Effects of a work-based critical reflection program for novice nurses

Abstract

BackgroundCritical reflection is effective in improving students’ communication abilities and confidence. The aim of this study was to evaluate the effectiveness of a work-based critical reflection program to enhance novice nurses’ clinical critical-thinking abilities, communication competency, and job performance.MethodsThe present study used a quasi-experimental design. From October 2014 to August 2015, we collected data from 44 novice nurses working in an advanced general hospital in S city in Korea. Nurses in the experimental group participated in a critical reflection program for six months. Outcome variables were clinical critical-thinking skills, communication abilities, and job performance. A non-parametric Mann-Whitney U-test and a Wilcoxon rank sum test were selected to evaluate differences in mean ranks and to assess the null hypothesis that the medians were equal across the groups.ResultsThe results showed that the clinical critical-thinking skills of those in the experimental group improved significantly (p = 0.003). The differences in mean ranks of communication ability between two groups was significantly statistically different (p = 0.028). Job performance improved significantly in both the experimental group and the control group, so there was no statistical difference (p = 0.294).ConclusionsWe therefore suggest that a critical reflection program be considered an essential tool for improving critical thinking and communication abilities among novice nurses who need to adapt to the clinical environment as quickly as possible. Further, we suggest conducting research into critical reflection programs among larger and more diverse samples.

Effect of Reflective Training Program on Nurse Interns' Critical Thinking Disposition and Communication Competency

“…As well as the satisfaction of nurse interns with the content of the program and their motivation to apply the process of reflection that enhances critical thinking disposition and the desire of nurse interns to gain knowledge to be ready for any critique for his or her own self. This result confirms the finding of previous study done by Kim et al (2018) conducted a study on 44 novice nurses working in an advanced general hospital in Korea and found that critical-thinking disposition of novice nurses improved directly after program application. Also, Zhang et al (2017) studied the effects of reflective training for nursing students on their critical thinking disposition in Medical University in China and found that there was highly statistically differences in all domains and the total mean score of critical thinking disposition among nursing students before and directly after the program application.…”

“…On the other hand critical thinking is strongly linked with good communication. This result is compatible with Kim et al (2018) which found statistically significant correlation between total score of reflective practice, critical thinking disposition and communication competency after program application.…”

“…This result in agreement with that of Farrington and Townsend (2014) who studied nurse-patient communication and critical reflection and found that the total mean scores of the participants regarding communication competency increased immediately after training program application. Also, Kim et al (2018), who found that critical reflection training program didn't improve novice nurses' communication competency.…”

The Effect of Reflection on Nurse-Patient Communication Skills in Emergency Medical Centers

“…22 However, some studies have reported contradictory results regarding patient safety. 33,34 The domain of patient safety-related communication skills has a direct association with clinical competency of the nurses and their professionalism, 27 which was significantly enhanced through reflection in our study. Pearson et al, noted that reflection by surgical residents improved their medical performance, communication, and professionalism.…”

“…The results of the present study are in line with previous research findings according to which work-based critical reflection program or reflective journaling by hospital nurses (through fellowship program) improved critical thinking skills, communication abilities, and job performance. 27,28…”