Reflectivity in supervised practice: conventional and transformative approaches to physiotherapy

Abstract

Abstract This article sets out to discover how learning could be enhanced in the physiotherapy training given on placements. The study describes the experiences of 32 physiotherapy students during their trainee periods and focuses on their views of the supervision provided and of its effects on their performance. The research data were collected from discussions conducted in six small groups over a period of 2.5 years. In order to refresh the participants’ memory, videotaped extracts from their training sessions were shown during the discussions. An ethnomethodological method was applied in both collecting and analysing the data. The results show that conventional instruction led to continued adherence to the model given. The transformative approach, in contrast, encouraged the students to learn through reflection as they observed and analysed physiotherapy sessions, discussed with their supervisor and worked on their written assignments. Moreover, reflective learning helped the students as they were given more responsibility for their own actions. When supervisors asked the students questions or did not immediately provide direct answers, students learned to analyse situations themselves as well as to look for information and to find solutions. These methods appear to be the ‘keys’ in transformative physiotherapy training in which four phases are cyclically repeated: the experience gained from therapy sessions; the reflection prompted by supervisor–student discussions; the planning which incorporates clinical reasoning; and the actual therapy sessions together with guidance. Based on these findings and on the empirical evidence, a model of supervision, which encourages reflective learning and transformative physiotherapy, has been outlined.