Advancing Reflective Practice: An Evaluation of an Observed Practice Workshop for Occupational Therapists and Physiotherapists
Morley, Mary, Smith, Jane, Petty, Nicola, British Journal of Occupational Therapy
Introduction and overview
An action research study (Morley and Petty 2010) resulted in an observed practice programme to advance the reflective skills of occupational therapists and physiotherapists. The programme was developed in response to research that considered the clinical development of practitioners at different career stages. Morley (2007) reported that observed practice with a senior practitioner, within a preceptorship programme (College of Occupational Therapists 2009), increased the confidence and competence of new practitioners. Its value as a means to enhance the clinical expertise of United Kingdom physiotherapists undertaking a musculoskeletal practice-based MSc was also demonstrated (Petty 2009).
In this context, the term 'observed practice' refers to the direct observation of practice by a colleague, with the aim of enhancing skill and knowledge. Its value has been understood in education (Gosling 2002, Shortland 2004), including its use in occupational therapy higher education (Davys et al 2008). Despite evidence of its potential impact as a development strategy in clinical practice (Schon 1987, Titchen 2001, Eraut 2004), there appears to be no practical guidance on observed practice within occupational therapy or physiotherapy. This action research study was initiated to develop and evaluate a theory-based programme of observed practice.
The purpose of this study was to develop and evaluate a work-based observed practice programme for occupational therapists and physiotherapists of all levels of experience in collaboration with stakeholders within a mental health organisation. Action research offered a way to build positive engagement and empowerment of practitioners in order to create knowledge and improve practice (Robson 2000). This approach of insider research, in which the researcher conducts a study into his or her own work, drew on local practitioners' knowledge and enthusiasm to develop practice, individually and collectively (Coghlan and Brannick 2001).
The study has three phases:
* The development of the observed practice programme
* The implementation of the programme
* An evaluation of the programme to enhance its effectiveness.
The initial phase summarising the programme development and stages of the observed practice process has been published (Morley and Petty 2010). The process involves pairs of therapists taking on the roles of the observer and the observed. The pairs undertake a briefing stage and then carry out the observed session. Immediately afterwards, the person being observed reflects on the session and then both engage in a detailed debriefing one week after the session.
The present paper reports on the first part of the evaluation, looking at how the workshops to launch the observed practice process were perceived. A longitudinal evaluation on the observed practice programme and its impact on practice is being conducted by the lead researcher from a higher education institution. This will be reported as a third paper.
In August 2009, the local Ethics Committee considered the study to be a service evaluation and, as such, the study did not require ethical review by a National Health Service Research Ethics Committee or submission to the Research and Development Committee.
The study was overseen by a steering group, with membership of the director of therapies, the lead researcher and the development lead of the organisation. A working group with participants from both professions took on the role of coresearchers, drawingon their personal and practice expertise and knowledge. The power imbalance between the participants and the senior managers was the most significant ethical issue of this study. To redress this, the project goals and development of the programme were undertaken collaboratively. Occupational therapists and physiotherapists with different levels of experience working in different teams joined a working group. …