student nurse reflection on learning and development

California Privacy Statement, Compassionate care: Student nurses' learning through reflection and the use of story. The nursing education sector has had to rethink the knowledge and skills it provides and how it teaches patient interaction to its students [9]. 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]. The complex technologies in some of these units represent a challenge for students who have limited existing knowledge or experience. Contreras et al. Purposeful reflection is a tool that helps nurses gain self-knowledge and insight (Palmer, 2007). Students also viewed Spinal Cord and Nerves Anatomy week 2 Week2 notes for This is consistent with findings in Lewallen and DeBrews studies [13, 21]. Declaration of Helsinki - Ethical Principles for Medical Research Involving Human Subjects [https://www.etikkom.no/en/ethical-guidelines-for-research/medical-and-health-research/declaration-of-helsinki/], Norwegian Social Science Data Services (NSD) [http://pvo.nsd.no/prosjekt/sok?s=40573&innmeldt_fra=&innmeldt_til=&institusjon=0&side=1. Unauthorized use of these marks is strictly prohibited. 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. The importance of skill development in nursing education is vital as it promotes self-awareness and develops best practice (Dolphin, 2013; Vaughan, . Which circumstance led you to reflect more? 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. Reflective Practice: Transforming Education and Improving Outcomes. Universitetet i Oslo, Det medisinske fakultet Unipub; 2008. This study shows that the use of outpatient units for clinical placement in nursing studies faces several challenges. Coyne and Needham [12] show that a higher nurse-patient ratio allows more time for student supervision. 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. Chambers D, Thiektter A, Chambers L. Preparing student nurses for contemporary practice: The case for discovery learning. Understanding the factors considered by faculty in the clinical evaluation of nursing students. Immediately after the interviews, notes were made by author1 to capture the setting and reflections in respect of the informants emotional responses. This account will identify practical needs that I must improve with supportive evidence based research, and evaluate the impact of this need for my personal development as a future qualified nurse. 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]. 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. The .gov means its official. It was often like you could just sit down in a nook and answer the questions because it wasnt really busy.. Previous research also suggests that learning is stimulated when students conceptualize their experiences and are led into reflecting upon specific situations [26]. Jaiswal A., Lyon J.A., Zhang Y., Magana A.J. 2022 Mar;7 (3):e008007. Levett-Jones T, Lathlean J, Higgins I, McMillan M. The Duration of Clinical Placements: A Key Influence on Nursing Students Experience of Belongingness. Several quotes were utilized to describe the research results, providing the research subjects a real voice [19]. FOIA When planning rotation between the regular ward and the outpatient unit, the timing of placement in the outpatient unit should be in the middle or end of the overall clinical placement period. Publishers Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. . The evaluation of the programme showed that some outpatient units were unsuitable for providing sufficient relevant learning situations for nursing students [17]. 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]. 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. Nurse Educ Pract. Int J Nurs Stud. Younger S.J. During the reflection phase, they also require their trainers advice, direction, and supervision. However, more meaningful reflection and learning can be undertaken if formal reflection takes place. To ensure credibility, the researcher documented and published the whole study procedure, allowing others to do follow-up investigation. sharing sensitive information, make sure youre on a federal As author2 was also a nurse educator for the informants, author1, who was unknown to the informants, was in charge of the interviews. Previous literature indicates however that students may not actually comprehend how to effectively prepare for their clinical placement [12, 13], which might also be the issue among some of the students in this study. Choperena A., Oroviogoicoechea C., Zaragoza Salcedo A., Olza Moreno I., Jones D. Nursing narratives and reflective practice: A theoretical review. Another student also shared a similar testimonial, the clinical instructor motivates us to be not only skillful but also knowledgeable and have critical thinking skills to integrate theory and practice and he demonstrates this through his work with us and with his patients and colleagues this alone makes me think that I want to be this skillful and professional thus I reflect on my practice skills and knowledge I use in caring for my patients so that I can advance myself (S16). The students spent one week at the outpatient unit out of a total of eight weeks in clinical placement. A Login to ePAD T ePAD user guide In all of the included studies, it was possible to categorise the level of reflection attained as low, middle, or high, however, comparison between studies was challenging. Some tools included specific questions for participants to reflect on, while others included open questions, or no questions. Data were analyzed by means of content analyses. 2013;3(9):106. Nurse Educ Pract. Save my name, email, and website in this browser for the next time I comment. This study aims at exploring nursing students perspectives on the facilitators of reflective practices in the clinical setting. 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. Each transcription was compared against recordings to ensure authenticity. Another student also said, it is always very interesting to handle the complicated and heavy cases as you feel the sense of responsibility and achievement that makes you want to reflect on your performance and make it better this proves to me the worth of the work we are doing (S19). 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]. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); This site uses Akismet to reduce spam. The trainer is responsible for creating such conditions [26]. volume15, Articlenumber:49 (2016) The time scheduled for the interviews was changed shortly before they were due to take place and two students failed to notice the change. 