#OTalk 12th December – Critical reflection

This weeks #Otalk is on the topic of “Critical reflection” and will be hosted by Stephanie Lancaster (@TheOutloudOT).

Stephanie has practiced as an OT for over 25 years. She is currently an assistant professor in the Department of Occupational Therapy at the University of Tennessee Health Science Center in Memphis, TN. Stephanie blogs at www.stephanielancaster.com and hosts a podcast for people interested in OT called On The Air (www.OnTheAir.us)

Years before I went back to school to get a Master’s degree in Leadership & Policy Studies, a colleague of mine told me that she had been asked by her faculty what her one big take-away had been.  Her response, she said, had been that it’s important to read the foreword in a book.  

In all honesty, I didn’t see the value in the behavior she recommended at the time of our conversation; it wasn’t until years later that I discovered the wisdom in her words.  Something else that exchange did for me, though, was to serve as a prompt during my own graduate studies, I identified my own big take-away: There is great value in the process of critical reflection.

Since I began teaching, I have been interested in how, when, and why they reflect in a critical fashion and how that impacts their learning. Over time, what I have noted is that there is great variability in the methods of instruction in and in the expectations and evaluation of critical reflection and to the reflective writing process that accompanies this. In fact, “the widespread espousal of reflection as a key to effective learning has meant that its meaning is assumed to be obvious to all” (James & Brookfield, 2014, p. 26); however, in the midst of the multitude of methods of delivery and expectations associated with this teaching and learning technique, only infrequently are students provided with structured and distinct instruction about the process of reflective writing (James, 2007).

I have heard students and practitioners ask what the difference is between reflection and critical reflection and want to address that question here:

Reflection is defined as looking back at something, and sometimes the phrase giving serious thought to is also added into the mix. Critical reflection occurs when we analyze and challenge the validity of our presumptions – or what we think we know – and then assess the appropriateness of our knowledge base, our understanding, and our beliefs, given our current context (Mezirow, 1990). It involves looking back and looking inward and then comparing that to another set of information or viewpoint, followed by actively reconciling, or making peace between, the two data sets. While the two terms are sometimes used interchangeably, critical reflection is a more involved process that is expected to have a more perceptible impact on one’s level of understanding (Brookfield, 1990).

Several months ago, I came across an article by Martin Hampton in the Department for Curriculum and Quality Enhancement at the University of Portsmouth (n.d.) that provides a detailed breakdown the components of a high-quality critical reflection.  In the article, reflective writing is defined as evidence of critically reflective thinking and, in the context of academics, described as having three components:

  • Looking back at something
  • Analyzing what occurred, including thinking from different perspectives or places of understanding
  • Determining and expressing what that means for you and your ongoing progress as a learner and/or practicing professional​

Please note that this is just one way to structure critically reflective writing; there are other ways, and you may be required or you may choose to follow a different model. Please remember, though, regardless of the format you choose, that there is great value in reflection … and that, like many other things in life, oftentimes what you get out of this process is directly related to what you put into it.

Questions to consider

Q1: What do you know about critical reflection?

Q2: How have you gained this understanding?

Q3: In what, if any, form of critical reflection do you currently engage?

Q4: How can OT students and practitioners improve their ability to critically reflect?

Q5: Provide an example of a professional development goal written to target critical reflection.

References
Brookfield, S. D. (1990). Using critical incidents to explore learners’ assumptions. In J. Mezirow (Ed.). Fostering Critical Reflection in Adulthood. Pp. 177-193. San Francisco: Jossey-Bass.

Hampton, M. (n.d.) Reflective writing: A basic introduction. University of Portsmouth:          Department for Curriculum and Quality Enhancement. Retrieved from http://www.port.ac.uk/ask
James, A., and Brookfield, S. D. (2014). Engaging Imagination: Helping Students Become Creative and Reflective Thinkers. San Francisco, CA: Jossey-Bass.
James, A. (2007). Reflection revisited: Perceptions of reflective practice in learning and teaching. Art, Design, & Communication in Higher Education, 5(3), 179-196.

 

Mezirow, J. (1990). How critical reflection triggers transformational learning. In J. Mezirow (Ed.). Fostering Critical Reflection in Adulthood. Pp. 1-20. San Francisco: Jossey-Bass.

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#OTalk Research – Tuesday 5th December – Staying the course – maintaining momentum in research

December’s #OTalk Research is exploring maintaining momentum in research. It is being led by Tilly Greenwell (@Tilly_OT) with Emma Hooper (@hooper_ek) on the @OTalk_ account.

