Student conceptions of self-reflection and its relationship to occupational competence and clinical performance in level II fieldwork
Iliff, Susan Lowell
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This mixed-methods study investigated the relationship between self-reflection, occupational competence, and clinical performance in occupational therapy students in Level II Fieldwork. Occupational therapy student conceptions of self-reflection and its influences during fieldwork were also explored. Convenience sampling was used to recruit 24 participants. Quantitative data was collected via a demographic survey and self-assessment questionnaires measuring self-reflection, occupational competence, and clinical performance. Data were analyzed using multiple linear regression to determine whether self-reflection was a predictor of occupational competence and clinical performance. Twenty-one interviews were also conducted to elicit detailed data on their conceptions of self-reflection. Qualitative data were analyzed using a phenomenographic approach to discover collective findings of the “what” and “how” aspects of self-reflection. Quantitative results revealed a statistically significant relationship between self-reflection and occupational competence. As self-reflection scores increased, occupational competence scores increased (p = 0.0053). Conversely, self-reflection was not a predictor of clinical performance. Five main codes or categories emerged in the phenomenographic analysis of interviews focused on self-reflection: Definition, Example, Outcome, Importance, and Personal Use. Sub-codes further defined the main codes for Outcome (occupational competence—balanced or unbalanced and clinical performance—positive or negative), Importance (growth development), and Personal Use (how—internal or external, when, and where—alone, driving, exercise, or outside in nature). Findings showed that participants defined self-reflection similarly, and those, who were 20-30 years old, self-reflected the most. They felt self-reflection helped balance their well-being and maintain a healthy occupational competence. Participants also valued self-reflection and felt it contributed to their personal and professional growth and had a positive impact on their clinical performance, meaning it informed their decision-making and intervention planning with clients. Findings also showed that participants self-reflected in a variety of ways, times, and purposes. In conclusion, students consider self-reflection beneficial and a vehicle for strengthening performance skills and patterns in occupational therapy students who are preparing for Level II Fieldwork. Teaching a variety of routinely guided self-reflection methods in the classroom may better prepare students for a clinical setting. Providing clinical instructors with training and resources on self-reflection can foster healthy habits and increased clinical performance during fieldwork.