Constantly Thinking: Virtue in the Reflection of Practising Physiotherapists

  • Jayne Dalley-Hewer

Student thesis: Doctoral ThesisDoctor of Philosophy


Reflection is now a key component of physiotherapy undergraduate education and an expectation for professional practice although little is known about reflection as practised by qualified physiotherapists.

Aims of the study: The purpose of this research was to explore reflection as practised by physiotherapists. Initially, the interest was in exploring what benefits reflection might bring to physiotherapists’ practice; however, once the richness of physiotherapists’ reflection was experienced, the focus of the research shifted to the process and nature of their reflections.

Study design: The study took a pragmatic, qualitative, three-stage course through a grounded theory approach, where the research interest directed methods and analysis. Data collection used photo-elicitation interviews for stage one, audio diaries for stage two and for the stage of verification of the theory.

Analysis: The interpretive analysis used a coding process which included the ‘thinking strategies’ of asking questions of the data, writing memos and making comparisons. The theory was further developed with an evolved theoretical coding family.

Participants:15 physiotherapists took part over the three stages of the research; 13 were female and two were male. Their clinical backgrounds included neurology, cardio-respiratory, musculoskeletal, sports therapy and paediatrics; their places of work included NHS, private, acute hospital, and community settings.

Findings: Reflection was used by physiotherapists in order to fulfil a purpose in their practice. The purposes are summarised by the categories of Understanding, Seeking and Being Worthy. Each category had two sub-categories, giving six purposes of reflection: making sense of self, making sense of other, seeking a solution, questing for a novel clinical solution, practising worthily and demonstrating worthiness to others. The outcomes of reflection can be grouped into three types: changes in practice, changes in the practitioner and outcomes which did not create change but which had value to the practitioner, such as ease of mind. The purpose of demonstrating worthiness was the only form of reflection which regularly included writing and which had no direct benefit to practice. In addition, practitioners’ reflections were not bounded by their working hours: they typically reflected in hours of routinized, non-cognitively demanding activities such as walking, cycling, or showering. They also used reflective strategies such as reading and discussion with colleagues.

Conclusions: Practitioners used a rich practice of reflection in order to achieve Aristotle’s ‘good life’, which is to say they used reflection for their personal sense of fulfilment and professional satisfaction with their work.
Date of Award2017
Original languageEnglish
Awarding Institution
  • Coventry University
SupervisorDeanne Clouder (Supervisor), Mark Jones (Supervisor) & Mary Deane (Supervisor)

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