title: Development of a model of holistic reflection to facilitate transformative learning and practice in midwifery
Creators: name: Bass, Janice C
Publisher: name: Griffith University
Year: 2022
Subjects: subject: reflection
subject: midwifery practice
subject: education tools
subject: Education Design Research (EDR)
subject: Bass Model
subject: pedagogy

description: Background Reflective capacity is an essential professional attribute that underpins the development of midwives as competent, autonomous, self-determined, life-long learners and critically reflective thinkers. Despite this requirement, little is known about how reflective capacity is developed, facilitated, or measured within midwifery education and practice. Aim The aim of this PhD (with publication) program of work was to develop a model of holistic reflection and education tools that facilitate transformative learning in midwifery practice. Methods A mixed-methods, education design research approach was used to develop educational resources to facilitate the development and measurement of holistic reflection within midwifery education and practice. Education Design Research (EDR) within the pragmatist paradigm provides a flexible approach to choosing the appropriate research method linked to the purpose of each phase of the study. Study 1. Conceptual framework and development of a model of holistic reflection This descriptive study involved the development of a conceptual framework and the Bass Model of Holistic Reflection (Bass Model). The unique combination of education and practice philosophy, transformative, emancipatory, and whole-person learning represents a novel design that incorporates reflection, critical reflection, and reflexivity within a holistic continuum of reflective practice to facilitate transformative learning. Study 2. Testing the Bass Model of Holistic Reflection This study was conducted in two parts and included: Study 2a. Developing reflective capacities in midwifery students: Enhancing learning through reflective writing. A pre-and post-intervention design was used to determine the efficacy of the Bass Model in supporting the development of reflective capacity through reflective writing. The introduction of the Bass Model made a significant improvement in the written reflections of students. Improved scores ranged between 14% to 57% with a mean improvement of 31.2%. Study 2b. Midwifery students' experiences and expectations of using a model of holistic reflection. The second part involved focus groups with students. Data were thematically analysed. The study revealed that the use of the Bass Model, combined with integrative and structured reflective activities, facilitated holistic reflection, and identified the factors that effectively facilitated the development of reflective capacity from a student perspective. Study 3. Exploring the needs and experiences of educators in facilitating the use of the Bass Model of Holistic Reflection. A survey was conducted to identify the professional development needs of educators in relation to the implementation of the Bass Model. Survey results informed the development of a workshop and reflective practice toolkit (the intervention). A focus group was conducted one month after the last workshop. This study revealed the importance of adequate preparation and ongoing support of educators, including specific skills required to facilitate students’ development of reflective capacity. Study 4. Development of a tool to measure holistic reflection in midwifery students and midwives. This tool was designed to assess the development of holistic reflection in midwifery students and midwives. The draft tool was developed using a staged approach and administered in a cross-sectional survey with 187 participants. Testing revealed the tool was reliable, stable, and valid, and assisted in measuring aspects of critical reflection, reflective practice, and reflexivity in midwifery students and midwives. Conclusion Overall, this PhD program of work made an important contribution to understanding reflective pedagogy, including the factors that facilitate development and assessment of holistic reflective practice. This adds to the body of knowledge regarding holistic reflection as a tool to promote transformative learning and practice.