Occupational Therapy CPD Reflection: Kolb

Concrete experience

I attended a one-day workshop on collaborative goal-setting in rehabilitation. The most challenging part was a recorded roleplay exercise: watching my own footage, I saw that I asked patients what mattered to them and then, within a minute or two, translated their answer into a clinician-shaped goal - measurable, timetabled, and noticeably different from what they had actually said. The facilitator called this 'goal laundering', and the phrase landed uncomfortably well.

Reflective observation

My discomfort watching that footage was informative. I had always considered patient-centred goal-setting a strength of mine, and the evidence showed a subtler reality: I invited the patient's priorities and then quietly overwrote them with my own professional framing. Reflecting on why, I think measurable goals feel safer - they audit well and progress is demonstrable - whereas goals in the patient's own language feel vague and harder to defend in documentation. I had been optimising for the record, not the person.

Abstract conceptualisation

The principle I took away is that the patient's own words are data, not raw material: a goal reworded is often a goal replaced. The course introduced a simple discipline - record the goal verbatim first, then negotiate the measurable steps beneath it - which preserves ownership while still giving the clinical structure I need. More broadly, I concluded that my sense of which parts of my practice are 'strengths' deserves periodic testing against evidence, because that is exactly where blind spots hide.

Active experimentation

Since the course I have restructured my initial sessions: the patient's goal is documented in their exact words at the top of the plan, with clinician-framed objectives nested underneath it. Across the first several patients, two things have been noticeable - conversations about progress refer back to the patient's own phrase, and one patient corrected my proposed objective because the verbatim goal made the mismatch visible, which is precisely the mechanism working. I have booked a follow-up peer observation with a colleague in three months to check whether the habit has survived contact with a full caseload, and I presented a short summary of the technique at our team's in-service session.