Hsieh HF. Archer-Kuhn B., Samson P., Damianakis T., Barrett B., Matin S., Ahern C. Transformative learning in field education: Students bridging the theory/practice gap. Newton and McKenna [23] argue that students are often not ready to understand the expertise and advanced treatments that take place in such specialist areas. and M.F. Choperena A., Oroviogoicoechea C., Zaragoza Salcedo A., Olza Moreno I., Jones D. Nursing narratives and reflective practice: A theoretical review. 2022 Mar;7 (3):e008007. Banning (2008) suggests that a 'think out loud' approach may be an excellent way to get student nurses to learn as they problem-solve a case study, just as they would in real life practice. Qualitative Research in Nursing: Advancing the Humanistic Imperative. Another subtheme that was prevalent as an internal driver for reflection on clinical experience revolves around the students strong desire to develop professionally into highly competent registered nurses. More focus on outpatient care has also led to fewer opportunities for studying the continuity of a patients life situation. Learn how your comment data is processed. The aim of this study was to explore students' experiences of structured learning activities using forms for unit-specific learning outcomes and targeted reflection during clinical placements in outpatient units. National Library of Medicine Reflective journal writing: how it promotes reflective thinking in clinical nursing education: a students' perspective. A new model of reflection for clinical practice. Overview First year student nurse, Emma Second year student nurse, Saima Third year student nurse, Darren The focus of this scenario is the learning that Darren, a third-year student nurse undertook whilst on a shift on ward A which is a surgical ward. Consequently, if Dewey once defined learning as a pathway that consists of a mixture of encounters and reflection, one should now define learning as a procedure that consists of a mixture of experience, reflective thinking on encounter, and application of the findings in other scenarios [24]. The researchers alternated conducting the interviews to avoid the potential of a moderators domination; Each interview took between 20- and 25-min. Coyne and Needham [12] show that a higher nurse-patient ratio allows more time for student supervision. 2013:17. What does the term reflection mean to you? volume15, Articlenumber:49 (2016) Nursing students satisfaction with supervision from preceptors and teachers during clinical practice. Purpose Statement This site needs JavaScript to work properly. Reflective practice in nursing: A concept analysis This analysis identifies the need for future nursing researchers to develop reflective models or strategies that promote reflection among nurses and nursing students before, during, and after the clinical experiences. Perceptions of student nurses on the writing of reflective journals as There was also lack of standardisation in how reflection outcomes were classified. The steps are Description, Feelings, Evaluation, Analysis, Conclusion and Action Plan (Gray, 2007). Research suggests nurses who are able to effectively reflect are better at developing strategies that promote a flexible, individualised and holistic approach to patient care; resolving problems through reasoning; and monitoring and enhancing their professional competence. 81 Report Document Comments Please sign inor registerto post comments. As a result, the investigators worked on the study for over three months. and transmitted securely. It also provides insight for those in smaller organisations addressing their particular challenges in identifying learning and development needs. For example, one of the students said, my patient is my responsibility even though I am still a student but I need to learn how to take responsibility for my actions with the patients so I need to reflect on my practices, skills and knowledge so that I can learn more and be read for more complex cases and provide the patient with their needs (S5). Time management in nursing. Reflection on clinical skills by nursing students during the clinical learning process is critical to the development of such student competencies [6]. Students may not feel adequately prepared for the multiple challenges, and it can be difficult to know how to approach this. Participants willingness to learn more and thus reflect on their experiences was certainly strong. The forms seemed to give the students more confidence as they had something meaningful to do between procedures. During the final 30min approximately, author2 left the room so that her presence did not hinder the informants from talking freely about their experiences. Google Scholar. 2015;14(1):110. When confronted with unfamiliar circumstances, learners started to ponder on clinical experiences and seek knowledge from various resources in order to minimize information gaps. The other main theme that was prevalent among the students who took part in this study related to the extrinsic drivers of reflection. PDF A Guide to Nursing Students' Written Reflections for Students and Educators They have also indicated that they do not want to be a kind of nurse that is just performing technical procedures. The questions in the form made me look away from all the equipment they have at the outpatient unit, they made me more focused on the patients and made me think more about how the patients were being informed.. Stewart, Raymet, Fatima and Gina are four students who share their learning journey throughout the chapters of the book. Nursing Reflective Essay: Examples + Useful Writing Tips [2023] This research received no external funding. One area that has continued to raise particular challenges in community nursing is maintaining the level of student learning capacity, supervision and assessment to the extent of pre-pandemic levels. California Privacy Statement, This study