IDENTIFICATION OF THE LEARNING OUTCOME FROM REFLECTIVE JOURNAL WRITING WITH PHYSIOTHERAPY STUDENTS

PURPOSE: On the basis of educational development and evidence based teaching the purpose was to impart to the construction of a framework concerning initiation and outcome evaluation of reflective learning processes. RELEVANCE: The establishment of a Danish Clearing House for Educational Research involves debate on the use and sense of evidence thinking in education. This project was looking for evidence based outcome from reflective journal writing. The outcome was understood as acquirement of: 1) physiotherapy competences aiming for aspects of humanistic practice accentuated in the Danish rehabilitation area. 2) An ability for reflective thinking as a generic competence in connection to ideas of knowledge society and late modern thinking. PARTICIPANTS: 21 physiotherapy students (13 female, 8 male) participated in their 5th term, during their second clinical course. All students had attended the same modules previous to the intervention. METHODS: Quasi-experimental, randomized, single blinded, control group design with pre- and posttest. The class was randomly split in two groups, going to attend comparable 8 week clinical courses. Prior to the course both groups followed teaching lessons concerning humanistic practice. In the pre-test they were presented to a written case and questions relating to practice. Written answers were returned to the lecturer. In the intervention group reflective activities were initiated by guided reflective questions. These were formulated on the basis of Mezirow’s taxonomy of reflective thinking (Mezirow; 1998), and on an analysis of constituting competences for humanistic practice. After the course both groups attended the post-test. Answers from the tests were presented to 4 blinded judges, all experienced academic lecturers, provided with rating formulas sensitive to categories of competence for physiotherapy practice and levels of reflective thinking. Rating was based on consensus between judges. ANALYSIS: Fisher Exact Test was used for nominal scale categories of competence in physiotherapy practice. Mann-Whitney Rank Sum Test was used for ordinal scale levels of reflective generic competences. RESULTS: • Re categories of competence for physiotherapy practice: Intervention group had higher score than control group in post test (p < 0.005). No difference between pre- and post test within the intervention group (p > 0.2). • Re levels of reflective competence: No difference between groups in post test (p > 0.2). No difference between pre- and post test within the intervention group (p > 0.5). CONCLUSIONS: Results show very little impact from reflective journal writing on students’ reflective competence. In categories of competence the groups were equal at pre test/baseline (p > 0.2), but signs of increasing competence in post test are due to decreasing score in control group. Re levels of reflective competence groups were unequal at pre test/baseline (p < 0.05). Further research is needed to explore the coherence between reflective learning processes and the construction of experimental design to measure and identify learning outcome. IMPLICATIONS: The experiment will be repeated in the light of results from qualitative analysis of reflective journals and interviews with students and judges. The adjustments are expected to concern the reflective questions, rating scale sensitivity and student motivation. The construction of this framework is seen as an ongoing process in the development of skilled designing of reflective learning courses. KEYWORDS: Reflection, journal writing, experimental design. FUNDING ACKNOWLEDGEMENTS: University College cvuvita, School for Physiotherapy, 7500 Holstebro, Denmark. University of Aarhus, Research Unit for Multidimensional Learning, 8000 Aarhus C, Denmark. CONTACT: [email protected]