Abstract:

This research examined the role that peer-facilitated reflection (PFR) played in influencing the abilities of physical therapist assistant (PTA) students to cope with critical incidents in their academic and clinical coursework. Physical therapist assistants are expected to possess well-developed critical thinking abilities upon graduation that will guide them through professional practice. Several scholars contend that critical thinking abilities should be developed within the curriculum, and that they are best cultivated through reflective practice. However, traditional modes of curricular-based reflective practice have come under scrutiny, revealing shortcomings in their efficacy. These include: a theory-practice gap, unsuitable modes of reflection, ineffective facilitation, deficient models of assessment, and unrealistic time commitments. Consequently, a model of PFR was proposed as a more utile reflective approach to develop critical thinking amongst PTA students. An action-research investigation was carried out using Flanagan’s critical incident technique, which favors reflection and planning based upon an emotionally significant event. Five PTA students engaged in a peer-reflective discussion centered on individual accounts of critical incidents. Group members collectively reflected and developed action plans to put into practice. Data gleaned from post-discussion interviews was used to determine the effectiveness of the PFR approach, and was examined in light of the criticisms levied against reflective practice. Interview findings indicated that students viewed PFR positively, and that they felt the discussion helped them cope with challenges confronted in their academic program; thus impugning the assertion that reflection does not lead to practice changes. Participant feedback and observational analysis revealed challenges with facilitating reflective discussions, as discourse tended to wander. This highlighted the importance of facilitator presence. Deeper levels of reflection were not evident during the reflective discussion; however, post-discussion interviews impelled students to recognize how previous coping strategies had been ineffective toward problem solving, and how changes to their ways of thinking and doing had proved beneficial. Post-interview analysis revealed that reflective practice can be assessed, providing assessment looks solely at the efficacy of the reflective approach itself, and not at reflective ability. Time comparisons with more traditional reflective modes provided evidence that PFR offers a feasible, time-friendly alternative. Peer-facilitated reflection was also deemed to be more popular amongst students and faculty alike. Recommendations for future iterations of enquiry and implementation include: expansion of PFR into other disciplines, reflection on 'positive' critical incidents and non-programmatic topics, varied discussion facilitators, student-led discussions, and ad-hoc reflective groups. Study findings indicate that PFR is a viable alternative to more traditional modes of reflective practice, and that it can play an instrumental role in developing critical thinking abilities amongst PTA students. Generated knowledge claims are not confined solely to physical therapy academic departments, but possess trans-disciplinary value.

Keywords:

Reflective practice, peer-facilitated reflection, critical thinking, physical therapy, physical therapist assistant, action research.