Reflective processes of practitioners in head and neck cancer rehabilitation: a grounded theory study

Abstract

Purpose: This study systematically examined how experienced Speech-Language Pathologists (SLPs) use the processes of reflection to develop knowledge relevant for practice in the context of head and neck cancer (HNC) rehabilitation.

Method: In-depth, semi-structured interviews were conducted with 12 SLPs working in HNC rehabilitation in North America. Grounded theory methodology was adopted for data collection and analysis.

Result: The findings inform a preliminary reflective practice model that depicts the processes of reflection used by practitioners interviewed. Nine categories of reflective processes were identified by participant SLPs in terms of the processes of reflection: ongoing questioning, experimenting through trial and error, integrating knowledge from past cases, embracing surprise, thinking out of the box, being in the moment, consulting with colleagues, putting oneself in the patients’ shoes, and discerning ethical issues. These findings provide empirical evidence that supports Schön’s theory of reflective practice and contribute to knowledge about the ways in which SLPs use processes of reflection in the context of HNC rehabilitation.

Conclusion: The findings of this study have implications for how SLPs perceive and consider their role as knowledge-users and knowledge producers in their day-to-day clinical work, as well as for building capacity for reflective practice.

Keywords:

• Reflective practice; speech-language pathology
• head and neck cancer
• grounded theory
• professional learning
• professional practice knowledge

Acknowledgements

This work was done as part of the requirements of a doctoral degree under the supervision of Dr Kinsella and Dr Doyle at Western University (Canada). The first author (MEC) is currently affiliated with the Université du Québec à Trois-Rivières. The authors would like to extend appreciation to the SLP participants for their generosity and valuable insights in advancing understanding about reflection and reflective practice. Thanks are also extended to Dr Doreen Bartlett, Dr Marilyn Kertoy and Dr Allyson Dykstra for their input on this research and to Suneet Cheema and Julia Vasarevic, who provided research assistance. Many thanks to the Faculty of Health Sciences, the Health and Rehabilitation Sciences Program, the Health and Professional Education Field and the School of Communication Sciences and Disorders at Western University for their ongoing support of this work. Extended thanks to the Université du Québec à Trois-Rivières. This work was supported by Richard J. Schmeelk Canada Fellowship and Ontario Graduate Scholarship.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.