student nurse reflection on learning and development

Rapid progress in the treatment of many medical conditions has caused a shift in nurses duties and functions and many changes in nursing education over the last two decades [7, 8]. The study has a qualitative explorative design. One area that has continued to raise particular challenges in community nursing is maintaining the level of student learning capacity, supervision and assessment to the extent of pre-pandemic levels. They have also indicated that they do not want to be a kind of nurse that is just performing technical procedures. 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]. In this study, students stated that novel situations during the training session give a framework for reflection. Thereafter the interviews were read word by word. Reflective practice in nursing: A concept analysis This analysis identifies the need for future nursing researchers to develop reflective models or strategies that promote reflection among nurses and nursing students before, during, and after the clinical experiences. 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]. The data was analyzed using a standard qualitative content analysis technique. Reid, (1993) describes reflection as a process of reviewing an experience of practice in order to describe, analyse, evaluate and so inform learning about practice. Download. The interviews were carried out using virtual meeting technologies by the investigators, who were able to conduct interviews until data saturation was reached. Data were analyzed by means of content analyses. April 25, 2023. AKH and AGG collected the data. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Clipboard, Search History, and several other advanced features are temporarily unavailable. Empathy and support in nursing. 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). Nurse Education in Practice, 15 (3) (2015), pp. Another external driver for reflection was prevalent in the experiences expressed by the students, where they have indicated that the instructional methods, communication approaches, and leadership style that have been adopted by the clinical instructors that were mentoring them at the clinical site are highly influential factor, that encouraged them to reflect on their performance. Informed consent was obtained from all subjects involved in the study. 8600 Rockville Pike 2017 Jul;25:1-4. doi: 10.1016/j.nepr.2017.04.004. Community nursing placements: student learning experiences during a This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (, reflection, nursing students, qualitative, perspectives, clinical setting. 2007;44(7):12317. Influenced by an ongoing project at Bethesda North called the Off ward shadowing experience [18] a project team consisting of nurse educators from HI and nurses working at S outpatient units developed forms with unit-specific learning outcomes and targeted reflection for eight technologically advanced procedures in cardiology and neurology outpatient units. Reflecting on health and wellbeing as a student nurse: a personal journey | Nursing Times EMAP Publishing Limited Company number 7880758 (England & Wales) Registered address: 10th Floor, Southern House, Wellesley Grove, Croydon, CR0 1XG We use cookies to personalize and improve your experience on our site. Google Scholar. In this reflective essay, I am going to reflect on what I have learned from nursing course. Relji N.M., Pajnkihar M., Fekonja Z. Self-reflection during first clinical practice: The experiences of nursing students. 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]. Contreras et al. Ensuring the quality of the findings of qualitative research: Looking at trustworthiness criteria. 2015;14(1):110. Quotations were selected to support each description and to secure the trustworthiness of the data. Artioli G., Deiana L., De Vincenzo F., Raucci M., Amaducci G., Bassi M.C., Di Leo S., Hayter M., Ghirotto L. Health profes-sionals and students experiences of reflective writing in learning: A qualitative meta-synthesis. The https:// ensures that you are connecting to the There are many reflective models . Tellingly, none of the 17 studies examined included the same combination of elements. Contemp Nurse. If I did not have those forms to help me reflect, I would never have understood what I was actually doing or was a part of., The fact that you are being guided towards what you are supposed to look for and stuff, I really liked it.. The meaning of reflection for understanding caring and becoming a This study employed a phenomenological explorative methodology in order to explore the nursing students perspectives on the facilitators of reflective practices in the clinical setting. Another student has addressed the knowledge of the patient saying, one time I had a patient who has been chronically ill and also works in the healthcare fieldthat moment made me feel that I had to be very knowledgeable to be able to care for this patient as I cant have less information about the patient case than the patient themselves this had me doing a lot of research every time I handle a case (S14). A new model for organizing practical training]. As this was their first encounter with an outpatient clinic and such procedures, using the forms and preparing ahead enabled students to be more alert