The Role of Reflection for Continuing Professional Development of In-Service Health Care Professionals: A Narrative Inquiry in Four Health Professions.

Introduction: Health care providers (HCPs) use reflection to intervene in complex, ambiguous clinical situations. Yet, there is scant evidence about the circumstances when HCPs use reflection and how they perceive reflection within their continuing professional development. We selected a narrative inquiry approach to study how HCPs perceive reflection's role in learning in four health professions.

Methods: We invited 26 health professionals to a narrative interview conducted by a student in one of the four selected professions: medicine, nursing, occupational therapy, and speech-language pathology. The narrative events that make up the stories were analyzed and interpreted using structural analysis based on the narratives' historic-empirical and psycho-semantic dimensions.

Results: Physicians told us that reflection bolsters their clinical performance and confidence. Nurses told us that reflection allowed them to develop resilience as they sought to integrate their work setting and gain autonomy. Occupational therapists spoke of how reflection spurred them to innovate and extend the scope of their practice to advocate for their patients' health better. Speech-language pathologists described how they reflect on "educating" other HCPs about their profession and enhancing their communication skills with patients.

Discussion: The communicative power of storytelling allowed us to fathom what is hard to describe in words: how reflection builds clinical and psychosocial skills and introspective capacity. Hence, findings provide empirical evidence of reflection's perceived role in maintaining professional skills that make HCPs effective in complex, ambiguous situations.