The role of critical reflection as a part of health professional clinical education has become an integral part in the literature and can serve as a guideline to understand the current complexity filled environment of health care practices (Delany & Watkin, 2008).
A critical reflection over the past year helped me to realize that it is necessary in order to analyze my practice with regards to physiotherapy. This in turn helps those engaging in critical reflection to learn from, and redevelop their practice in an ongoing way (Delany & Watkin, 2008). It is my opinion that it will motivate one to improve ones’ skills by ongoing research, attending workshops and courses in order to keep up with the latest developments to provide optimal care for patients. This also reflects in the South African Society of Physiotherapy (SASP) code of conduct specifically referring to: In terms of their commitment towards science and continuing professional education – 1. Participate in continuing professional development in order to improve the standard of care (South African Society of physiotherapy, 2012).
My persos act as a foundation for distinguishing between right and wrong. My parents, my teachers, religious leaders and individuals who earned my respect have played profound roles in the development of my core personal values. After the first two blog posts (where I was “forced” to reflect on my clinical experiences), reflecting weekly became sort of a habit, unintentionally. It helped me to compare certain situations within the clinical setting that I have faced and how I handled it. I would then think of ways to improve on my plan of action when faced with a certain dilemma.
My struggles and clinical challenges that I have faced over the past two years have contributed to my professional and ethical development. I have to mention that my main struggle was TRAVELLING. The uncertainty of how to reach my destination was a constant worry. I live far and I did not live on campus nor did I have my own transport. Each block I found myself living with different people and I was always dependent on someone having to fetch me after a block. I had to wait until someone was available and in this way I lost a lot time with regards to my work. Consequently, even the smallest amount of work was too much to handle. This in turn was challenging with regards to managing my time.
My actions make me who I am, so it is important that I honor the following commitments in all of my actions. I remember the first time reading through the code of conduct, I would see how much of its content was how I saw myself. If there was anything of the code of conduct that I did not practice, I would try to adhere to it.
A few years ago I came to the realization that I wanted to live by a single moral conviction: to help, not to harm. It is the basic definition of ‘kindness’ and is a simple ethic that underlies a whole range of moral convictions (for example do not lie, cheat, gossip, steal, etc.). Yet, there can arise dilemmas with the simplest of intentions. Clinical experiences I recently faced illustrate the point.
Referring to a previous incident that I blogged about earlier this year, it was a challenge for me to go back and face each day after what happened. It was a challenge to find courage to deal with the situation and bravery to go forth and stand up for what I believe in. When I was faced with a similar dilemma later in the year, I knew exactly how to go about the situation. As per the SASP code of conduct, rule 5: In terms of their commitment to maintain professional relations with colleagues, they should conduct themselves in a professional manner that is beyond reproach, and take any necessary steps to correct unethical behavior by colleagues(South African Society of physiotherapy, 2012); encouraged me not to change who I am for others, and to stand up for my beliefs even when they are unpopular .If I’m not confident in myself and respectful of what I believe in, I cannot expect others to exhibit confidence in me and respect my beliefs. In this regard I can confidently say that I have ethically grown.
What is a moral decision, or a compromise or personal integrity for that matter? We face these challenges daily when an action conflicts with our conviction of right and wrong. According to Goodstein (2000), compromise on important values may be necessary when we confront situations in our personal and professional lives. When principles conflict it is not always easy to decide which should dominate.
My GOLDEN RULE is that I will treat people as I want to be treated myself. Put simply, I will always be courteous and civil in my day-to-day dealings with people. Just because I am in a bad mood does not give me the right to take my frustrations out on the world. In fact, it is important that I try to brighten other peoples’ days and have a positive impact on everyone with whom I come into contact with.
I refer to another clinical experience, to demonstrate a typical dilemma that I had no experience on how to handle. After I blogged about it, I did some research and reflected on how to handle similar situations. With my last clinical block, I encountered a similar situation which was not as intense, but it did somehow make me feel very uncomfortable. I overheard students bad mouthing a patient that they treated together, not knowing this person’s life journey or their struggles. As I was more prepared to take on this situation, not only did I respectfully inform them of their disrespectful reproach, but I also shared my knowledge that I have gained in a previous clinical block. I also reminded them of the code of conduct they should adhere to.
On another point of view with regards to students, and according to Shapiro, Kasman and Shafer (2006) patient care was more effective by student physicians who made use of reflective writing. In 2006 Shapiro et al. found that “writing/reading/listening can help learners become comfortable with a reflective process that addresses loss of certainty, personal voice and others’ voice, multiple perspectives, emotion, vulnerability, mindfulness, and witnessing” (p. 242). These factors positively contribute to professional development, physician well-being and patient care.
Critical reflection helped me view my life as a gift and be grateful for it and my circumstances each and every day. God has given me the best possible family and life for which I could ever ask. I have been blessed with an extremely comfortable life, and I realize that this is not the norm. For this reason, I am thankful for what I have been given every day, and I try to use my privileges to improve my community through service.
My personal code of ethics will guide my resolution of ethical dilemmas. Since my code of conduct is based on values that have been ingrained in me by my parents and educational institutions, it should not be especially hard for me to follow. However, as I continue to grow personally and professionally, and as I encounter new ethical dilemmas that cannot be resolved according to my code, I will seek continuous improvement.
As I reflect on my professional and ethical development for 2016, I came to the conclusion that I will never be satisfied with anything less than my very best effort. I am committed to trying my best in all aspects of life, be it a work assignment or a personal relationship. To me, excellence is not about the results I achieve; instead, it is about the means by which I achieve them and my adherence to standards and rules that I have set for myself.
Since I am only a physiotherapy student, my work at times used to feel tedious and unimportant. Only when I began to think about where I fit into the interdisciplinary team, and how my daily tasks (by constructing the optimal treatment plan for my patients) fit in for my patients’ well-being, I then realized how important my contributions to my team are and having my patients best interest at heart. I was so surprised, but felt honored at the same time when a doctor asked my “go ahead” for a patient to go home for the weekend with regards to the safety of his mobility.
More importantly, by looking at the bigger picture, it became clear how important the communication and education was in this profession. It allows for a better understanding of conditions for patients. They also learn about ways in which to prevent, in possible cases, a condition from reoccurring. With this optimistic insight, I am certain that I have chosen the best profession and I am satisfied that I have the opportunity to make a difference in society. For that I am so grateful. I might not have known from the very beginning who or what i wanted to become one day, but one thing I was SURE about, is that I wanted to make a difference.
Delany, C. & Watkin, D. (2008). A study of critical reflection in health professional education: ‘learning where others are coming from’. Advances In Health Sciences Education, 14(3), 411-429. http://dx.doi.org/10.1007/s10459-008-9128-0
Goodstein, J. D. (2000). Moral Compromise and Personal Integrity: Exploring the Ethical Issues of Deciding Together in Organizations. Business Ethics Quarterly, 10(4), 805.
Shapiro, J., Kasman, D., & Shafer, A. (2006). Words and Wards: A Model of Reflective Writing and Its Uses in Medical Education. Journal Of Medical Humanities, 27(4), 231-244. http://dx.doi.org/10.1007/s10912-006-9020-y
South African Society of Physiotherapy (2012, July 3). Code of Conduct. Retrieved from https://www.saphysio.co.za/media/1115/policy-sasp-code-of-conduct-2012.pdf