Fostering reflective practice: self-assessment abilities of physical therapy students and entry-level graduates.

Adopting the American Physical Therapy Association Clinical Performance Instrument, physical therapy (PT) interns are required to self-assess, hence the need for development of self-assessment abilities. The purpose of this research was threefold: (1) to develop an interview guide instrument to gather qualitative data, (2) to investigate the experience of self-assessment of PT students and new graduates, and (3) to identify training needs and propose a plan to incorporate self-assessment for PT lifelong learners. This study evaluated the self-assessment abilities of PT learners by investigating the following self-assessment components: (1) abilities and skills, (2) barriers and/or support, (3) training needs, and (4) essential elements for development. The sample consisted of 11 PT learners and internal and external evaluative committee members. Qualitative and evaluative methods were implemented to generate data addressing research questions related to ( 1 ) interview instrumentation; (2) self-assessment, with data gathering through semistructured interviews; and (3) evaluative examination of the plan to incorporate self-assessment. Data were analyzed for emerging codes and themes, synthesized, and recontextualized. Formative and summative evaluative committees validated the interview guide instrument and proposed plan for incorporation of self-assessment. Core themes emerged pertaining to specific aspects of self-assessment, including requirements, areas for improvement, motivational and promotion factors, and activities that facilitate self-assessment. Participants exhibited self-assessment abilities, encountering obstacles and support, important to health care professionals, educators, and clinical faculty. Training needs were identified for PT learners and for clinical and academic faculty. These findings parallel with Schon's concept of reflective practice and Bandura's social learning theory. The self-assessment plan includes practice improvement components viahle for health professions education. J Allied Health 2006; 35:30-42. AS LIFELONG LEARNERS, competence in self-assessment is an essential skill for all health care professionals. The American Physical Therapy Association (APTA) Standards of Practice1 call for self-assessment in "staff development plans with individual goal setting, and organizational needs in directing continuing education and learning activities."The APTA Guide for Professional Conduct states "A Physical Therapist shall engage in self-assessment, which is a lifelong professional responsibility for maintaining professional competence." Accreditation criteria state that students will be reflective practitioners with a dual ability to assess and reflect.2 The APTA developed the Clinical Performance Instrument3 to evaluate clinical interns, requiring self-assessment, in conjunction with clinical instructor evaluation; hence, it is germane to incorporate appropriate development of self-assessment skills for both students and graduates. When students are not helped to learn the skills of self-assessment, the learners' appraisal of knowledge and performance may be potentially misleading.4 Eva et al. report that as the "rapidity with which medical knowledge is generated, disseminated and amplified, an increasing emphasis has been placed on developing the necessary skills for lifelong learning; one such task is the ability to evaluate one's own deficiencies."5 Self-assessment is a method to help professionals better understand inherent learning needs to determine how to perform effectively, intertwined with reflective practice. Literature Review PHILOSOPHY Qualitative research involves multiple strategies of investigation, including, but not limited to, ethnography, phenomenology, and grounded theory. To investigate the lived experience of self-assessment, a philosophical and research approach of phenomenology was implemented. Phenomenology is classically referred to as the "study of appearances" and attributed to the logical positivist, Husserl, as the founder, with related writings in the 1930s. …