How to Support the Real-World Use of Reflection as an Ongoing Learning Strategy by Speech Pathology Educators and Students

Reflection can be a valuable learning strategy for connecting theory with practice and illuminating new insights and understandings from complex or messy experiences. Speech pathology students, like student doctors, nurses, physiotherapists and many other health professionals, are expected to reflect on their practice as part of their formal education and ongoing learning. Reflective practice is encouraged during health sciences education as it can aid students and future professionals to identify their learning needs and influences, and develop plans to address outcomes for safe and effective care. The problem with this expectation is that it assumes students know how, why and when to reflect. It also assumes that educators have the capabilities and knowledge to support student development of reflective attributes to fulfil curriculum requirements and future professional learning. The thesis purpose of enhancing speech pathology student practice of reflection during their tertiary education through real-world inquiry lies in the author’s experience of this expectation as a clinical educator and the associated challenges in supporting speech pathology student reflection. In keeping with this real-world focus, this thesis explores the research context, philosophy, and then the research phenomenon of reflection as a foundation before detailing each investigation in the multiphase research program. The philosophical perspective of Deweyan pragmatism has been taken to view and understand the triggering problem (i.e., expectation) and the research purpose. This perspective recognises that reality is situationally held by individuals; it is constantly changing; and it can be shared amongst individuals depending on the similarity of their experiences. A multiphase, mixed- methods research program was undertaken, consistent with this perspective. In this research program, each phase used a bespoke ‘what works best’ methodology based on outcomes from the previous study to capture, analyse and interpret data. This progressive approach enabled the problem of enhancing speech pathology student reflection to be viewed from multiple perspectives, while maintaining a connection with the overarching purpose and the real-world experiences of outcomes. This design also enabled outcomes from the research program to contribute to real-world challenges in student reflection as they were developed and tested in the complex contexts in which speech pathologists, like other health professionals work. The first study of the multiphase research program used an exploratory typology within a systematised literature review method. The purpose was to understand the literature between 2005 and 2015 regarding the use of reflective teaching strategies and the role of contextual factors during clinical education. Knowledge gained from this study informed the development of three evidence-based propositions for testing in the second study through a convergent typology that used a single case study with embedded units method. This design enabled an understanding of the student perspective on reflection across two community- based clinical placements. Learnings from the second study on the student perspective identified the emergent phenomenon of ‘educators and their influence on student reflection’. This phenomenon was explored in the third study through an explanatory typology that used a descriptive qualitative analysis to capture the experiences of speech pathology educators from several typical workplace contexts across New South Wales. The fourth and final study of the research program gathered knowledge from the previous three studies to inform the development of a reflective intervention embedded in a speech pathology professional practice curriculum. This feasibility study used a differentially weighted convergent, mixed-methods (qualitative and quantitative) study design to test an evidence-based intervention supporting student reflection. Key interrelated findings from this thesis show tensions in the purpose of, and how reflection is used between speech pathology students and educators during clinical education. This tension involves the use of educator-centric rather than student-centric reflective teaching and learning strategies, which appear to influence where students are situated on a continuum of engagement with and practice of reflection. The interaction of these findings indicates that students of all reflection capabilities are more likely to practice reflecting if they engage with the reason for, and have opportunities to practice in a personally meaningful way. These findings can enhance the implementation of reflective practice supports or strategies in the real-world through flexible, student-centred reflection in a rich learning context. Recommendations and limitations for the translation of findings to speech pathology student education are discussed, including future research directions investigating the role reflection can have in developing agentic learners