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Does Reflective Practice Work? : Developing an Empirical Evidence Base of the Efficacy of Reflective Practice for Improving Applied Service Delivery Across Contexts
Within the sport, exercise and health science domains researchers and practitioners interested in understanding factors and processes associated with competent and effective practice have steadfastly advocated the value and contribution of reflective practice. In spite of this, there remains a lack of empirical evidence to support these contentions, which has potentially stifled the acceptance of reflective practice throughout the applied practice community. To address this limitation, this thesis provided an in-depth examination of reflective practice for enhancing the effectiveness of allied health practitioners' service delivery and development of a therapeutic alliance with support seeking clients. Utilising a mixed methods approach that incorporated both qualitative and quantitative methods of inquiry, the thesis comprised three separate studies that collectively aimed to: (a) examine the journey of allied health practitioners towards aligning their theoretical orientations and applied practice; (b) develop an empirical evidence base to support the purported benefits of reflective practice noted within the wider literature; (c) examine the developmental nature of reflective skills as an outcome of reflective practice; (d) determine the relationship between reflective skills and practitioner effectiveness measures; and (e) investigate whether engaging clients receiving support-services with reflective practice has a positive impact on their health endeavours. To gain a greater depth of knowledge and understanding of reflective practice and its associated skills, the author's personal journey as an applied practitioner was explored during Study 1. Specifically, the contribution of reflective practice for facilitating his professional philosophy and aligning techniques and interventions with personal values and beliefs were illuminated. The insight gained from this formative study provided the foundation for the construction of subsequent reflective practice interventions in Study 2 and Study 3. Study 2 utilised a crossover design to support the effectiveness of a reflective practice intervention for developing reflective skills (i.e., processes) that facilitated positive changes (i.e., outcomes) to the service delivery characteristics of applied allied health practitioners working with Emirati National Service recruits. Follow-up social validation interviews indicated that reflective practice led to improved self-awareness and an enhanced ability to consider alternative approaches to service delivery that were cognisant to clients' needs. An emerging theme from Study 1 and Study 2 was the potential for reflective practice principles to be incorporated into service delivery programmes that engaged clients in the process. As a result, in Study 3, a reflective practice intervention was developed and delivered by participants from Study 2 to health support seeking clients (e.g., National Service recruits). Findings indicated that developing reflective skills (i.e., processes) of clients has the potential to improve the ability to self-regulate health related behaviours leading to a positive impact on overall health status (i.e., outcomes). Further, the empirical evidence generated and the adoption of reflective practice into existing health-support programmes should enhance professionals within the allied health community's confidence regarding the value of reflective practice for bringing about meaningful changes to both their own applied practice endeavours and their clients' circumstances. Therefore, the findings of this thesis have the potential to direct future developments to training and education programmes aimed at applied health practitioners, with the intention of supporting pathways towards being competent and effective service providers.