56 Caring to Communicate

Speech and language therapists as reflective practitioners

The use of learning journals in continuing professional development

PRISCILLA REA University of Portsmouth, UK. SHEILA RYAN Cheltenham and Gloucester College of Higher Education, UK.

ABSTRACT Continuing professional development (CPD) is now an integral part of euery speech and language therapist‘s working life and an essential requirement for annual practitioner registration. Traditional taught courses can be a useful part of this process. However; research has shown that the development of a reflective practitioner approach (Schon, 1983), which enhances learning from taught courses, enables the skills and knowledge deueloped to be transferred to clinical practice in an eualuatiue manner rather than by rote. In addition, reflection forces practition- ers to eualuate their effectiueness in daily practice. The use of a ‘learning journal’ could assist speech and language therapists (SLTs) to reflect on and critically eualu- ate formal learning and their own clinical experiences. This approach includes the facility to prioritise releuant management information and the practitioner’s rec- ognition of the need to change. By use of a uariety of examples drawn from the fields of management self-deuelopment and education, the authors argue that the use of their learning journal model, deueloped for CPD, integrates indiuidual and organisational development to optimum effect (Attwood & Minett, in Burgoyne, Pedlar & Boydell, 1994) and should result in four main outcomes: (1) self-deuelop- ment; (2) objective setting in performance reuiew (Armstrong, 1994); (3) contribu- tions to clinical knowledge using an action researcWcase study-based methodology; (4) production of data ta inform providers and purchases of SLT seruices. The paper explains the way in which the structure of the learning journal leads to the above four outcomes, supported by findings from an inquiry into the use of this model in SLT seruices within both community and hospital NHS Trusts.

INTRODUCTION

Continuing professional development (CPD) is essential for practising speech and lan- guage therapists (SLTs). The Royal College of Speech and Language Therapists (RCSLT) has produced a discussion document (RCSLT, 1995) which will enable its practitioners to agree ‘a policy for the future’. This policy forms part of the movement towards a full

Professional Development and Research Issues 57

practice register. The RCSLT is one of the professional groups within the National Health Service (NHS) which requires its members to provide a record of CPD for annual registration. Its members work in organisations which include not only NHS Trusts but also independent charities and private practice. SLTs work autonomously, are frequently accountable to managers who are not qualified speech and language therapists and have limited access to funding for taught courses. Such practitioners need a method of capturing the process of planning, conducting and evaluating their CPD which fulfils the requirements of the professional body and is of use to the indi- vidual.

Research has shown that ‘learning journals’ are of value to the individual as a record of their continuous self-development (Pedlar, Burgoyne & Boydell, 1986). This paper describes action research undertaken with a sample of SLTs. A personal learning jour- nal (PLJ), designed to meet the CPD needs of individual SLTs and enable their CPD to contribute to their organisation was kept by the study participants. The results of this pilot study are presented and discussed by the authors and will be used to comment on the RCSLT’s discussion document (RCSLT, 1995).

Research into continuous development as an approach to the management of learning is presented in the case examples taken from a selection of organisations (Lathrope et al., in Wood, 1988). These studies were undertaken as part of the lnstitute of Person- nel Management’s 1984 campaign ‘A Boost for Continuous Development’. The need for organisations to develop ways in which individuals can learn from real experiences at work and throughout their working lives without being confined to useful but occa- sional injections of ‘training’ was fulfilled by the identification of the continuous devel- opment approach. However, when the employees of an organisation are also mem- bers of a profession, responsibility for human resource development becomes more complex. The continuous development of employees then becomes their CPD.

A number of stakeholders in CPD are identified by Clyne (1995). This work enabled the authors to identify the individual professional SLT as the key stakeholder in their pilot study. Clyne (1995) also includes managers in the ideally ‘shared partnership’ (p. 17) between the employer, the individual and the professional body. SLT managers provide access to formal learning through organisational resources and conduct formal reviews of work performance. They also provide personal support for individuals and negotiate time at work for recognised CPD activities. Their role in CPD was considered when designing the PLJ for the SLTs’ use.

The PLJ model was chosen after studying the use of ‘learning logs’ in the manage- ment of self-development (Greene & Gibbons, 199 1). The systematic reflection on experience which is then used to form ‘action plans’ for individual development ap- peared to offer more than learning logs which consisted of a record of attendance at training courses. Examples of these were found in the survey of professions conducted by the UK Inter-Professional Group (Madden & Michell, 1993). The RCSLT has pro- duced a model similar to those in the survey which is currently in use.

