Nursing students perceptions and experiences of reflective practice: A qualitative meta-synthesis. 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. 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. Colet P.C., Cruz J.P., Cruz C.P., Al-Otaibi J., Qubeilat H., Alquwez N. Patient safety competence of nursing students in Saudi Arabia: A self-reported survey. Upon students clinical training, instructors responsibility is critical, and that the instructor should pay attention to the students discourse, critique their rationalization and perceptions, assess their effectiveness in patient interaction from various angles, and provide prompt and appropriate input. This study shows that the use of outpatient units for clinical placement in nursing studies faces several challenges. According to the results of the data analysis, a qualified trainer might help students in clinical practice with their reflection process. One of the students said for instance, I reflect on my clinical experiences because when I graduate I want to be not just any other nurse I want to be an outstanding example of the highly professional nurse who continually works on developing themselves through increasing their knowledge and skills by reflecting on the areas needing improvement and thus develops into a higher standard of care (S9). Part of 8600 Rockville Pike A suitable schedule for the interviews was agreed upon with each participant, especially considering their hectic academic schedules, in order for them to be approachable and provide accurate descriptions of their encounters. Contreras et al. An outpatient unit is also quite specific in terms of offering students the possibility of observing and participating in a range of different skills. Most studies investigated the differences between tools and educational approaches using structured reflection frameworks, or looked at the differences when dividing participants into paired or unpaired groups. The outcomes of the study can be used to develop a clinical education program that bridges the gap between theory and practice. PhD thesis. However, more meaningful reflection and learning can be undertaken if formal reflection takes place. Nursing students in this study have identified both personal and external drivers to practice reflection. 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]. At the very end of the interviews, which were each 50min long, a verbal summary of the content was presented to the informants to ensure that their experiences had been correctly understood. The model will be applied to the essay to facilitate critical thought, relating theory to practice where the model allows. Data revealed that some of the students lacked comprehensive understanding about being part of this specific project, of the terms used and about the forms. Lewallen LP, Debrew JK. This study aims at exploring nursing students perspectives on the facilitators of reflective practices in the clinical setting. Chambers D, Thiektter A, Chambers L. Preparing student nurses for contemporary practice: The case for discovery learning. Lautebach and Becher (1996) relate self-reflection to caring for the self. Purpose Statement Concept analyses should be conducted when concepts require further clarification, as is the case with NSCL. Reflection as a learning tool in graduate medical education: A systematic review. Self-reflection looks inward and listens to the whispers. [This is how I am - A study of student nurses moral development]. April 25, 2023. Fifty percent of nursing education in Norway consists of clinical practice where the students are under the supervision of registered nurses. They have also indicated that they do not want to be a kind of nurse that is just performing technical procedures. Google Scholar. ; data curation, Y.A., B.A., L.B. They took place at the end of the informants clinical placements. 2023 BioMed Central Ltd unless otherwise stated. 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 . Before 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.. 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 reflection. 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]. According to the findings, the drivers of reflection ranged from personal and extrinsic levels. Solvoll B-A, Opsahl G, Granum V. Hvordan bidrar rammeplanen for norsk sykepleierutdanning til akademisk profesjonskompetanse? 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. Outpatient units traditionally have a higher nurse-patient ratio. Nurse students experiences with clinical placement in outpatient unit a qualitative study. In order to secure as open-minded an approach as possible, the researchers discussed their own preconceptions on the topic and made efforts to put these aside during the data collection and analyses. En ny modell for organisering av praksisstudier. The foundation of learning through experiencing is reflection, which involves the combination of both knowledge and practice. This assignment is a critical analysis and reflection of my continuing personal and professional development (CPPD) needs in practice. Anney V.N. The complex technologies in some of these units represent a challenge for students who have limited existing knowledge or experience. Careers. Privacy 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. The mean age of the students was 21.65 1.27 years (Table 1). Efforts were made to establish an audit trail throughout the entire study. The second group consisted of only two informants, as two informants did not show up for interview. They value debriefing following experience and there is evidence that they would benefit from training in mental previewing techniques prior to embarking on new experience. BMC Nursing The data was analyzed using a standard qualitative content analysis technique. A high level of preparedness seemed to be close to a prerequisite in order for a student to perceive the week as successful. 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. What levels of reflection are identified or achieved: low (descriptive), middle (application), or high (evaluative)? For the purposes of this analysis, the term 'Nursing Student Clinical Leadership' (NSCL) will be used to describe clinical leadership in nursing students. Another external driver for reflection was prevalent in the experiences expressed by the students, where they have indicated that the instructional methods, communication approaches, and leadership style that have been adopted by the clinical instructors that were mentoring them at the clinical site are highly influential factor, that encouraged them to reflect on their performance. The importance of skill development in nursing education is vital as it promotes self-awareness and develops best practice (Dolphin, 2013; Vaughan, . The paper was designed and written according to the Consolidated Criteria for Reporting Qualitative Research (COREQ) reporting guidelines [16]. Instructors have been perceived by the students to have an important role in guiding students through reflection on clinical experiences, with a particular focus on their relationships and motivating elements. 