to new experiences. This conceptual model may be a useful tool to guide nurse educators in facilitating role development and the transition from the classroom to the clinical setting for the nursing student. PDF A Guide to Nursing Students' Written Reflections for Students and Educators The intention of clinical practice is to acquire basic nursing skills in a natural environment [4]. Given these conditions, HI teamed up with S in 2014 for a new project. For example, one of the students said, my patient is my responsibility even though I am still a student but I need to learn how to take responsibility for my actions with the patients so I need to reflect on my practices, skills and knowledge so that I can learn more and be read for more complex cases and provide the patient with their needs (S5). Successful and Unsuccessful Clinical Nursing Students. ); bl.ude.uab@issat.a (A.T.). Lfmark A, Thorell-Ekstrand I. As a library, NLM provides access to scientific literature. 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. When I wasnt informed like I was supposed to about how to use the forms, I guess I wasnt able to benefit from them as intended.. Before En ny modell for organisering av praksisstudier. When confronted with difficult conditions, there is a lack of contact and the creation of a sense of need [29]. 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]. Uniped. Ultimately, the authors concluded that while reflection is a core component of nursing education and RN standards for practice, there is little agreement among the research community on how best to assess the measurement and quality of reflection. Before However the findings also revealed opportunities for making the placement a positive experience for the students. A high level of preparedness seemed to be close to a prerequisite in order for a student to perceive the week as successful. Some students highlighted information failure and a lack of communication of expectations as reasons for not understanding what to do. In Norway there has been a 6% reduction in hospital beds from 2010 to 2014 [2]. AKG, AGG and AKR designed the study. Disclaimer. Students stated that they found the forms helpful, since they made them use the extra time wisely in reflecting on the procedures they had been observing. Some tools included specific questions for participants to reflect on, while others included open questions, or no questions. The interview guide was used as a reminder to the researchers to ensure that the themes were covered. 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. Over the past decade, there has been a reduction of hospital beds in most European countries. In the first year of my nursing programme my first placement was in an acute admission ward for older people. It also provides insight for those in smaller organisations addressing their particular challenges in identifying learning and development needs. This study shows that preparedness and guidance during placement were essential to making the week in the outpatient unit meaningful. The other main theme that was prevalent among the students who took part in this study related to the extrinsic drivers of reflection. Careers. Reflecting-in-action involves private and personal thoughts and feelings. This study aims at exploring nursing students' perspectives on the facilitators of reflective practices in the clinical setting. 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. Even if clinical placements in outpatient units face several challenges, they also have the potential to offer students positive experiences. This research received no external funding. The importance of skill development in nursing education is vital as it promotes self-awareness and develops best practice (Dolphin, 2013; Vaughan, . 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. Description. In order to meet these challenges, structured learning activities with special forms were developed by nursing educators and nurses at outpatient units. Federal government websites often end in .gov or .mil. 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]. This problem arises in the face of complicated and unique situations that are difficult to resolve [30]. In Saudi Arabia, the only study that tackled the reflection highlighted the perspectives of preceptors rather than students. The .gov means its official. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); This site uses Akismet to reduce spam. Methods: Semi-structured interviews were conducted among 21 Saudi nursing students at one major university in Saudi Arabia. Reflection is more than being contemplative; it relates to a mechanism that may help people learn from their experiences. 2009;26(2):816. 2015;15(3):15561. Thus, the findings of the study highlight the importance of emphasizing the significance of professional values such as personal responsibility and intrinsic motivational factors. Four of them undertook clinical placement at the cardiology unit and three of them at the neurology unit. Research suggests nurses who are able to effectively reflect are better at developing strategies that promote a flexible, individualised and holistic approach to patient care; resolving problems through reasoning; and monitoring and enhancing their professional competence. Gibbs model of reflection incorporates the following: description, feelings, evaluation, and conclusion. This paper has important evidence and implications for nurses, nursing educators, researchers, and regulatory bodies because reflection and reflective practice are so central to education, training, clinical practice, and registration standards and requirements both in Australia and around the world, Dr Peters said. 