The authors considered that a PW would encourage the SLT to:

Reflect on practice. Evaluate learning from experience. Maximise learning opportunities. Plan further self-development.

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The development of a PLJ with sections designed to provide the SLT with a model for lifelong CPD has been the rationale for this research. The sections included areas for personal profiling, professional development and organisational objective setting for appraisal/performance review.

By use of a variety of examples drawn from management self-development and education, it is argued that use of the PW integrates individual and organisational development to optimum effect (Attwood & Minett, in Burgoyne, Pedlar & Boydell, 1994). Use of the PW leads to four main outcomes:

1. Self-development: professional and personal. 2. Development of objective setting for appraisal/performance review. 3. An action research/case study-based approach to develop reflective clinical prac-

4. The production of data to inform providers and purchasers of the cost effective- tice.

ness of SLT services.

METHOD

Two managers in NHS Hospital and Community Trusts were identified who were pre- pared to ask their SLTs to undertake this research. The staff groups included a range of full- and part-time employees; specialist and generalists; newly qualified and experi- enced SLTs. Six hospital staff and 10 community staff agreed to participate in the pilot study, which involved writing the PLJ for 3 months. The SLTs were introduced to the structure of the PW and the underlying theoretical concepts by the authors. Initially, the SLT managers supported their staff by allocating two 3-hour sessions at work for this purpose. The two groups were revisited after 3 weeks to clarify any issues concern- ing the PLJ framework. A final visit was made at the end of the 3-month period to conduct interviews and collect the P u s .

An ‘action research’ approach was taken to support the strong aspiration towards a greater degree of autonomy within professional practice, in order to counterbalance the managerial ideology and technocratic approaches which now tend to dominate professional areas. The process of empowerment is developed through the use of reflection on practice. Action research provides an alternative to scientific research by developing a practitioner-based approach. A ‘multi-methods’ approach was taken when collecting data in order to develop an objectivity-subjectivity focus (Elliott, 1992). As case studies are a considered and accepted way of publicly reporting action research it was decided to use sets of individual case studies (focusing on the use of the PLJ). These then became the link between the group and individual interviews held with the SLTs and their managers. The focus of both sets of interviews were related to the main research outcomes and use of the PLJ. Different interview strategies were used for the group and individual interviews. This approach allowed the researchers to use a struc- tured set of questions which could be added to or explained as required. Questions took an open form by asking for the views and opinions of the SLTs. Documentary evidence was gathered via analysis of the PUS, which was seen as being an ‘indirect’ rather than ‘direct’ technique of data collection (Robson, 1993). The identified conceptual frame- work was used as a means of structuring the sections of the PW (Figure 1).

Professional Development and Research Issues 59

Service Manager’s Views/

Requirements

Appraisal Objectives

System Effectiveness

and costs

Continuing Professional Development

The Reflective

Practitioner

SLT’s Needs/Goals

SLT’s Professional

and Personal

Development

Learning Journal

Framework

FIGURE 1:The identified conceptual framework used as a means of structuring the sections of the PW.

FINDINGS

As stated, the interviews were focused on a set of predetermined and grouped ques- tions, which referred back to the four main learning outcomes initially identified in the research.

In Section 1 of the structured interview the SLTs were asked what immediate benefits were gained from the use of the PW and what were the advantages and the disadvan- tages of using this approach. A high proportion (over 60%) stated that the PW had been useful in the identification of both strengths and weaknesses by clarifying what ‘areas of me as a person needed developing’ . Actually writing down and thinking about ‘objective setting’ had enabled them to develop their reflective approach to prac- tice. The structure of the journal helped in developing a process of immediate reflec- tion. One SLT found that looking more objectively at past and present areas enabled her to focus on what she was doing now. The ‘where am 1 going’ aspect started the process of thinking.

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Section 2 concerned objective setting in performance review. The responses to this varied considerably between the two sample groups. One organisation did not have a formal performance review system in place, whereas the other group met annually with their manager. Both groups felt, nonetheless, that the manager should support the use of a PW for performance review. The link in this instance to a personal analysis of strengths, weaknesses, opportunities and threats (SWOT) was constantly highlighted.

Section 3 asked about contributions to clinical knowledge. One SLT stated that:

... so much had been thrown at them concerning Audit that both the journal and in particular the action research /case study approach had helped the whole process.

She and three colleagues decided to use the PW as part of their Trust’s peer review process. The action research spiral (Carr & Kemmis, 1986) gave them a clear example of what could be done. The outline appeared to help in terms of ‘formalising‘ what the SLTs felt they already do. In fact, one commented that it was ‘a useful tool’ and ‘once you know the action research framework and haue worked through it - i t becomes easier’.

