Objective: The preparation of reflective practitioners is crucial with the ever changing dynamics of the healthcare environment. Reflection involves the personal collection of information with subsequent contemplation and deliberation. This reflective process serves as the basis for gaining understandings, attaching meaning and guiding future actions. A challenge for nursing faculty is to implement new and innovative methods to assess and evaluate both reflection and affective learning. The purpose of this study is two-fold; to develop a theory-based coding system to assess affective learning, and to evaluate the feasibility and applicability of this coding system in reading and responding to students' reflective clinical journals. Methods: The coding system is based on an alignment of the affective domain taxonomy and Mezirow's theory of transformative learning. A research team developed this system, and then utilizing predetermined coding guidelines, scored clinical journal entries written by graduate entry pathway students. Inter-rater reliability and qualitative data in the form of faculty anecdotal comments supported on-going revisions to the coding system. Results: In the early stages of the coding, the IRR averaged 0.5 with the last set ranging from 0.75-1.00. Team meeting and the use of the research team's anecdotal logs served to address inconsistencies in the process. Conclusions: The results of this study support the feasibility to both establish a consistent theoretical foundation to guide student assessment and evaluation of affective learning. Identification of student exemplars was also created to orient new faculty concerning the stages of reflection. The results of this study also support the course design process in terms of alignment of student learning objectives, instructional methods and evaluation plans.
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