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]. and M.F; writingoriginal draft preparation, Y.A. Hgskolen i stfold, Sykehuset stfold; 2011. Readers are introduced to the process of critical and reflective thinking and the translation of these into coursework that will help them to achieve better grades in nursing courses. Even if clinical placements in outpatient units face several challenges, they also have the potential to offer students positive experiences. Milko / iStock. 8600 Rockville Pike An assessment form for clinical nursing education: A Delphi study. As this was their first encounter with an outpatient clinic and such procedures, using the forms and preparing ahead enabled students to be more alert to new experiences. The scoping review included 17 studies from around the world, conducted between 2007-2020 . Efforts were made to establish an audit trail throughout the entire study. The foundation of learning through experiencing is reflection, which involves the combination of both knowledge and practice. This is consistent with findings in Lewallen and DeBrews studies [13, 21]. The resulting reflection, feedback, and restructuring model describes an inductive, iterative process strongly influenced by feedback. Reflection is a formal process that can help nurses and nursing students develop crucial skills and competencies when undertaking training in clinical practice settings. 2023 BioMed Central Ltd unless otherwise stated. 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. Assistance with this reflection is often found in student handbooks, as part of induction days, by allowing access to past students' successful reflective work and through stated sessions containing learning theories and styles, meta-cognition, self-analysis of strengths and weaknesses and the writing of personal statements (Helyer and Price . Generally, students may scrutinize their behaviors and activities within the experiential context in which they engage through reflection, therefore, resolving the inconsistencies in their performance [5]. Preparedness and guidance during placement were imperative for making the week in the outpatient unit meaningful. Nilsen SR. Nr samhandling kreves : et helsevesen i endring krever ny kompetanse. The outcomes of the study can be used to develop a clinical education program that bridges the gap between theory and practice. Students who did not use the forms, expressed less alertness. Another student also indicated, I aspire to be an international level nurse a nurse that can practice in any type of challenging and complex setting a nurse that can be part of the leadership team; therefore, to be that, I need to always reflect on my performance to prove myself to be more competent than before and work on my areas of weakness (S20). Cite this article. The methodology used in this research is predicated on Colaizzis phenomenological framework, which uses respondents viewpoints and observations to explain the phenomenon in question, culminating in the recognition of common attributes within the sample group rather than personal qualities [15]. One of the most important aspects in the clinical practice reflection process was students willingness to learn more about clinical care. Halden: Hgskolen i stfold; 2013. Before Reflection in medical education can be implemented in multitude of ways, depending on the restrictions of the coursework. Licensee MDPI, Basel, Switzerland. The students reported uncertainty concerning proper use of time. Bookshelf The students expressed their urge to enhance their critical thinking, decision making and practical skills so that they evolve into highly competitive nurses in the labor market. Therefore, the researchers who established contact with the students had no influence on them or the participation process and deciding against it, did not affect their assessments. Another student also had a similar experience, one time I was assigned to care for a child who had a very serious condition it made me think a lot about the importance of each step of care I was giving I have never seen such a case at such a small age when I went back home and had to prepare a care plan assignment about her case, I found myself thinking a lot about everything we did for her (S10). 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. 2009;26(2):816. Nursing in the Australian Healthcare System (NUR1101) Introduction to Psychology II (PSYU1102) Software Testing (ITECH7409) Civil Procedure and Arbitration (200813) Newest Vector Calculus (MAST20009) Fraud and Cybercrime (3026ccj) Foundations of Property Law (LAWS12065) Foundations of Nursing Practice 2 (NURS11154) Corporations Law (LAWS13009) and transmitted securely. Artioli G., Deiana L., De Vincenzo F., Raucci M., Amaducci G., Bassi M.C., Di Leo S., Hayter M., Ghirotto L. Health profes-sionals and students experiences of reflective writing in learning: A qualitative meta-synthesis. The authors want to acknowledge the efforts of the research assistant who helped in the data collection and publishing of this paper as well as the participants who were involved in the study. 2003 Jan;23(1):11-8. doi: 10.1016/s0260-6917(02)00158-2. Our results are also in line with Choperena et al. However the findings also revealed opportunities for making the placement a positive experience for the students. Compassionate care: Student nurses' learning through reflection and the use of story. If I did not have those forms to help me reflect, I would never have understood what I was actually doing or was a part of., The fact that you are being guided towards what you are supposed to look for and stuff, I really liked it.. 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. Self-reflection looks inward and listens to the whispers. 1 - Recognise the importance of reflective practice and understand the process of reflection This outcome relates to the NMC Proficiency of 'Demonstrate the responsibility for one's own learning through the development of a Record of Achievement of practice and recognise when further learning is required'. Mayring P: Qualitative Content Analysis. HHS Vulnerability Disclosure, Help PubMed Kindly elaborate on one of your clinical encounters that has prompted you to ponder and reflect more? Reflection has been more prominent in educational facilities over the past years, and it is now recognized as a component in gaining competency. 