Enhancing Critical Reflection of Students During a Clinical Internship Using the Self-S.O.A.P. Note

Background and Purpose: Critical reflection is a skill all physical therapists need to develop to be successful in professional practice. Scholars have defined the varied processes, purposes and outcomes of reflection. Journaling is one technique for encouraging the process of critical reflection. While journaling can take many forms, a structured journal format with clear instructions and ongoing feedback has been found to be most successful in maintaining student engagement. Method Description and Evaluation: A journal structured in a S.O.A.P. note format was implemented as a weekly assignment during a clinical education experience. Students were required to submit the weekly self-S.O.A.P. note to the academic coordinator of clinical education (ACCE). The ACCE provided students with occasional feedback on their notes to encourage further reflection. Perceptions of the benefits and pitfalls of the activity were gathered through means of a focus group interview. Outcomes: The four students in the focus group identified several benefits which can be grouped into four categories relating to the clarity of format, effect of feedback, support of summative evaluations and self-recognition of progress. Discussion and Conclusions: Self-S.O.A.P. notes provide a familiar structure to assist students in the process of critical reflection. Further research is needed to determine the level of reflection that is occurring, the effect of feedback on the students’ critical reflection, and if a relationship exists between high levels of critical reflection and high summative evaluation ratings.