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]. government site. When having used the given tools, data indicated that students felt a higher ability to focus on their upcoming practice. 2019 Feb;35:32-41. doi: 10.1016/j.nepr.2018.11.013. Cadman K, Clack E, Lethbridge Z, Millward J, Morris J, Redwood R. Nurse Educ Today. Sarah Byrne is a third-year nursing student in Trinity College Dublin Student Focus - Reflection - With experience comes confidence All rights reserved by INMO. official website and that any information you provide is encrypted Solvoll B-A, Opsahl G, Granum V. Hvordan bidrar rammeplanen for norsk sykepleierutdanning til akademisk profesjonskompetanse? 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]. 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. 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). When comparing results between studies, authors should explicitly state the foci or themes reflected on, as well as the length of the intervention period and the level of students educational experience.. The https:// ensures that you are connecting to the The scoping review included 17 studies from around the world, conducted between 2007-2020, which aimed to report participants competencies in using reflective tools or approaches, such as workshops, journals/diaries, or coaching. 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. 8600 Rockville Pike ; data curation, Y.A., B.A., L.B. Halden: Hgskolen i stfold; 2013. Levett-Jones T, Lathlean J. Belongingness: A prerequisite for nursing students clinical learning. Box 700, NO, 1757, Halden, Norway, Ann Karin Helgesen&Anne Grethe Gregersen, Nursing Department, stfold Trust Hospital, P.O. Nursing students perceptions and experiences of reflective practice: A qualitative meta-synthesis. A substantial number of students have expressed that their sense of responsibility towards providing patients with their needs and answering their inquiries is a major driver for reflection. Accessibility Given that students often feel lost and uncertain in the initial phase of clinical placement, time plays an important factor in their experience of a good learning process [16]. 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. Thus, the findings of the study highlight the importance of emphasizing the significance of professional values such as personal responsibility and intrinsic motivational factors. The art of caring should therefore be emphasized both in theory and in clinical practice. By using this website, you agree to our 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? could you please elaborate on this?). Nine students were asked to participate in the study, but only seven ultimately participated in the interviews. Hwang B., Choi H., Kim S., Kim S., Ko H., Kim J. Google Scholar. PMC The feelings evoked by the encounter as well as a professional evaluation of the experience will be discussed. Compared to the regular ward which was perceived as more active, the outpatient placement was described as a relatively passive learning environment. Cite this article. Background: Reflection increases meta-cognitive capacities, promotes student-instructor relationships, overcomes the theory-practice gap, and enriches learning. J Nurs Educ Prac. Overall, the review found interventions, tools, approaches and the measurement of nurses reflection in clinical practice settings are highly varied. Speziale H.S., Streubert H.J., Carpenter D.R. In this reflective essay, I am going to reflect on what I have learned from nursing course. Data showed that the forms guided the students through their placements in the outpatient unit. 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. 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). 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]. More focus on outpatient care has also led to fewer opportunities for studying the continuity of a patients life situation. Would you like email updates of new search results? Bethesda, MD 20894, Web Policies Reflection in Action: Developing Reflective Practice in Health and Social Services. According to Lovell (2018), encouraging activity analysis should be accomplished in conjunction with other determinants to enable reflection in the medical field, such as making sure that trainers are sufficiently educated are able to offer a consistent atmosphere for students, and have an effective relationship with their students. It is noteworthy that students did not see it as a problem to undertake a rotation at the end of their clinical placement. The study has a qualitative explorative design. Accessibility The authors declare that they have no competing interests. ; formal analysis, Y.A., B.A., L.B. Some of the findings agree with other studies that have found that using outpatient units as clinical placements in nursing studies has several challenges [17]. 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]. Ann Karin Helgesen. 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. Benner P. From Novice to Expert Excellence and power in clinical nursing practice. Students need guidance in understanding concepts and in applying expectations. Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. As a student enrolled nurse, there were strict practice standards and regulations, especially when medication is involved and supervision from our mentor was required at all times. The mean age of the students was 21.65 1.27 years (Table 1). I was placed in a private ward during clinical placement as a student nurse. Karanikolos M, Mladovsky P, Cylus J, Thomson S, Basu S, Stuckler D. Financial crisis, austerity, and health in Europe. The scoping review found most studies used physical tools and reflective dialogues in clinical settings. Kindly elaborate on one of your clinical encounters that has prompted you to ponder and reflect more? Conventional content analysis following Hsieh and Shannon [19], also described as inductive category development [20], was used. It also enables you to learn more deeply about a variety of situations and events, not just . As researchers were granted access to a registry of university webmail, students were contacted by email. PhD thesis. They took place at the end of the informants clinical placements. 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. and A.T.; resources, Y.A. 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). In: Valle R.S., King M., editors. As a library, NLM provides access to scientific literature. The site is secure. Methods The study has a qualitative explorative design. A high level of preparedness seemed to be close to a prerequisite in order for a student to perceive the week as successful. The study was approved by the Norwegian Social Science Data Services (reference number 40573) [28]. Methods: Semi-structured interviews were conducted among 21 Saudi nursing students at one major university in Saudi Arabia. The Practice Assessment Document (PAD) provides a comprehensive record of professional development and performance in practice. 