15 Best Reflective Essay Topics: Nursing. Students were chosen starting from the second semester because nursing students must complete around 39 credits in the clinical area, which commence in the second semester, and they are regularly confronted with a variety of challenging situations from the outset of their training program, that might drive reflection. The forms seemed to give the students more confidence as they had something meaningful to do between procedures. The mean age of the students was 21.65 1.27 years (Table 1). The importance of preparing students for their clinical practice, including an ability to integrate theory into a clinical setting and to secure time for reflection, to promote learning and confidence, has been highlighted in several studies [1214]. [Adapting to the future specialist healthcare. 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). Students attempt to obtain information that may be applied in a variety of clinical contexts by reflecting on clinical training [23]. 2013;3(9):106. The study followed the principles of the Declaration of Helsinki and the Norwegian Social Science Data Services [27, 28]. In: Valle R.S., King M., editors. 2012;3(01):2234. Choperena A., Oroviogoicoechea C., Zaragoza Salcedo A., Olza Moreno I., Jones D. Nursing narratives and reflective practice: A theoretical review. 47 to the Storting (20082009) [https://www.regjeringen.no/en/dokumenter/report.no.-47-to-the-storting-2008-2009/id567201/], Rammeplan for sykepleierutdanning : fastsatt 25. januar 2008 av Kunnskapsdepartementet. This study shows that it could be hard for students to leave the ward with which they have barely had time to familiarize themselves, and readjust to a new field. [How does the curriculum in the Norwegian nurses' education system contribute to an academic professional competence?]. Taking responsibility for ones own learning is an important part of being prepared [13] and being prepared for clinical placement is an attribute that can separate the successful students from the unsuccessful ones. In this reflective essay, I am going to reflect on what I have learned from nursing course. When having used the given tools, data indicated that students felt a higher ability to focus on their upcoming practice. For instance, one of the students said my work as a nurse is guided not only by professional ethics but also by moral and cultural values too, which makes me in need to always relate my practice and performance to, so that I can be sure that I am doing the right thing I mean I would want to be treated in a dignified manner if I was ever in the place of the patient (S1). 81 Report Document Comments Please sign inor registerto post comments. Motivational parameters were reported by the students to be key in promoting their reflection on clinical skills on an individual basis. Nursing students in this study have identified both personal and external drivers to practice reflection. Informal reflection has many benefits but can result in superficial learning. An interesting finding was that, although both written and oral information was given by the nurse educators, some of the students were almost unaware of being part of a project, of the concepts being used and how to use and to fill out the forms. What do we know about coaching in medical education? The sections of the interviews that dealt with the participants encounters with the reflection-facilitators were selected. Although there have been many changes in the health care sector and in the education of nurses, caring is still the essence of nursing and has been described as an intricate interplay in the care context [11]. In spite of limited numbers of informants in one of the focus group, rich data was provided. Reflective writing in undergraduate clinical nursing education: A literature review. 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. DeBrew JK, Lewallen LP. Time expended, attitudes used, responsiveness to patients talk, analysis of logical path of discussion, and technical abilities are all part of this assessment. The evaluation of the programme showed that some outpatient units were unsuitable for providing sufficient relevant learning situations for nursing students [17]. and M.F. A similar experience was also shared by another student, I mean with clinical training you get to detect where exactly is your knowledge and skills are lacking and this should make you feel that you need to fill these gaps this can only be done by reflecting on where did you go wrong or where you could have done better or thinking about which aspects of patient care you still do not know much about this motivation to learn more about patients and clinical care makes me want to reflect every piece of new knowledge on my practices (S21). ; data curation, Y.A., B.A., L.B. Understanding the factors considered by faculty in the clinical evaluation of nursing students. which reflection model/frame should be used? (2020) also discovered that self-reflection combined with clinical knowledge and expertise reduces anxiety, allowing nurses to build competence in real-world settings [6]. As author2 was also a nurse educator for the informants, author1, who was unknown to the informants, was in charge of the interviews. 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. Article Box 700, NO, 1757, Halden, Norway, Ann Karin Helgesen&Anne Grethe Gregersen, Nursing Department, stfold Trust Hospital, P.O. In addition, Artioli et al. The forms were designed with the aim of enhancing reflection, consciousness and recognition of basic nursing skills in order to yield a better learning experience from placements in outpatient units. The majority of the respondents indicated they reflected on clinical encounters from a specific position, such as a lack of information or a necessity they were unaware of at the moment. Background: Reflection increases meta-cognitive capacities, promotes student-instructor relationships, overcomes the theory-practice gap, and enriches learning. What levels of reflection are identified or achieved: low (descriptive), middle (application), or high (evaluative)? This has led to a sustained investment in outpatient treatment facilities and ambulatory care [2]. Reflection and learning in student nurses One aim of