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]. (2019) who have found that students carrying out reflective practices have expressed to have higher level of knowledge, critical thinking abilities, advanced practices and relationship with patients; outcomes which have driven their reflection [20]. Data revealed that the students preparedness when entering the outpatient unit impacted on how they described the week. Reflection for professional development Nursing Essay Example for MSN Nursing Students. I had been working two shifts at the ward, so there was a lot going on in my head already, so I was maybe a little stressed because I knew absolutely nothing when I came there, so I thought that was a little senseless. 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. 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. [Adapting to the future specialist healthcare. An external reviewer with experience in qualitative studies evaluated conformability. The decrease in the number of hospital beds in parallel with the increase in the number of nursing students has created a challenge in terms of providing the best possible learning facilities under given conditions in hospitals. Licensee MDPI, Basel, Switzerland. Background: Reflection increases meta-cognitive capacities, promotes student-instructor relationships, overcomes the theory-practice gap, and enriches learning. FOIA The literature suggests that developing a professional identity and an aspiration to learn are influenced by the length of the clinical practice [16]. Our results are also in line with Choperena et al. The scoping review included 17 studies from around the world, conducted between 2007-2020 . Given these conditions, HI teamed up with S in 2014 for a new project. The encounter will be analysed and conclusions on the need for nursing professional conduct will be drawn. The most used reflection tools among the 17 studies were written cases, narrative, and diaries. Helgesen, A.K., Gregersen, A.G. & Roos, A.K.. and transmitted securely. Bethesda, MD 20894, Web Policies The time scheduled for the interviews was changed shortly before they were due to take place and two students failed to notice the change. Facilitating student learning with critical reflective journaling in psychi-atric mental health nursing clinical education: A qualitative study. The evaluation of the programme showed that some outpatient units were unsuitable for providing sufficient relevant learning situations for nursing students [17]. To pass or to fail? official website and that any information you provide is encrypted This study shows that use of outpatient units for clinical placement in nursing studies has several challenges but also the potential for creating positive experiences for the students. The researchers alternated conducting the interviews to avoid the potential of a moderators domination; Each interview took between 20- and 25-min. Reflection in medical education can be implemented in multitude of ways, depending on the restrictions of the coursework. Informal reflection has many benefits but can result in superficial learning. 2013;381(9874):132331. 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. When I wasnt informed like I was supposed to about how to use the forms, I guess I wasnt able to benefit from them as intended.. 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). Data revealed the challenges of being a student in a highly technological world. It also enables you to learn more deeply about a variety of situations and events, not just . When nurses reflect, they purposefully "bend back" their attention in a focused attempt to discover personal . The transcriptions were anonymized and coded where each participant was assigned pseudonym from S1 to S21. Hwang B., Choi H., Kim S., Kim S., Ko H., Kim J. Box 700, NO, 1757, Halden, Norway, Ann Karin Helgesen&Anne Grethe Gregersen, Nursing Department, stfold Trust Hospital, P.O. 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. Nursing is the art of caring for the patient during illness. Short-term placement has been shown to offer students less opportunity to participate in the social interactions that go into making them future professionals [15]. Communication with patients is one of a nurse's most important tasks. Many instructors suggested that in order to cope with the present problems in the clinical context, educators should prepare students for reflection on clinical encounters [2]. Ensuring the quality of the findings of qualitative research: Looking at trustworthiness criteria. 2017 Jul;25:1-4. doi: 10.1016/j.nepr.2017.04.004. The steps are Description, Feelings, Evaluation, Analysis, Conclusion and Action Plan (Gray, 2007). and A.T.; resources, Y.A. The quotations were provided in a narrative and insightful terms that captured the spirit of the data provided, and then those phrases were grouped, rearranged, and compiled into qualitative themes, which the investigators considered to guarantee a precise and detailed comprehension of the students experiences. Relji N.M., Pajnkihar M., Fekonja Z. Self-reflection during first clinical practice: The experiences of nursing students. Complex technologies in some of these units represent a challenge for students who have limited existing knowledge or experience. 2012;3(01):2234. and transmitted securely. Existential Phenomenological Alternatives for Psychology. Being prepared, which was one of the categories, incorporated the subcategories being able to understand what to do, being at the right place at the right time and being alert for new experiences. Younger S.J. PubMed 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. Students were emailed a generic invitation to participate in the research as well as an explanation of the study objectives, and if they were willing to participate, they were asked to return a signed informed consent form. In addition, Artioli et al. AKG, AGG and AKR designed the study. As a result, the investigators worked on the study for over three months. There are many reflective models . Griggs V., Holden R., Lawless A., Rae J. Informed consent was obtained from all subjects involved in the study. Students could decline to be further contacted. Box 300, 1714, Grlum, Norway, You can also search for this author in 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]. Integrate themes into a thorough description, Determine the underlying basis of the phenomenon, Contact respondents for additional information. As a result, facilitation of reflection and reflective capacities is seen as an essential part of professional growth [7]. Barksby J., Butcher N., Whysall A. Please enable it to take advantage of the complete set of features! [Influences on nursing studensconfidence and learning in clinical practice]. The site is secure. 