81 Report Document Comments Please sign inor registerto post comments. Get a custom paper on Reflection for professional development from a nursing writer. Anney V.N. Inclusion in an NLM database does not imply endorsement of, or agreement with, 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. Another important part of being prepared was linked to being in the right place at the right time. Quotations were selected to support each description and to secure the trustworthiness of the data. In an advanced clinical setting with complex technology and treatments, it can be difficult for inexperienced nursing students to actively seek knowledge. Customized forms can help students who spend the clinical placement in an outpatient unit see the nursing perspective more clearly. The first extrinsic driver that was prevalent among the nursing students who took part in this study showed that the students were motivated by the complex cases rather than the common ones to reflect on their knowledge and skills. Adamson E, Dewar B. Compassionate Care: Student nurses learning through reflection and the use of story. Reflection as a learning tool in graduate medical education: A systematic review. 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 . BMC Nurs 15, 49 (2016). 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. Forum: Qualitative Social Research 2000, 1(2). What outcomes are measured in the studies where reflection has been used for nursing education by nursing trainees and educators in clinical settings. 2012;42(1):97104. Reflection is a formal process that can help nurses and nursing students develop crucial skills and competencies when undertaking training in clinical practice settings. 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). Nursing is the art of caring for the patient during illness. Depending on the outpatient units, students can acquire skills that are essential to nursing practice as well as more specialized knowledge about different examinations and treatments, and an enhanced understanding of the human anatomy, as well as a wider understanding of the nurses role. Students who did not use the forms, expressed less alertness. 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. Milko / iStock. One of the most important aspects in the clinical practice reflection process was students willingness to learn more about clinical care. In the first year of my nursing programme my first placement was in an acute admission ward for older people. 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. The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board (ECO-R-103). Download. An external reviewer with experience in qualitative studies evaluated conformability. Reflection for the undergraduate on writing in the portfolio: Where are we now and where are we going? the contents by NLM or the National Institutes of Health. Nursing students must enhance their clinical education in order to manage these developments [1]. Lautebach and Becher (1996) relate self-reflection to caring for the self. 2013:17. Another student also proclaimed, theres still a lot for me to learn so that I can become a proficient nurse and every time I feel like I lack knowledge in a certain aspect of care it only makes me more encouraged to dig deeper and reflect on my practice skills so that I can provide higher care quality for patients (S3). by studentnurse88 (student) University Degree Subjects allied to Medicine The purpose of this essay is to reflect on my experience and skills gained during a two-week clinical placement as a first year Student Nurse and also the learning outcomes stated in my Personal Development Plan (PDP). Medical trainers must encourage reflection by assessing students reflective work and identifying educational obstacles in medical curricula while utilizing handwritten or web-based portfolios. 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. 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. An official website of the United States government. 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. Stewart, Raymet, Fatima and Gina are four students who share their learning journey throughout the chapters of the book. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. The students were approached by the researchers who were not affiliated with their university, and did not teach them any classes. Reflective writing requires one to reflect on a personal experience for the purpose of self-awareness and professional growth (Kerr, 2010). April 25, 2023. government site. [The Nursing education curriculum 25. When nurses reflect, they purposefully "bend back" their attention in a focused attempt to discover personal . Nurse Educ Pract. Nonetheless, the required abilities for reflection are vague, and learning reflection is difficult. The researchers used several methods in accordance with past research in the field of qualitative analysis in attempt to optimize the study reports credibility and prevent biases from emerging [18]. Our results are also in line with Choperena et al. Facilitating student learning with critical reflective journaling in psychi-atric mental health nursing clinical education: A qualitative study. In addition, another student shared a similar anecdote, God is watching everything we do and my religion tells me that I need to do the most good to the people around me thats why I need to always keep myself in check and make sure that my performance is up to the level that will make the patient better and not do harm, whether clinically or even psychologically (S15). The majority of the students felt that their values have driven them to reflect on what they have practiced, how they dealt with the patient, the family, and their colleagues so that they can detect any wrongdoing and make sure to avoid such encounters in the future. Students could decline to be further contacted. Students also find the procedure of reflection difficult and feel that it does not occur spontaneously, therefore, it needs a safe and secure atmosphere in which they may cultivate reflection with the assistance of professionals. Supporting student reflective practices through modelling-based learning as-signments. Hgskolen i stfold, Sykehuset stfold; 2011. 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.

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