showed that the students think that reflecting on clinical training progress and development is facilitated by their desire to obtain practical knowledge, responsibility to patients, and students inclination to be influenced by their values. Federal government websites often end in .gov or .mil. Time expended, attitudes used, responsiveness to patients talk, analysis of logical path of discussion, and technical abilities are all part of this assessment. In: Sluttrapport S-Hi. The aim of the 17 included studies was to help students and supervisors to fulfil their jobs at the highest possible level, authors wrote. AKG, AGG and AKR designed the study. The students shared that the more the case challenged them, the further they felt that they need to reflect on how they performed and see what they would do differently, especially regarding carrying out related research. Data revealed the challenges of being a student in a highly technological world. Communication with patients is one of a nurse's most important tasks. statement and official website and that any information you provide is encrypted 2004;48(3):2918. Karanikolos M, Mladovsky P, Cylus J, Thomson S, Basu S, Stuckler D. Financial crisis, austerity, and health in Europe. Pre-registration nursing students enjoy a wealth of learning during community placements, develop invaluable knowledge and skills and gain exposure that may help them consider this dynamic field . Received 2022 Jun 20; Accepted 2022 Jul 25. 2003 Jan;23(1):11-8. doi: 10.1016/s0260-6917(02)00158-2. This problem arises in the face of complicated and unique situations that are difficult to resolve [30]. Three Approaches to Qualitative Content Analysis. First-semester students were excluded because they lacked clinical experience. Chambers D, Thiektter A, Chambers L. Preparing student nurses for contemporary practice: The case for discovery learning. The https:// ensures that you are connecting to the Methods: Semi-structured interviews were conducted among 21 Saudi nursing students at one major university in Saudi Arabia. Qual Health Res. Reflection Of My Placement | student nurse reflection examples PubMedGoogle Scholar. Students who had their week at the outpatient unit at the end of their clinical placement period perceived that they achieved better learning outcomes from their placements than the other students. Contreras et al. Some tools included specific questions for participants to reflect on, while others included open questions, or no questions. Lfmark A, Thorkildsen K, Rholm M-B, Natvig GK. Lawrence C., Mhlaba T., Stewart K.A., Moletsane R., Gaede B., Moshabela M. The hidden curricula of medical education: A scoping review. Reflection for professional development Nursing Essay Example It is a matter of fact that nursing students gradually advance from understanding the general aspects to the more complex areas of nursing [12, 22]. Lewallen LP, Debrew JK. Reflection as a Student Nurse on Placement University The University of Adelaide Course Nursing Science (NURSING 7200) 13 Documents Academic year:2013/2014 Uploaded byMwatu Wambua Helpful? In our study, the existence of a form to guide the students as to what aspects of nursing are important seems to have had a positive impact on their ability to acknowledge the patient. Reflection in medical education can be implemented in multitude of ways, depending on the restrictions of the coursework. The researchers were aware that inclusion of more informants might have provided additional data; it was however only these students who underwent this particular experience. An official website of the United States government. This study aims at exploring nursing students perspectives on the facilitators of reflective practices in the clinical setting. The study followed the principles of the Declaration of Helsinki and the Norwegian Social Science Data Services [27, 28]. Publishers Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Personal Reflection on Learning Outcomes of Professional Practice An outpatient unit is also quite specific in terms of offering students the possibility of observing and participating in a range of different skills. government site. Many teaching programs require students to keep a reflective journal, and the writings are frequently used for evaluation, thus highlighting the students weaknesses and encouraging students to improve [10]. Informed written consent was given by all informants. (2020) also discovered that self-reflection combined with clinical knowledge and expertise reduces anxiety, allowing nurses to build competence in real-world settings [6]. Two categories and 6 subcategories, describing students experiences of using forms for unit-specific learning outcomes and targeted reflection in outpatient units, were identified (Table 1). For instance, one of the students said, at many instances in my clinical rotation I feel that I lack deep knowledge about clinical decision making and expertise this pushes me to make the best out of each clinical encounter by stopping and thinking more about what has been done for this patient or that patient so that I can add that into my clinical experience (S18). The second-year students undergoing clinical placement were informed by two instructors in the upcoming program that a study would take place in the outpatient units and that some of them would be contacted and asked if they wanted to participate in the study. Another limitation was that despite students were from various levels of the nursing program they all used the same type of reflection practice, thus there was no insight into different types of reflection provided, and the accounts of the students in first and third year about the same level of reflection might have weakened the data. As per several pieces of research, reflection improves student-instructor interactions, bridges the theory-practice gap, deepens learning, and strengthens