The clinical work which one therapist had carried out using the action research framework would, as she states:

... in the future always be now considered seriously in the treatment of motor speech problems.

Section 4 related to information generated about the resourcing of speech and language therapy services. Again, the two groups varied enormously in their responses due to the different organisational structures. One community SLT had used this aspect of the PLJ to put forward some quite radical ideas on timing and costing per case to her manager. One hospital SLT felt that this was the manager’s area of work and ‘not mine to pick up’.

Section 5 asked general questions about the format of the PW and its use in the development of skills in reflective practice. The following comments were made repeat- edly:

Too much repetition in the PW sections. There was a strength in developing a learning support group. If one was newly qualified it would be useful to have a PLJ with a structure like this. Time management was a difficulty in achieving completion of the PLJ. The reflective process was helpful and a new way of working.

One manager identified that the reflective approach of the PLJ and the use of this model developed ‘something concrete for a member of staff’. Examples of staff re- cruitment and selection were cited by both managers. They also saw the PW as being useful in preparing for their own appraisals. The general manager who has ‘little idea of what SLT seruices prouide’ could be given relevant information from the SLT man- ager’s PW as part of an appraisal interview. Both managers felt that they were better able to assess applications for training courses as part of a ‘staff development process’ and to monitor the transfer of formal learning to practice. This was essential when training budgets for resources were constantly reduced by the organisation.

Professional Development and Research Issues

SUMMARY OF FINDINGS

61

SLTs welcomed a way of recording CPD which allowed for planned personal and professional development. The PLJ sections were appropriate, but require minor revision to avoid repeti- tion. The PW allows core information, for example, a CV and job description, to be updated regularly. The structure of the PLJ was easy to follow and provided enough space for reflection on personal and professional development. The role of the SLT manager played a vital part in CPD.

CONCLUSION

Findings from the pilot study demonstrated a clear preference for a PW which SLTs would be able to use for CPD. This would enable all CPD activities to be recorded for individual and organisational use. There is a concern that the present personal log used by the profession for CPD focuses almost exclusively on continuing professional educa- tion (CPE). Access to advanced clinical courses and other formal learning, which con- stitutes most CPE learning for SLTs is restricted by budgetary constraints and being allowed time away from work. This showed the strength of the PLJ approach, which is sufficiently flexible to include all CPD activities throughout the professional career of the SLT.

The support of the SLT manager for CPD is vital. The manager is the link between the organisation, the individual SLT and the professional body. SLTs clearly needed their manager’s understanding of the CPD activities relevant to the development of current and future clinical practice and career progression.

The continued support of the research team was a crucial factor in enabling the SLTs to maintain commitment during the initial stages of implementation of the study.

SLTs felt empowered when using the PW. The use of this PW model gave them a strong sense of ownership and involvement in CPD as well as the development of reflective practitioner skills. All participants commented on the fact that time needed for CPD activities should become part of their work activities. The time spent in keeping the PW was highly valued by the SLTs and they recommended its continuation.

ACKNOWLEDGEMENT

The authors wish to thank Dr Mark NK Saunders. Faculty of Business and Social Studies, Cheltenham and Gloucester College of Higher Education for his help and advice during the initial stages of the research.

REFERENCES

Armstrong M (1994). Improving Organisational Effectiveness. London: Kogan Page. Burgoyne J, Pedler M, Boydell T (1994). Towards the Learning Company: Concepts and Practices. Maid- enhead: McGraw Hill. Carr W, Kemmis S (1986). Becoming Critical: Education, Knowledge and Action Research. London: Falmer. Clyne S (Ed.) (1995). Continuing Professional Deve1oprnent:Perspectiues on CPD Practice. London: Kogan Page. Greene M, Gibbons A (1991). Learning logs for self-development. Training and Development 9. Elliot J (1992). Action Research for Educational Change. Buckingham: Open University Press.

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Madden CA, Michell VA (1993). Survey: Professions, Standards and Competence. Bristol: University of Bristol. Pedler M, Burgoyne J, Boydell T (1994). A Manager’s Guide to Self-Development (third edition). Maidenhead: McGraw Hill. Royal College of Speech and Language Therapists (1995). Continuing Professional Development for Speech and Language Therapists: A Policy for the Future. Draft for Discussion. London: RCSLT. Schon DA (1983. The Reflective Pratitioner: How Professionals Think in Action. USA: Basic Books. Wood S (Ed.) (1988). Continuous Development: The Path to Improved Performance, London: Institute of Personnel Management.