Interactive reflective dialogue to support learning on role-emerging placements: It’s all about sensemaking!
Authors:   , Venn Hayley 
Published: April 2022

Role-emerging fieldwork placements prepare occupational therapy students for a continually changing healthcare environment by providing unique learning opportunities and challenges. The demand for reflection and a deeper application of core occupational therapy theory to inform practice is heightened by the role-development and self-directed nature of these placements. Moreover, the off-site clinical supervision inherent in role-emerging placements presents the practice-problem of how to support students’ learning between weekly face-to-face supervision sessions. There is a paucity of research evidence to guide current methods of supporting learning on these placements, especially outside of clinical supervision sessions. This study considers and explores the practice of daily reflective dialogue between the student and off-site supervisor to support learning and reflection on role-emerging placements. Interpretive description methodology guided the inductive thematic analysis of the on-line daily dialogue between three students and their respective off-site supervisors, which was supported by a process of member checking through the DAViT questionnaire. The dialogue-as-data provided an in-depth and continuous window into the nature and process of learning on these school-based role-emerging placements. Sensemaking appeared central to learning through this interactive reflective dialogue and was seen to develop through the collaboration between student and supervisor. Themes fell into three categories of sensemaking corresponding to ‘theory-driven sensemaking,’ ‘developing sensemaking skills,’ and ‘personal and professional growth.’ Theory is required to justify and inform practice on role-emerging placements, the supervisors’ input within the interactive dialogue guided theory-driven sensemaking, assisting students to bridge the theory-practice gap and to develop an occupational therapy perspective. Interactive dialogue appears particularly useful to build conceptual knowledge, with the dialogue comprising a strong theoretical focus. Furthermore, interactive dialogue addresses procedural knowledge, a dimension of learning which is not usually possible to attend to on role-emerging placements. This tool therefore adds to the long-arm supervisors’ bow by enabling close mentoring and coaching of reflective inquiry along the occupational therapy process, and thus facilitating students’ reflective skills. Student agency, participation and intent ranged within the dialoguing; students who engaged more within the dialogue process and approached reflective dialogue to make meaning rather than document, tended to make sense of the placement and their role sooner and more comprehensively. The dialogue involved open and honest reflection which appeared to trigger deeper learning, and growth on a personal and professional level. Ultimately role-emerging placements provide the opportunity for learning which requires deeper deliberation and reflection, providing the press for personal and professional growth; while interactive dialogue supports this deeper reflective process and outcome, thereby facilitating successful sensemaking, which can involve transformational learning. The idea of sensemaking may assist students, supervisors, and educators in conceptualising and facilitating learning on these placements. Interactive dialogue appears to provide an effective learning tool during role-emerging placements, conducive to the constructivist and reflective learning requirements of role-emerging placements. Educators and supervisors are encouraged to use reflective dialogue to support learning and reflection on role-emerging placements: a useful means to overcome the constraints of off-site and infrequent clinical supervision.