From reflection to phronesis in 'good' physiotherapy practice.

ABSTRACT

BACKGROUND: Reflection is promoted in health professional education as a way to learn in and on practice. 'Being reflective' is considered important to 'good' and 'expert' physiotherapy practice, yet there is limited research on reflective practices of experienced physiotherapists. For Aristotle, a good person reasons and acts in ways to promote human flourishing. Physiotherapists' perspectives on the place of reflection in good practice has the potential to advance professional understandings of how it may be enacted. Such knowledge may inform health professions education, regulatory guidelines, professional practices, and patient interactions. PURPOSE: The purpose of this research was to examine experienced musculoskeletal (MSK) practitioners' perceptions of reflection in the practice of a 'good' physiotherapist. METHODS: A secondary analysis of data arising from a hermeneutic phenomenological study into physiotherapists' perceptions of the qualities and practices that constitutes a 'good' physiotherapist was undertaken. The secondary analysis focused on ways of 'being reflective', which emerged as a major theme in the original study. FINDINGS: Six themes were identified related to 'being reflective' in a 'good' physiotherapist 1) learning from experience; 2) integrating multiple perspectives; 3) navigating indeterminate zones; 4) developing embodied knowledge; 5) questioning assumptions; and 6) cultivating wisdom. CONCLUSIONS: Findings support the notion that 'good' physiotherapy involves a disposition toward making wise judgments through reflection. This practice-based knowledge can inform educational initiatives that nurture practices that foster attention to reflective processes that inform phronesis in professional life. Through reflexivity on what the profession takes for granted, physiotherapists may be better prepared when navigating the indeterminate zones of practice.