meta-cognitive abilities [11,12,13]. Manage cookies/Do not sell my data we use in the preference centre. Across EU member states, the Health at a glance Europe 2012 report asserts a decrease in hospital beds from 6.5 beds per 1000 population in 2000 to 5.3 in 2010. A high level of preparedness seemed to be close to a prerequisite in order for a student to perceive the week as successful. [7] claim that good co-operation between clinical staff and nurse educators is necessary for providing a good learning environment for nursing students. The transcriptions were placed in a sealed envelope, delivered to the translation professionals and were received back in a sealed envelope. What causes you to reflect on these scenarios? government site. This may agree with what Coyne and Needham [12] refer to as customizing learning needs. Findings also revealed that the forms guided the students attention from the technological devices towards the patients and their experiences, and also to the relationship between nurse and patient. (2021) has published results that corroborate our findings, where this study has explored qualitatively the perspectives of students on the use of reflective practice and has shown that students were driven towards reflection to enhance their knowledge and practice capabilities in order to become more competent nurses and develop professionally [22]. The evaluation of the programme showed that some outpatient units were unsuitable for providing sufficient relevant learning situations for nursing students [17]. Self-reflection looks inward and listens to the whispers. Barksby J., Butcher N., Whysall A. It is worth noting that there are seven steps to the Colaizzi techniques as described in Table 3: Since the interviews were conducted in Arabic, the transcriptions were sent to two official translators that are experts in the field where translation and back translation were carried out and then translations were sent to an external expert to check their authenticity. This sense has led students to reflect on their clinical experiences and knowledge as they want to be completely responsible for their patients and doing them good. A new paper, Reflection as a learning strategy for the training of nurses in clinical practice setting: a scoping review, delved into the tools and approaches used for reflection as a learning strategy for nurses and nursing students in clinical settings. J Nurs Educ Prac. California: Addison-Wesley Publishing Company Nursing Division Melno Park; 1984. The importance of skill development in nursing education is vital as it promotes self-awareness and develops best practice (Dolphin, 2013; Vaughan, . When students engage in reflective thinking, they are better able to analyze and evaluate their experiences, which enables them to extract meaning and actively process what they have learned . MeSH The trainer is responsible for creating such conditions [26]. Reflection is essential for students to learn and understand caring, their formation as human and caring beings, and their ability to meet patients in a caring way. 2012;3(01):2234. 2015;15(3):15561. More research is needed on the use of structured learning activities such as unit-specific learning outcomes and targeted reflections in special clinical placements such as outpatient units. document.getElementById( "ak_js_2" ).setAttribute( "value", ( new Date() ).getTime() ); Interventions, tools, approaches and the measurement of nurses reflection in clinical settings are highly varied, a new paper has found. Students stated that they found the forms helpful, since they made them use the extra time wisely in reflecting on the procedures they had been observing. However a rotation between an outpatient unit and a regular ward might be challenging, as a key influence on nursing students sense of belonging relates to the length and organization of the clinical placement [16]. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (, reflection, nursing students, qualitative, perspectives, clinical setting. The .gov means its official. The scoping review included 17 studies from around the world, conducted between 2007-2020 . (2019) who have also indicated the value of reflective practice among student nurses in enhancing their knowledge, skills, and intellectual abilities [21]. National Library of Medicine My week at the outpatient unit, was in my second week of clinicals. J Adv Nurs. student nurse reflection on learning and development An interview guide, with themes concerning the informants experiences with the forms unit-specific learning outcomes and targeted reflection in the outpatient unit, was used. Reflection on creating a coaching approach to student nurse clinical Clinical leadership in nursing students: A concept analysis Nurse Educ Pract. To gain a thorough grasp of the data, the researchers reviewed the transcripts and played each recording multiple times, extracting relevant data, coding repetitious data, and finally summarizing the data as themes, according to the Colaizzi method. This has led to a sustained investment in outpatient treatment facilities and ambulatory care [2]. Concept analyses should be conducted when concepts require further clarification, as is the case with NSCL. Compared to the regular ward which was perceived as more active, the outpatient placement was described as a relatively passive learning environment. Efforts were made to establish an audit trail throughout the entire study. Data revealed that the students preparedness when entering the outpatient unit impacted on how they described the week. Not only the details of the disease itself has motivated the participating students to reflect on their clinical practice but rather the patients themselves and their sociodemographic characteristics and interaction patterns have also played a key role in driving and facilitating students to reflect more on their performance. The