Journal writing to promote reflection by physical therapy students during clinical placements

The purposes of this qualitative study were to describe physical therapy students' perceptions of their learning during a clinical placement and to promote their reflective thinking. Fifty-six students kept journals and reflected on at least one learning event per week in their clinical placement. They were asked to describe each learning event, their reactions to it, and its value, and to discuss the new learning, and indicate how they may respond in the future. Each journal was read by two out of four educators who independently read, coded, and categorized the events, and evaluated the level of reflection. All four then worked together to group the categories into themes. Six major themes were identified: (1) process of making clinical decisions; (2) complexity and richness of interactions with patients; (3) effects of the practice environment on learning and patient care; (4) acquisition of clinical and administrative skills; (5) value of clinical experiences in validating and integrating previous learning; and (6) acknowledgment and evaluation of different learning methods. The majority of the students (42) demonstrated a new understanding as a result of their reflections. Journal writing demonstrated that the students recognized the value of their clinical experiences and that they were reflective practitioners.