 

Intro Blog:

A requirement of my MSc Pre-Reg Occupational Therapy course was to undertake a major project for which I chose to do a small-scale quantitative research project. This experience, although challenging, was also exhilarating and led to me catching the research bug. I loved discovering findings that were not in previous papers and being able to present my results at COT16 so the results could be taken into consideration in others’ practice.

As a recently qualified occupational therapist, beginning a journey into the world of research is a daunting experience. There are many paths that can be taken to start this journey and trying to navigate the options can be overwhelming to say the least; this is what led me to attend a Research Coaching Programme at Manchester Metropolitan University (MMU) for allied health professionals (including @hooper_ek) and MMU lecturers from clinical backgrounds.

At the first event we were guided to explore alternative perspectives with regards to our research and given strategies to reflect on our current approaches to our academic endeavours. At the follow up event three months later, we discussed the specific difficulties the attendees were experiencing. We explored how the group members have sustained their enthusiasm and kept on track with their research when they were going through a particularly tough time. As one of the least experienced members of the group I found the answers helpful and motivating.

The last 6 months have felt like an emotional rollercoaster ride. There have been amazing highs, including being accepted for publication by the American Journal of Occupational Therapy and being offered a place on to the Professional Doctorate programme at Teesside University. However, there have also been mighty lows, as I could not enrol on the Doctorate due to circumstances out of my control. Since then, I have been finding it particularly difficult to sustain my drive and enthusiasm for research and this has led to a feeling of lacking direction. Through attending the research coaching programme I realised that I am not alone in these experiences, and that it can be difficult to stay the course and maintain momentum in research.

I hope this topic will be informative for you as we learn from each other’s experiences; helping to guide progression, overcome barriers and maintain momentum in our research adventures.

Questions to consider:

  1. At what points in the research process have you struggled to maintain momentum?
  2. What do you think caused this to happen?
  3. What or who helped you to get back in to the swing of things?
  4. What did it feel like to get back into the swing of things?
  5. What advice would you give to someone who has got bogged down with their research?
  6. What recent small achievement can you celebrate?

I am looking forward to discussing this topic with you all, thank you in advance for sharing your thoughts.

POST CHAT

online transcript

The Numbers

1.467M Impressions
396 Tweets
37 Participants
317 Avg Tweets/Hour

#OTalk Participants


11Avg Tweets/Participant

#OTalk 28th November – Frailty, Cancer and the role of OT

 

This weeks #Otalk is on the topic of “Frailty, cancer and the role of OT” and will be hosted by Jeni Woods and Helen Bowker (@Jeni_Woods_OT and @Bowker_Helen).

Here is what they have to say…

The demographics of the UK are changing with more people living longer. There are over 11.8 million people aged 65 or over in the UK with this figure set to rise by approximately 40% over the next 17 years (Age UK 2017). One of the most significant shifts in the population is that more people are living beyond the age of 85 (ONS 2016, Age UK 2017).

An ageing population brings some major challenges for health and social care. The number of people living with longer term conditions and multi-comorbidities increases with age, all of which will impact on the individual’s engagement in occupational roles, ADLs and social participation (Macmillan 2012, Age UK 2017). Age UK (2017) state that by the time an individual reaches their late 80s, over one in three people have difficulty in manging five or more activities of daily living.

Macmillan (2012) reported that the UK had the worst survival rates in Europe for older people. Given that the UK is faced with an ageing population, who potentially are living with multiple comorbidities and long-term conditions, it is important to review how we support older patients through their cancer journey.

Handforth et al (2015) state that over half of older cancer patients have frailty or pre-frailty, which can have the following consequences: increased risk of mortality, post-operative complications and cancer treatment intolerances.

Frailty is commonly associated with ageing with the British Geriatric Society (2015) defining it as a distinctive health state related to the ageing process in which multiple body systems gradually lose their in-built reserves.”

Frailty can have a significant impact on an individual’s ability to engage in activities of daily living. Frail older people often have more frequent unplanned admissions and readmissions, longer hospital stays, higher mortality rates and are more likely to require social care support on discharge (Age UK 2017, Torpy et al 2006, Oliver et al 2014)

This reinforces the need for health and social care professionals to evaluate the way that they support older patients through their cancer journey, through effective assessments and MDT working to improve outcomes and quality of care.

Frailty has the potential to impact many patients across their disease pathway journey, not just cancer. It is important for occupational therapists to share best practices in their field, so that we can promote the role of occupational therapy in supporting the nations ageing population to maintain their independence in undertaking ADLS, participating in occupational roles and social engagement.

Some questions to consider…

  • How would you define frailty?
  • What assessments do you use for identifying frailty?
  • What outcomes do you use for older patients who are frail?
  • Which occupational therapy models do you use to guide your practice with working with older patients?
  • What can occupational therapists offer to supporting frail patients through their cancer journey?
  • What examples are there of effective MDT working in your area that could support frailty?
  • What training is available for occupational therapists for managing frailty?