Reflection, Feedback, and Restructuring Model for Role Development An external reviewer with experience in qualitative studies evaluated conformability. Comparison of convenience sampling and purposive sampling. Int J Nurs Stud. This paper has important evidence and implications for nurses, nursing educators, researchers, and regulatory bodies because reflection and reflective practice are so central to education, training, clinical practice, and registration standards and requirements both in Australia and around the world, Dr Peters said. Introduction and background. The encounter will be analysed and conclusions on the need for nursing professional conduct will be drawn. According to Anderson, Willman, Sjstrm-Sand and Berglin [11], the changes occurring in health care place nurses under stress and basic care is not secured. Consequently, to facilitate nurse students' development into professionals, learning support is needed where the focus is on understanding caring and becoming caring nurses. This theme had four main subthemes; Motivation to learn, Responsibility towards patients, Desire to develop, and Ethical Regard. Reflection and learning in student nurses - PubMed Lovell B. Words which were interpreted to capture key experiences of the informants were highlighted in the text and assigned preliminary codes [19]. The interview guide was used as a reminder to the researchers to ensure that the themes were covered. Reflection is a vital skill in contemporary nursing with student nurses expected to engage in reflective learning from the very beginning of the nurse educational programme. The most used reflection tools among the 17 studies were written cases, narrative, and diaries. One aim of the reforms in nurse education is to produce reflective practitioners. As researchers were granted access to a registry of university webmail, students were contacted by email. Methods The study has a qualitative explorative design. This conceptual model may be a useful tool to guide nurse educators in facilitating role development and the transition from the classroom to the clinical setting for the nursing student. The transcriptions were anonymized and coded where each participant was assigned pseudonym from S1 to S21. Our findings show that, when in an outpatient clinic, students have more time between patients. vol. The reforms have also required nursing education to consider different areas for clinical placements for their students, and outpatient units in hospitals have been increasingly formalized as clinical learning environments. 4. The key is not to cause harm but to help afterward. It is also suggested that further study be carried out on how to facilitate reflection in nursing education from the perspectives of instructors, physicians, and nursing professionals. (2018) on nursing staff, there was a link between reflection, intellectual growth, and career development; additionally, it was discovered that reflection improves mental wellbeing. Accessibility The site is secure. Data showed that the forms guided the students through their placements in the outpatient unit. I was part of a 60-hour long placement in the hospital and had . The members checking was used to compare the consistency of concepts obtained from data and respondents views. Only 4 (19.04%) were in the second semester of the third year. Terms and Conditions, Epub 2017 Apr 7. Allowing students to discuss their results while also reflecting on the reasons, encourages them to speak openly about their flaws, limitations, uncertainty, and confusion, rather than hiding their possible negligence. The Practice Assessment Document (PAD) provides a comprehensive record of professional development and performance in practice. The study has a qualitative explorative design. Because we found such variability across the studies we examined in terms of several factors, this shows that despite being fundamental to policy and practice, the research underpinning reflection is still limited by lack of consistency and comparability which should be addressed.. According to the results of the data analysis, a qualified trainer might help students in clinical practice with their reflection process. Another student has addressed the knowledge of the patient saying, one time I had a patient who has been chronically ill and also works in the healthcare fieldthat moment made me feel that I had to be very knowledgeable to be able to care for this patient as I cant have less information about the patient case than the patient themselves this had me doing a lot of research every time I handle a case (S14). Before Our findings indicate that, when given a form with questions to answer and settings to reflect upon, students take a more active approach to seeking knowledge. Perspectives of Nursing Students on Promoting Reflection in the This is consistent with Relji et al. The researchers had no prior relationship with the students; however, they were introduced upon receiving the email of participation through mutual colleagues and professors who taught the students. Learning through reflection: the critical role of reflection in work The data was analyzed using a standard qualitative content analysis technique. January 2008]. [The Nursing education curriculum 25. Purposeful reflection is a tool that helps nurses gain self-knowledge and insight (Palmer, 2007). Lancet. Holmsen TL: Hva pvirker sykepleierstudentenes trygghet og lring i klinisk praksis? Ultimately, the authors concluded that while reflection is a core component of nursing education and RN standards for practice, there is little agreement among the research community on how best to assess the measurement and quality of reflection. Reid, (1993) describes reflection as a process of reviewing an experience of practice in order to describe, analyse, evaluate and so inform learning about practice.
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