Self-reflection and its relationship to occupational competence and clinical performance in Level II fieldwork




Fletcher, Tina
Parham, Diane
Bowyer, Patricia
Tool, Gaylene
Iliff, Susan
Freysteinson, Wyona

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Nova Southeastern University


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's 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.


Article originally published in Internet Journal of Allied Health Sciences and Practice. English. Published Online 2021.


Clinical performance, Competence, Education, Fieldwork, Occupation, Self-reflection


This is the published version of an article that is available at Recommended citation: Iliff, S., Tool, G., Bowyer, P., Parham, L., Fletcher, T., & Freysteinson, W. (2021). Self-reflection and its relationship to occupational competence and clinical performance in Level II fieldwork. Internet Journal of Allied Health Sciences and Practice. This item has been deposited in with the author’s permission and in the absence of publisher policies.