A creative alternative to reflective writing: promoting skills of reflection through walking a labyrinth

Background: Stage one of a grounded theory study exploring reflection by physiotherapists in the UK (Dalley-Hewer 2012) found that physiotherapists used walking and other activities outside work to reflect on their work events. However, participants considered ‘reflection’ to be a writing process rather than a thinking process and did not always recognise the thinking while walking and doing other activities as reflection. This may be due to the emphasis on writing strategies when developing reflective skills in undergraduate students. Labyrinths are ancient tools used for introspection, reflection, decreasing anxiety and decreasing stress. They are like a maze, with a single path which, when followed, leads to the centre and out again. In order to promote the introspection and critical self-awareness considered necessary for reflection a labyrinth was introduced to physiotherapy and other health profession students in the first few weeks of their programme. For this, a portable labyrinth painted on canvas and laid on the floor was used. Reflective writing and reflective models were introduced some weeks later. Purpose: The purpose of this educational audit was to evaluate the use of labyrinth walking on a canvas as a strategy to promote the skills necessary for reflection. Methods: An on-line questionnaire was used to seek students’ views on the labyrinth experience. This included a combination of multi-choice questions and open responses. Anecdotal evidence was also collected from studentś verbal and emailed feedback. 127 questionnaires were returned, from a cohort of 600 students. Results: 127 questionnaires were returned, of which, 58 students had walked the labyrinth. The other 69 students had either used a finger labyrinth, or had not walked the labyrinth. Many of the students who walked the labyrinth reported experiences which demonstrated the development of reflective ability (n = 33) Some students reported experiencing insights or inspiration (n = 21) and some students reported that it helped them to feel calmer (n = 40). Several students made plans to incorporate reflective space in their lives, for example, by going for a walk. Some of the personal accounts showed evidence of profound experiences and insights. Conclusion(s): The introduction of labyrinth walking was considered a useful tool for facilitating reflection and self-awareness. Creating space for students to reflect in was a valuable part of their experience. Placing the focus on thinking skills and self-awareness emphasised that reflection is a thinking skill and encouraged students to make space for thinking in their busy lives. Implications: Strategies other than writing can be used alongside written models of reflection to develop the ability of students to reflect on their practice and on their personal development. Developing the awareness in students that space for thinking in is helpful to learning may foster behaviour which supports reflection on practice. Future research might include the development of practical creative strategies for enhancing reflection for busy clinical staff.