Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-23T15:58:05.108Z Has data issue: false hasContentIssue false

Radiation therapists’ perspectives of the role of reflection in clinical practice

Published online by Cambridge University Press:  15 September 2010

Angela Cashell*
Affiliation:
Radiation Medicine Program, Princess Margaret Hospital, Toronto, Ontario, Canada
*
Correspondence to: Angela Cashell, Room 2B 619, Princess Margaret Hospital, 610 University Avenue, Toronto, Ontario M5G 2M9, Canada. E-mail: [email protected]

Abstract

A recurring theme from the literature is that the definition of reflection is nebulous and/or complex. Many authors have suggested that more research needs to be conducted to better understand an individual’s perception of reflection and reflective practice, and how these concepts affect their clinical practice as well as their personal growth and development. This paper offers the findings of a qualitative study of radiation therapists in Canada. The aim of the study was to explore radiation therapist’s understanding of the concept of reflection, and to understand how they incorporated it into their daily practice. Secondary objectives were to examine some of the perceived barriers to its use, and the possible challenges of implementing reflective writing. Two focus groups were initially conducted, and a follow-up questionnaire was developed using the themes generated from the focus groups. The questionnaire was distributed to radiation therapists at two large cancer centres in Toronto, Canada. Most participants indicated that it is an integral part of their practice and professional lives, and that they use a variety of different methods for engaging in reflection. It is not without its barriers, but many of these can be overcome by providing time, coaching and a supportive work environment. Respondents were divided as to whether they would benefit from being taught reflection; however, small group teaching would be the favoured method. Further study is suggested to determine whether there are any improvements to patient care and in particular patient outcomes.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Reid, B. ‘But we’re doing it already!’ Exploring a response to the concept of reflective practice in order to improve its facilitation. Nurse Educ Today 1993; 13: 305309.CrossRefGoogle Scholar
2.Taylor, BJ. Reflective Practice: A Guide for Nurses and Midwives. Maidenhead: Open University Press, 2000.Google Scholar
3.Schon, DA. The Reflective Practitioner; How Professionals Think in Action. New York: Basic books, 1983.Google Scholar
4.United Kingdom Central Council for Nursing, Midwifery and Health Visiting. The PREP Handbook, 2001.Google Scholar
5.Guide to AIR continuing professional development. http://www.air.asn.au/files/uploads/0316_CPD_Guide1.pdf. Accessed on April 26th 2009.Google Scholar
6.Cooney, A. Reflection demystified: answering some common questions. Br J Nurs 1999; 8: 15301534.CrossRefGoogle ScholarPubMed
7.White, N. Reflective practice in radiotherapy radiography. Synergy. 2003; 7–9. Retrieved April 1, 2008, from ProQuest Nursing & Allied Health Source database.Google Scholar
8.Newnham, J. To reflect or not? Reflective practice in radiotherapy. J Radiother Pract 1999; 1: 109116.CrossRefGoogle Scholar
9.Carroll, M, Curtis, L, Higgins, A, Nicholl, H, Redmond, R, Timmins, F. Is there a place for reflective practice in the nursing curriculum? Nurs Educ Pract 2001; 2: 1320.CrossRefGoogle Scholar
10.Mackintosh, C. Reflection: a flawed strategy for the nursing profession. Nurs Educ Today 1998; 18: 553557.CrossRefGoogle ScholarPubMed
11.Jones, P. Hindsight bias in reflective practice: an empirical investigation. J Adv Nurs 1995; 21: 783788.CrossRefGoogle ScholarPubMed
12.Smith, A, Jack, K. Reflective practice: a meaningful task for students. Nurs Standard 2005; 19: 3337.CrossRefGoogle ScholarPubMed
13.Turley, C. Fostering reflective practice. Radiat Therapist 2009; 18: 6668.Google Scholar
14.Wilkinson, J. Implementing reflective practice. Nurs Standard 1999; 12: 3640.CrossRefGoogle Scholar
15.Li, W, Palmer, C. Investigating the effectiveness of reflective journaling for radiation therapy students. A student perspective. J Can Assoc Med Radiat Technol 2004; 35: 39.CrossRefGoogle Scholar
16.Wong, FKY. Assessing the level of student reflection from reflective journals. J Adv Nurs 1995; 22: 4857.CrossRefGoogle ScholarPubMed