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. Supporting student reflective practices through modelling-based learning as-signments. Many of the respondents wished to improve their own expertise in order to give better treatment. Nilsen SR. Nr samhandling kreves : et helsevesen i endring krever ny kompetanse. In this profession, the doctors diagnose the disease and do the surgeries when required but people take the efforts of nurses for granted. 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). how long is the intervention period? Careers, Unable to load your collection due to an error. In order to learn, students need to feel a sense of belonging [15]. Springer Nature. Its crucial to establish a secure setting in which people may reflect on their experiences [9]. Adamson E, Dewar B. Compassionate Care: Student nurses learning through reflection and the use of story. 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]. ; formal analysis, Y.A., B.A., L.B. In the next step of the process, the research team met and compared their codes and sorted them into categories and subcategories. It is a useful and indispensable method for improving professional nursing, and it is broadly utilized in learning and teaching methods in both lecture halls and clinical contexts [3]. I was part of a 60-hour long placement in the hospital and had . A new model of reflection for clinical practice. One limitation of the current study was that it only looked at nursing students perspectives; thus, additional research should look at additional subtopics, such as nursing educators perceptions of encouraging reflection in clinical settings. [How does the curriculum in the Norwegian nurses' education system contribute to an academic professional competence?]. The authors declare no conflict of interest. This is consistent with findings in Lewallen and DeBrews studies [13, 21]. how should findings and outcomes be reported consistently? HHS Vulnerability Disclosure, Help STUDENT NURSE REFLECTION ON LEARNING AND DEVELOPMENT September 14th, 2022 admin Education One of the most important sectors of human life is health. As a library, NLM provides access to scientific literature. Nurse Educ Pract. Lfmark et al. The sections of the interviews that dealt with the participants encounters with the reflection-facilitators were selected. It has something to do with information failure. 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). 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. Download. Students may not feel adequately prepared for the multiple challenges, and it can be difficult to know how to approach this. asking about their experiences of the use of unit-specific learning outcomes). California Privacy Statement, The forms seemed to give the students more confidence as they had something meaningful to do between procedures. Over the past decade, there has been a reduction of hospital beds in most European countries. 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). 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. In order to acquire profound and comprehensive data, it was sought to choose individuals with the most variety (in terms of semester, average level, and family status). Preparedness and guidance during placement were imperative for making the week in the outpatient unit meaningful. Witnessing change with aspiring nurses: a human becoming teaching-learning process in nursing education. Influenced by an ongoing project at Bethesda North called the Off ward shadowing experience [18] a project team consisting of nurse educators from HI and nurses working at S outpatient units developed forms with unit-specific learning outcomes and targeted reflection for eight technologically advanced procedures in cardiology and neurology outpatient units. Nurse Education in Practice, 15 (3) (2015), pp. The Practice Assessment Document (PAD) provides a comprehensive record of professional development and performance in practice. The reforms have also required nursing education to consider different areas for clinical placements for its students, and outpatient units in hospital have been increasingly formalized as clinical learning environments [10]. According to another research, students require the assistance of the trainer in identifying difficulties that require reflection. During the reflection phase, they also require their trainers advice, direction, and supervision. 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]. A literature review. Hgskolen i stfold, Sykehuset stfold; 2011. Instead of just observing, the forms helped the students take a more vigorous approach in seeking knowledge. The interviews started by obtaining biographical data and with open dialogue during which the informants were encouraged to talk freely about their experiences (e.g. Time expended, attitudes used, responsiveness to patients talk, analysis of logical path of discussion, and technical abilities are all part of this assessment. The review recommended that authors be explicit in their definitions of these categories according to standardised criteria. The number of nursing students rose by 14% between 2010 to 2014, from 3,179 to 3,630 [5]. 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. The development of new and improved technology has enabled a transition in most countries from long hospitalizations to same-day surgeries and increased use of outpatient treatments [1]. Only 4 (19.04%) were in the second semester of the third year. Our findings show that, when in an outpatient clinic, students have more time between patients. Disclaimer. Consequently, to facilitate nurse students' development into professionals, learning support is needed where the focus is on understanding caring and becoming caring nurses. Reflective Practice: Transforming Education and Improving Outcomes. Tong A., Sainsbury P., Craig J. statement and https://doi.org/10.1186/s12912-016-0167-1, DOI: https://doi.org/10.1186/s12912-016-0167-1. Results: Two major themes were prevalent upon thematic analysis, namely, Personal Drivers of Reflection which consisted of Motivation to Learn, Desire to develop, Ethical Regard, and Responsibility towards patients and External Drivers of Reflection which consisted of Patient characteristics, Case complexity, and Competent Instructors. Inclusion criteria for joining the study were: second-year students, undergoing clinical placement at the cardiology or neurology units. This essay is a reflection of my placement which I recently took at the Princess Royal University Hospital which is under the able guidance of King's College Hospital. 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].
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