Electronic Thesis and Dissertation Repository

Degree

Doctor of Philosophy

Program

Health and Rehabilitation Sciences

Abstract

Reflective practice is defined in this dissertation as a process of thinking 'about' and 'through' one's doings, such that practitioners become more skillful, and aware of the nature and impact of their performance within their professional practices. Because it is presumed to enable healthcare delivery practices that are more sensitive to patient needs and more in-line with evidence- based practices, RP is frequently noted as an essential attribute of competent clinical practice. Yet, little is known about the processes by which RP contributes to the professional learning of health-care practitioners in general, and Speech- Language Pathologists (SLPs) in particular.

This work is comprised of five manuscripts in addition to introductory, methodological and conclusion chapters. The first manuscript presents a case study that contributes to understanding of how Speech-Language Pathology (SLP) clinical experience may be processed through reflection to develop professional knowledge relevant to professional practice in the context of head and neck cancer rehabilitation. The second manuscript, a scoping review, maps the scholarship on reflection and reflective practice in the field of SLP. The third offers a discussion of theoretical underpinnings and key elements of RP and examines their applicability to SLP practice. The fourth manuscript investigates the relevance of RP for SLP, suggesting its potential to: (1) inform the generation of knowledge from practice, (2) balance and contextualize science with patient care, (3) facilitate the integration of theory and practice, (4) link evidence-based practice with clinical expertise, and finally, (5) cultivate ethical practice. The fifth manuscript details the grounded theory study, which examines the ways in which 12 SLPs working in head and neck cancer rehabilitation report using processes of reflection. These include: ongoing iterative questioning, experimenting through trial and error, integrating knowledge from past cases, embracing surprise, thinking out of the box, being in the moment, consulting with others, putting oneself in the patients’ shoes, and discerning ethical issues.

This thesis contributes to knowledge about how informal professional learning can be mediated by the use of RP. It also contributes to the emerging body of theoretical and empirical work on RP, with potential implications across a variety of health professions.

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