Reflective learning is associated with looking back on experiences and understanding what actions could be taken in the future (Schon, 1983).
Atwal & Jones, (2009) states that ‘reflective practice is a fundamental component of continuing professional development and is required by all regulatory bodies, in order to revalidate registration’; erasing complacency within healthcare. Reflection enables health professionals to share knowledge with others, to make sense of challenging situations (Chapman et al, 2009). Gibbs' reflective cycle (1988) encourages a description of the situation, analysis of feelings, evaluation, and analysis to make sense of the experience; however, this reflection will focus on free-form reflection (The University of Edinburgh 2018). as I found it more productive to think freely in regards to learning British sign language (BSL). I find some reflective models to be quite restrictive in regards to fully expressing the event or experience; such as Johns (1995) or Schon (1983); therefore whilst my original note-taking in my action plan followed a reflective model, I chose to not to follow one for my reflection. Hand, (1995) explains that reflection enhances personal development by leading to self-awareness; which ultimately leads to empowerment. The reflection will cover the identification of my own occupational identity, occupational performance, and what influences my own culture, morals, values, and ethics. The term professionalism will be examined; and how I define it personally. According to Christiansen and Townsend (2004) occupational science was established in the 1980s with the goal of ‘understanding and exploring the nature and meaning of occupation; and the correlations to health and wellbeing’. Key themes of occupational science that I will cover in this reflection are ‘Doing, Being, Becoming and Belonging’ (Wilcock 2006), ‘Occupational performance’, ‘Occupational flow’ ‘Professionalism and professional behavior’, ‘Culture, Ethics, values and morals’, and ‘Occupational identity’. BSL has been at the forefront of my mind since meeting my friend Abigail; whose son is deaf due to cytomegalovirus during pregnancy. He has a cochlear implant and uses sign language to communicate. Within my healthcare background, I have used Makaton and semiotics surrounding Dementia care; however, I feel sign language is a different concept and requires focus and time to learn; this is why I chose BSL for my occupational learning experience (OLE). By dedicating 4 hours a week to my OLE, I have been able to learn a new skill that will benefit my future occupational performance and identity. In order to link the occupational science concepts to my occupational learning experience; objectives were used to distinguish focus.
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Occupational performance is defined as ‘the result of a dynamic, interwoven relationship between person, environment and occupational over a person’s life span’ (Law et al 1996).
Within my research, I encountered facts about Wolverhampton having a strong and supportive Deaf community; which is progressive at changing the environment to ensure the needs of others were being met; making me question my own identity. ‘The “representation of the self” is the classical way of describing identity’ (McIlroy and Storbeck 2011). Before my OLE, I assumed the occupations of my identity as a mother and a student, were in balance within the PEO model (Kielhofner 2004); enabling enhanced occupational performance. I became aware that my occupational performance in learning sign language was diminished due to my environment; and needed adapting. I established a formal study space and utilized a timetable. I became aware of my own body language, and gestures. Hand movements are vital in communication as well as pronouncing words correctly in order for clear lip reading translation. Lieu et al (2007) state ‘individuals who are effective in lip reading, are able to understand around 30-45% of spoken English’.
‘The sense of belonging is a human need’ (Hall, 2019). Belonging to a group, or culture in society enables individuals to see value in their lives and gives a sense of direction. According to the National Registers of Communication Professionals working with Deaf and Deafblind People, there are only 908 registered sign language interpreters (Signature, 2015). Improving my own communication and increasing my occupational identity, has enabled me to belong to the sign language and Deaf community combined. Recently on Strictly come dancing, the presenters have been using sign language whilst on television, in order to promote and teach simple sign language to viewers; which I thought was a wonderful act of consideration and respect for the Deaf community.
My self-actualization in regard to my culture was realized halfway through my OLE. I no longer deemed my own culture to be primarily focused on being a mother, and a student. I found myself being drawn to the sign language culture when I realized I could simply finger-sign the alphabet. Through research, I learned that the term ‘Deaf culture’ is relatively new, in terms of definition for the UK Deaf community. The culture surrounding the grammar of the term ‘Deaf’ is dependent on the individual’s identity or perception of their self. ‘Deaf’ refers to an individual who identifies with and is an active participant in the culture and language (Berke, 2019). However ‘the term ‘deaf’ refers to someone with hearing loss but does not consider themselves participants in the deaf community’ (Inclusion London, 2019). I feel this classification will impact my future practice as the simple pronunciation surrounding the word ‘Deaf’ could be deemed as a risk factor for patients and professionals; this is due to preconceptions that support may be in place, or recommendations may be given without truly understanding ones’ occupational culture.
I have always thought of myself to have quite traditional values and morals in regard to my work ethic and my home life. I feel that my values and morals within my current and professional role can be adjusted, in accordance with my professional standing with the Royal College of Occupational Therapists code of conduct; to promote equality and diversity (College of Occupational Therapists 2015). Lesch et al (2019: 237-244.) state the importance of health professionals knowing basic BSL, in order to reduce cultural incompetence among health providers. Research into ethics surrounding the Deaf community identified the question of bypassing a child's consent in order to fit cochlear implants; based on the parent’s wishes and perceived perception of being Deaf. ‘The Deaf culture identifies this dilemma as an attempt to change the infant’s birthright cultural group’ (Hladek, 2009).
According to Hitch et al (2014: 231- 246) the term ‘doing’ is central to human life; and ‘serves as a socializing agent, and verifying one's efficacy as a competent contributing member of one’s society’ (Fidler and Fidler 1978: 305-310). The classification of ‘doing’ stems from the purpose occupations serve; whether that be self-care, contribution to community, family and culture, or leisure. The act of learning sign language was met with enthusiasm and willingness; however, it became apparent fairly quickly that Makaton and finger signing are very different concepts. Instead, I focused entirely on learning the finger-signing alphabet; understanding it would be the basis of my new form of communication.
The most effective form of learning for me was to meet with my close friend Abigail, who has over 7 years of knowledge of sign language and is a level 2 qualified interpreter. With her, I honed my signing skills and understanding. ‘Doing’ the actions, I became aware of occupational flow (Csikszentmihalyi, 1990); a need to ‘do more’ and fully engrossed in learning.
‘There is a strong correlation between becoming and the growth or development of an individual in order for fulfillment’; which involves competency and socialization (Kielhofner 2004). The identification of why I wanted to be able to use sign language was made clear after conversations with Abigail surrounding her communication with health professionals. Professionalism can be defined in a multitude of ways. ‘It is deemed that professional behavior is a form of etiquette in the workplace that is linked primarily to respectful and courteous conduct’ (Fuller n.d.). Differences between being professional, and professional behavior can impact building relationships between health professionals and patients. Due to having previous healthcare experience; I feel I have been able to adapt and improve my professional behavior to extend to being an active listener. Legislation, policies, and procedures are important in healthcare in order to ensure professionals follow standards of care; which are fundamental guidelines that maintain the integrity of the industry. The Royal College of Occupational Therapists and Health and care professionals council state that occupational therapists are to maintain the code of ethics and standards of proficiency, in order to validate and practice effectively (College of Occupational Therapists 2011)
The correlation between occupational science concepts and my OLE has enhanced my occupational being. Adapting my identity as a mother and student into a professional being; gave me a sense of belonging to the occupational therapy and sign language culture. Being a true advocate for person-centered care; I feel that BSL will enhance my occupational performance by being able to prevent miscommunication within the deaf culture in my practice; further enhancing my professional behavior. I feel that Abigail and her son are my purposive view of motivation; highlighting why learning BSL has become a meaningful occupation for me.
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