References:

Post Chat

online transcript

The Numbers

987.924K Impressions
420 Tweets
44 Participants
336 Avg Tweets/Hour
10 Avg Tweets/Participant

#OTalk Participants

Data for #OTalk can be up to 15 minutes delayed

 

 

#OTalk 21st November – Occupational Therapy and the STOMP campaign.

This weeks #Otalk is on the topic of “STOMP” and will be hosted by The RCOT People with Learning Disabilities Specialist Section (@RCOT_PLD).

Here is what they had to say…

Choosing a topic has not been easy as we acknowledge there is a lot we can talk about. We asked our members at our annual conference which was hosted at RCOT HQ on 14th October 2017 what they would like to discuss. The decision was occupational therapy and STOMP campaign – Stopping over medication of people with a learning disability, autism or both.

On 14 July 2015, reports were published highlighting widespread inappropriate use of antipsychotics and other medicines used to treat mental illness in people with learning disabilities. Following these reports, NHS England led a ‘call to action’ which brought together representatives of professional and patients groups to make sure changes were made to these inappropriate practices. This led to a pledge to reduce over medication and the start of the STOMP project about stopping the over use of psychotropic medicines. The 3 year project runs until 2019 (NHS England).

It is estimated that every day about 35,000 people with learning disabilities or autism are prescribed psychotropic medicines when they do not have a diagnosed mental health condition, often to manage behaviour which is seen as challenging.

For more information go onto the NHS England website – https://www.england.nhs.uk/learning-disabilities/stomp/

During this #OTalk we would like to gain a better understanding of what occupational therapist think about STOMP and how can we impact the campaign?

The questions we will ask are:

  1. Do you feel confident in discussing medication issues with MDT
  2. Do occupational therapists have a role with reducing challenging behavior
  3. Can occupational therapists support clients to reduce medication?
  4. What practice skills do you use to reduce challenging behavour?

Post Chat

Online transcript

The Numbers

1.537MImpressions
543Tweets
62Participants
434Avg Tweets/Hour
9Avg Tweets/Participant

#OTalk Participants

Data for #OTalk can be up to 15 minutes delayed

 

 

Occupational Balance – Saying Goodbye to Valued Occupations

I’m sure the astute among you will notice that I, @kirstyes, haven’t had much involvement in #OTalk of late. New members may indeed wonder who I even am.

When I helped co-found #OTalk six years ago I was in a very different place in my life. I was lecturing in OT and OTalk was a way for me to keep in touch with lots of different aspects of Occupational Therapy and to look at engaging with Occupational Science too.

Tuesday nights were part of my routine and if I wasn’t hosting a chat I’d be taking part in it. It was an extension of my day job AND a leisure activity.

Now I’m back working part time in clinical practice in a specialist field and I started to find that #OTalk started feeling less like fun and more like work. Not in a bad way and the team and the community are awesome but I was finding my capacity for it had diminished.

I won’t bore you with the details but I’ve had my battles with depression and fatigue and I’ve had to consider where to spend my time and energy.

Those of you who have stuck with me through my absence will have spotted that what time that I don’t work I spend reading and doing booky things and may know I harbour an ambition to be a published fiction author. Well it is time for my previous valued occupation to step aside and to be replaced with writing and editing.

I’ve loved my time on the team and have been honoured to work with some fabulous people past and present. It has been great to see the student interns develop into competent practitioners and join the team as full members and I hope the team continues to take on new OT talent and support the OT community with their CPD.

I have asked the team if they are happy for me to still share a connection with #OTalk as Sponsor (I’ll continue paying for the ongoing techie side of things – I’ve also offered research proofreading skills). I’m off to do some CPD this weekend at the MS Trust Conference and in time maybe I’ll pop back to take part in the odd chat.

I hope some of you still consider staying with me on twitter. Especially if you like books, after all if I get one finished I’ll need some people to buy a copy 😜.

<<
ke Hogwarts – OTalk will always be there to welcome you home. We all belong to the Order of the Phoenix.

So, it is with some sadness and also much gratitude that I say goodbye to OTalk and welcome space for a new balance of occupations in my life.

How have you found saying goodbye to valued occupations that you have taken part in?

#OTalk 14th November – Maintaining stroke specialist services in the current commissioning environment.

This weeks #OTalk is on the topic of “Challenges of maintaining stroke specialist services in the current commissioning environment” and will be hosted by the RCOT Specialist Section Neurological Practice- Stroke forum (@OTstrokeSSNP).

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