Effect of Reflective Practice Education on Self-Reflection, Insight, and Reflective Thinking Among Experienced Nurses

Abstract

A mixed-method study was conducted to determine whether nurses' participation in a reflective practice continuing education program using a structured reflection model makes a difference in nurses' self-reflection, insight, and reflective thinking about clinical practice situations. Findings suggested that use of structured reflection using question cues, written narratives, and peer-facilitated reflection increased nurses' engagement in self-reflection and enhanced reflective thinking in practice. Including reflective practice education in novice orientation and preceptor training may be beneficial.

Nursing narratives and reflective practice: A theoretical review

“…When using narratives to enhance reflective practice in nursing, the process of thinking back on a past experience to obtain new understanding was assumed by most of the authors as the theoretical starting point for engaging in the process (Hewitt, ; Asselin & Fain, ; Correia & Santiago, ; Forneris & Peden‐McAlpine, ; Levett‐Jones, ; Hargreaves, ; Taylor, ; Kim, ; Durgahee, ; Maeve, ). Indeed, this way of conducting reflection allowed participants to hold themselves apart and look back on what had happened in the clinical situation, to gain new insight into themselves and their practice (Asselin & Fain, ; Hewitt, ; Maeve, ; Taylor, ). Accordingly, many articles focused on defining how this way of examining practice was crucial when researchers were looking for ways to promote knowledge development and gain additional learning from experiences in nursing practice (Cathcart & Greenspan, ; Correia & Santiago, ; Durgahee, ; Forneris & Peden‐McAlpine, ; Hargraves, 2004; Kim, ; Levett‐Jones, ).…”

“…Furthermore, from this point of view, using narratives as a tool for assessing practice emerged as an opportunity for learning from practice (Asselin & Fain, ; Hargreaves, ; Levett‐Jones, ). In this sense, although there were some discrepancies in how to conduct assessments – the kind of narratives subject to evaluation (Hargreaves, ), or the potential tension between reflection and assessment (Levett‐Jones, ) – authors finally suggested that integrating this approach properly into nurses’ practice might contribute to the process of learning and knowledge development.…”

“…In some cases, an internal dialogue resulted in exploring feelings, opinions and meanings (Hewitt, ; Maeve, ). In other situations, an open dialogue was established as a shared examination and deconstruction of the narratives (Asselin & Fain, ; Forneris & Peden‐McAlpine, ; Kim, ; Levett‐Jones, ; Rittman & Sella, ). In this respect, dialogue was able to generate a climate of trust which promoted a sense of community between researchers and participants (Maeve, ; Rittman & Sella, ).…”

“…In fact, most of the articles incorporated dialogue for addressing narratives. Guided discussions challenged the writers of narratives to delve deeper into the reflective process written up in texts and to gain insights and broader perspectives from practice (Asselin & Fain, ; Brubakken et al., ; Durgahee, ; Levett‐Jones, ). Although there is some risk in sharing personal experiences in a group discussion which is related to the required disclosure of specific significant incidents in practice (Holdsworth, Belshaw, & Murray, ), it is generally accepted that focus group discussions are able to produce “collective narratives” for generating group perspectives on the issue being discussed.…”

Analysis of midwifery students' written reflections to evaluate progression in learning during clinical practice at birthing units

“…Research has shown that structured reflection models enhance reflective thinking in clinical 2 practice (Asselin & Fain, 2013) and that students' narratives may uncover practices that otherwise might go unnoticed (Levett-Jones, 2007). Schön (1995) described two types of reflection; "reflection-in-action" and "reflection-on-action".…”