17.Cirocco, M. How reflective practice improves nurses’ critical thinking ability. Gastroenterol Nurs 2007; 30: 405413.CrossRefGoogle ScholarPubMed
18.Nelson, S, Purkis, ME. Mandatory reflection: the Canadian reconstruction of the competent nurse. Nurs Inq 2004; 11: 247257.CrossRefGoogle Scholar
19.Burnard, P. Nurse educators’ perceptions of reflection and reflective practice; a report of a descriptive study. J Adv Nurs 1995; 21: 11671174.CrossRefGoogle ScholarPubMed
20.Ward, A, Gracey, J. Reflective practice in physiotherapy curricula: a survey of UK based professional practice coordinators. Med Teacher 2006; 28: 3239.CrossRefGoogle ScholarPubMed
21.Lowe, M, Rappolt, S, Jaglal, S, MacDonald, G. The role of reflection in implementing learning from continuing education into practice. J Cont Educ Health Prof 2007; 27: 143148.CrossRefGoogle ScholarPubMed
22.Roche, A, Coote, S. Focus group study of student physiotherapists’ perceptions of reflection. Med Educ 2008; 42: 10641070.CrossRefGoogle ScholarPubMed
23.Chapman, N, Dempsey, SE, Warren-Forward, HM. Workplace diaries promoting reflective practice in radiation therapy. Radiography 2009; 15: 166170.CrossRefGoogle Scholar
24.Hall, M, Davis, M. Reflections on radiography. Radiography 1999; 5: 165172.CrossRefGoogle Scholar
25.CMRTO Quality Assurance program. Cited April 20th 2009. Available from: www.cmrto.org.Google Scholar
26.Azer, SA. Use of portfolios by medical students: significance of critical thinking. Kaohsiung J Med Sci 2008; 24: 361366.CrossRefGoogle ScholarPubMed
27.Huston, P, Rowan, M. Qualitative studies. Their role in medical research. Can Fam Phys. 1998; 44: 24532458.Google ScholarPubMed
28.Mays, N, Pope, C. Qualitative research in healthcare: assessing quality in qualitative research. BMJ 2000; 320: 5052.CrossRefGoogle Scholar
29.Cohen, L, Manion, L, Morrison, K. Research Methods in Education, 5th edn. London: RoutledgeFarmer, 2003.Google Scholar
30.Erlandson, et al. Doing Naturalistic Inquiry: A guide to Methods. California: Sage publications, 1993.Google Scholar
31.Paget, T. Reflective practice and clinical outcomes: practitioners’ views on how reflective practice has influenced their clinical practice. J Clin Nurs 2001; 10: 204214.Google ScholarPubMed
32.Haddock, J, Bassett, C. Nurses perceptions of reflective practice. Nurs Standard 1997; 11: 3941.Google ScholarPubMed
33.O'Donovan, M. Reflecting during clinical placement—Discovering factors that influence pre-registration psychiatric nursing students. Nurs Educ Pract 2006; 6: 134140.CrossRefGoogle ScholarPubMed
34.Clarke, B, James, C, Kelly, J. Reflective practice: reviewing the issues and refocusing the debate. Int J Nurs Studies 1996; 33: 171180.CrossRefGoogle ScholarPubMed
35.Henwood, SM, Yielder, J, Flinton, D. Radiographer’s attitudes to mandatory CPD: a comparative study in the United Kingdom and New Zealand. Radiography 2004; 10: 251258.CrossRefGoogle Scholar
36.Boenink, AD, Oderwald, AK, De Jonge, P, van Tilburg, W, Smal, JA. Assessing student reflection in medical practice. The development of an observer-rated instrument: reliability, validity and initial experiences. Med Educ 2004; 38: 368377.CrossRefGoogle ScholarPubMed
37.Benner, P. From novice to expert: excellence and power in clinical nursing practice. Menlo Park: Addison-Wesley, 1984.CrossRefGoogle Scholar
38.Mamede, S, Schmidt, HG. The structure of reflective practice in medicine. Med Educ 2004; 38: 13021308.CrossRefGoogle ScholarPubMed
39.University of San Francisco. Cited April 20th, 2009. Available from: http://www.usfca.edu/osl/reflection.html.Google Scholar
40.Sobral, D. An appraisal of medical student’s reflection-in-learning. Med Educ 2000; 34: 182187.CrossRefGoogle Scholar
41.Newell, R. Anxiety, accuracy and reflection: the limits of professional development. J Adv Nurs 1992; 17: 13261333.CrossRefGoogle ScholarPubMed
42.Driessen, E, van Tartwijk, J, van der Vleuten, C, Wass, V. Portfolios in medical education: why do they meet with mixed success? A systematic review. Med Educ 2007; 41: 12241233.CrossRefGoogle ScholarPubMed
43.Dornan, T, Carroll, C, Parboosingh, J. An electronic learning portfolio for reflective continuing professional development. Med Educ 2002; 36: 767769.CrossRefGoogle ScholarPubMed
44.Williams, G, Lowes, L. Reflection: possible strategies to improve its use by qualified staff. Br J Nurs 2001; 10: 14821488.CrossRefGoogle ScholarPubMed