the reforms in nurse education is to produce reflective practitioners. and M.F. [Influences on nursing studensconfidence and learning in clinical practice]. This will require high quality, standardised, and reproducible research that includes comparable interventions, outcome measures, and study conditions.. The informants have given consent to publish. What does the term reflection mean to you? government site. A previous collaboration project between stfold University College (Hi) and stfold Trust Hospital (S) in Norway aimed to try out a rotation programme between traditional wards and outpatient units. Anney V.N. Nursing students are placed in clinical facilities to correlate classroom learning with real life situations to learn nursing skills and to socialise students into professional behaviours and practice (SANC, 2005).Nursing students are being prepared to become future competent registered nurses who are not only clinically competent but personally and . National Library of Medicine 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). Given these conditions, HI teamed up with S in 2014 for a new project. 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. It also provides insight for those in smaller organisations addressing their particular challenges in identifying learning and development needs. Immediately after the interviews, notes were made by author1 to capture the setting and reflections in respect of the informants emotional responses. The .gov means its official. In this study, students stated that novel situations during the training session give a framework for reflection. To pass or to fail? 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. Before Practice Assessment Document (ePAD) system information for School of Nursing students, practice assessors, practice supervisors and academic assessors ePAD is for Nursing students. The researchers alternated conducting the interviews to avoid the potential of a moderators domination; Each interview took between 20- and 25-min. statement and Lfmark A, Thorell-Ekstrand I. Curationis. The informants were verbally informed and given written information stating the purpose of the study, that the data would be handled confidentially, and that they had the right to withdraw at any time without any consequences for them. Chambers D, Thiektter A, Chambers L. Preparing student nurses for contemporary practice: The case for discovery learning. Clipboard, Search History, and several other advanced features are temporarily unavailable. Some students highlighted information failure and a lack of communication of expectations as reasons for not understanding what to do. Instead of just observing, the forms helped the students take a more vigorous approach in seeking knowledge. The researcher teaches in a diploma programme and decided to see if there was any evidence that students, one year into a Common Foundation Programme, were developing reflective skills or if they were learning through Medical trainers must encourage reflection by assessing students reflective work and identifying educational obstacles in medical curricula while utilizing handwritten or web-based portfolios. the contents by NLM or the National Institutes of Health. Reflection as a learning tool in graduate medical education: A systematic review. (Gibbs 1988). Reflective writing is the purposeful and recursive contemplation of thoughts, feelings, and happenings that pertain to significant practice experiences (Kennison, 2012). Ahmed M.H. Dr Micah DJ Peters, Director of the National Policy Research Unit from the ANMF Federal Office and author of the paper said training and developing competences based on reflection in an evidence-based practice has to be tested and validated. Data showed that the forms guided the students through their placements in the outpatient unit. From reflective learning to reflective practice: Assessing transfer. 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. Many of the respondents wished to improve their own expertise in order to give better treatment. Concept analyses should be conducted when concepts require further clarification, as is the case with NSCL. The importance of skill development in nursing education is vital as it promotes self-awareness and develops best practice (Dolphin, 2013; Vaughan, . Andersson EK, Willman A, Sjstrm-Strand A, Borglin G. Registered nurses descriptions of caring: a phenomenographic interview study. McLeod G.A., Vaughan B., Carey I., Shannon T., Winn E. Pre-professional reflective practice: Strategies, perspectives and experiences. There are many reflective models . The interviews without any biographical details of the informants were transcribed verbatim by a secretary and delivered to the three authors. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. and M.F; investigation, F.A., M.S.I. Which circumstance led you to reflect more? Ensuring the quality of the findings of qualitative research: Looking at trustworthiness criteria. The researchers protracted engagement with the data and good communication with the respondents have developed the credibility of the findings. Forum: Qualitative Social Research 2000, 1(2). Data revealed the challenges of being a student in a highly technological world. The current study was undertaken to explore the nursing students perspectives on the facilitators of reflective practices in the clinical setting. Faculty of Health and Social studies, stfold University College, P.O. Communication with patients is one of a nurse's most important tasks. The essay will give an in-depth analysis of the episode when I joined the community placement by the university. Privacy The time scheduled for the interviews was changed shortly before they were due to take place and two students failed to notice the change. The literature suggests that developing a professional identity and an aspiration to learn are influenced by the length of the clinical practice [16]. This assignment is a critical analysis and reflection of my continuing personal and professional development (CPPD) needs in practice. Many scholars think that providing a sufficient degree of complicated and demanding scenarios as part of a students learning process promotes the formation of reflection and cognitive and metacognitive abilities [28]. Students take a more active approach to seeking knowledge when given structured learing activities during clinical placement in outpatient unit. The category being guided which incorporated the subcategories from uncertainty to more confidence, from observer to seeking knowledge and from focusing on technology to seeing the person showed that the forms guided the students through the placement in the outpatient unit. Nine students were asked to participate in the study, but only seven ultimately participated in the interviews. This method entails a critical examination of prior experiences in order to induce change in behavior and improve personal and professional capabilities in the future [4]. Overview First year student nurse, Emma Second year student nurse, Saima Third year student nurse, Darren This scenario focuses on the learning that Saima undertook while on a shift during her third week of a ten-week practice learning experience on Ward A which is a surgical ward. 