The writing of a reflective diary is viewed as an effective tool for promoting reflection and learning in students, and for self-assessment and evaluation of a clinical learning experience. This work is a study of 30 undergraduate nurses and their use of reflective diaries during a period of community health care practice. The theoretical basis of the study is based on Schön's work on reflection-in-action. The research tool, developed for the study of nursing practice by Powell, is based on Mezirow's levels of reflectivity. The findings are that, in the sample used, students do reflect on their practice according to Mezirow's levels of reflectivity, but that the highest number of reflections occur at the lower levels of reflectivity (94% of the total number of scores). However, although only 6% of the total number of scores were found at the higher levels of reflectivity, some 22 of the samples of 30 students did attain conceptual and theoretical reflectivity, the highest levels of reflectivity.

Nurses must provide culturally appropriate care. A powerful strategy to enhance cultural competency is immersion. This can increase awareness of personal beliefs, values, behaviors, and learning from clients. A three week immersion experience for 17 senior undergraduate nursing students was organized in partnership with the Independent University, Bangladesh. Working with interpreters, students learned about people and healthcare through interviews and site visits. The purpose of this qualitative study was to discover the meaning of the immersion experience for nursing students through their reflective journals. These were thematically analyzed and four themes emerged: Beginning to See, Thinking about the Seen, Wanting to Change the Seen, and Transformed by the Seen. These themes combine into a framework that has been tentatively titled, Seeing Through New Eyes and will be further developed on future trips. Achieving cultural competency is a complex, long-term process that can be intensified with immersion experiences.

Every parent who faces an illness in their child might doubt their competence to care. When a chronic illness is diagnosed, competence can be severely challenged because of the sustained and multiple disruptions to daily life. A conceptual framework entitled 'Learning to be a Parent of a Child with Asthma' was developed from the results of a descriptive phenomenological study completed in Perth, Western Australia. It describes the stages of challenges to competency that parents experience as they learn to care for their asthmatic children. The impact of this illness on parents and the extent to which they are able to help their children respond to the demands of asthma are critical components in understanding the effect of this disease on parental competency. Insight into parental competency and the relationship to chronic illness will help health professionals provide the support and information needed by parents to manage asthma in their children.

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