feedback, (ii) sources describe PSUE at several research stages, within three larger phases: preparatory, execution and translational.Discussion and ConclusionsEfforts at developing a solid evidence base on PSUE are limited by the non‐standard and non‐empirical nature of much of the literature. Our proposed two‐part framework provides a standard structure and language for reporting and indexing to support comparative effectiveness and optimize PSUE.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/113737/1/hex12090.pd

A Study of the Amputee Experience of Viewing Self in the Mirror

PURPOSE: To describe the trajectory of viewing self in a mirror after an ampu-tation and participants’ perceptions of what health care professionals should know about mirrors. DESIGN: Hermeneutic phenomenology METHODS: Focus groups were conducted to collect the research data. FINDINGS: The mirror experience had three key moments: decision, seeing, and consent. The trajectory of viewing self in a mirror had four key themes: mirror shock, mirror anguish, recognizing self, and acceptance: a new normal. Participants’ recommendations for introducing the mirror after an amputation and using a mirror to avoid skin breakdown and infection, and correct gait and balance are described. CONCLUSIONS: This study provides a unique viewpoint into the world of those who have suffered amputation of a limb. CLINICAL RELEVANCE: Rehabilitation nurses and other health care professionals are encouraged through these participants to consider the effect and value of mirrors when caring for those who have had an amputation