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. The Practice Assessment Document (PAD) provides a comprehensive record of professional development and performance in practice. 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. Thereafter the interviews were read word by word. For example, one of the students shared, one time I had a patient who is 19 years old this made me put myself in their shoes and pay attention to more details regarding the case and the management as his case was truly critical and I was thinking I can be in his place at any moment in life this make me think a lot about my work and the value of careI felt I want to read more about it afterwards and I did (S2). What tools and approaches are used for reflection (both to facilitate/teach/instruct reflection and to measure the outcomes of reflection) in nursing education by nursing trainees and educators in clinical settings? Ruffinelli A., de la Hoz S., lvarez C. Practicum tutorials in initial teacher training: Conditions, strategies, and effects of reflective practice. For the purposes of this analysis, the term 'Nursing Student Clinical Leadership' (NSCL) will be used to describe clinical leadership in nursing students. Some tools included specific questions for participants to reflect on, while others included open questions, or no questions. Learn how your comment data is processed. Overall, the review found interventions, tools, approaches and the measurement of nurses reflection in clinical practice settings are highly varied. All authors have read and agreed to the published version of the manuscript. Data were analyzed by means of content analyses. 2019 Feb;35:32-41. doi: 10.1016/j.nepr.2018.11.013. Accessibility Levett-Jones T, Lathlean J. Belongingness: A prerequisite for nursing students clinical learning. Previous research also suggests that learning is stimulated when students conceptualize their experiences and are led into reflecting upon specific situations [26]. HHS Vulnerability Disclosure, Help ; methodology, Y.A., A.T., M.S.I. The interviews took place in a quiet room at the hospital, and, with the exception of a phone call, they were conducted without interruption. When confronted with difficult conditions, there is a lack of contact and the creation of a sense of need [29]. and M.F. 2013:17. Lawrence C., Mhlaba T., Stewart K.A., Moletsane R., Gaede B., Moshabela M. The hidden curricula of medical education: A scoping review. (2019) who have also indicated the value of reflective practice among student nurses in enhancing their knowledge, skills, and intellectual abilities [21]. ; supervision, Y.A. Cookies policy. They took place at the end of the informants clinical placements. Purposeful reflection is a tool that helps nurses gain self-knowledge and insight (Palmer, 2007). 2012;12(3):1649. 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. 2004;48(3):2918. Two focus group interviews were conducted with a total of seven nursing students who had experienced structured learning activities during clinical placements in an outpatient unit. 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. BMC Nurs. . Terms and Conditions, Rapid progress in the treatment of many medical conditions has caused a shift in nurses duties and functions and many changes in nursing education over the last two decades [7, 8]. These external motivational factors for reflection revolve around the clinical environment in which the students are practicing which included patients, clinical preceptors and the healthcare team with which the students are in constant contact. Stewart, Raymet, Fatima and Gina are four students who share their learning journey throughout the chapters of the book. Reflection has been shown to provide valuable professional development. [The Nursing education curriculum 25. The https:// ensures that you are connecting to the This shows that new concepts and the use of new forms must be explained in detail, since an understanding of what to do is an important part of being prepared. asking about their experiences of the use of unit-specific learning outcomes). Reflection is more than being contemplative; it relates to a mechanism that may help people learn from their experiences. A purposive sample of 21 nursing students from the second semester and above from one nursing school in Saudi Arabia and were employed into this study [17]. An official website of the United States government. Data also revealed that the timing of the students placements in the outpatient unit impacted on their preparedness, as they had to familiarize themselves with the group of patients and certain concepts before entering the unit. For instance, one of the students proclaimed, new difficult cases make you want to know more about the management and when you handle such cases it makes you feel that you need to always check how did you do and go back and think about all the steps you took and it motivates you to become more proficient in handling such situations (S4). According to the findings, the drivers of reflection ranged from personal and extrinsic levels. Nurse Educ Pract. Reflective approaches included lectures, workshops, or reflection with supervisors or peers in clinical settings. As a result, facilitation of reflection and reflective capacities is seen as an essential part of professional growth [7].
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