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]. statement and Solvoll B-A, Opsahl G, Granum V. Hvordan bidrar rammeplanen for norsk sykepleierutdanning til akademisk profesjonskompetanse? All of the researchers utilized the same questioning frameworks, posed identical inquiries, and extensively explored any new concepts in order to eliminate blind spots in the findings. In spite of limited numbers of informants in one of the focus group, rich data was provided. Across EU member states, the Health at a glance Europe 2012 report asserts a decrease in hospital beds from 6.5 beds per 1000 population in 2000 to 5.3 in 2010. In past years, a considerable discrepancy across instructional experiences and practical nursing services has resulted in a nursing care discrepancy, as well as critique of nurses care quality in some Saudi hospitals [14]. Levett-Jones T, Lathlean J, Higgins I, McMillan M. The Duration of Clinical Placements: A Key Influence on Nursing Students Experience of Belongingness. Unable to load your collection due to an error, Unable to load your delegates due to an error. Save my name, email, and website in this browser for the next time I comment. Only 4 (19.04%) were in the second semester of the third year. Concurrent data analysis allowed the generation of meaningful hypotheses through concurrent interviews, thus enabling the production of a complete understanding of the occurrences. The interviews were conducted by three of the researchers who were PhD holders and lecturing professors. Several quotes were utilized to describe the research results, providing the research subjects a real voice [19]. An interesting finding was that, although both written and oral information was given by the nurse educators, some of the students were almost unaware of being part of a project, of the concepts being used and how to use and to fill out the forms. Upon students clinical training, instructors responsibility is critical, and that the instructor should pay attention to the students discourse, critique their rationalization and perceptions, assess their effectiveness in patient interaction from various angles, and provide prompt and appropriate input. 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. Students in this study value reflection as a means of learning and it seems that reflection has led to behaviour change, problem-solving and personal and professional awareness as well as improved patient care. The literature suggests that developing a professional identity and an aspiration to learn are influenced by the length of the clinical practice [16]. BMC Nurs. Cadman K, Clack E, Lethbridge Z, Millward J, Morris J, Redwood R. Nurse Educ Today. One of the anecdotes was, our instructor is quite an inspiration he sets an excellent example for the competent and highly qualified registered nurse this makes me want to be like him when I graduate and it encourages me to reflect on my clinical practice so that I can develop into a professional nurse like him (S7). Coyne and Needham [12] show that a higher nurse-patient ratio allows more time for student supervision. They took place at the end of the informants clinical placements. asking about their experiences of the use of unit-specific learning outcomes). The Nursing and Midwifery Board of Australias (NMBA) Registered nurse standards for practice state RNs develop practice through reflection on experiences, knowledge, actions, feelings and beliefs to identify how these shape practice. ; formal analysis, Y.A., B.A., L.B. 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. Reflecting on Practices in Medicine Administration - UKEssays.com BMC Nurs 15, 49 (2016). https://doi.org/10.1186/s12912-016-0167-1, DOI: https://doi.org/10.1186/s12912-016-0167-1. 155-161. Students also viewed Spinal Cord and Nerves Anatomy week 2 Week2 notes for I had been working two shifts at the ward, so there was a lot going on in my head already, so I was maybe a little stressed because I knew absolutely nothing when I came there, so I thought that was a little senseless. ; project administration, M.F. Another student also indicated, I aspire to be an international level nurse a nurse that can practice in any type of challenging and complex setting a nurse that can be part of the leadership team; therefore, to be that, I need to always reflect on my performance to prove myself to be more competent than before and work on my areas of weakness (S20). Nilsen SR. Nr samhandling kreves : et helsevesen i endring krever ny kompetanse. Nursing students' perceptions and experiences of - ScienceDirect 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. 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. 2013;381(9874):132331. However, the study also identifies opportunities for making the placement in an outpatient unit a positive experience for the students. Barksby J., Butcher N., Whysall A. It also enables you to learn more deeply about a variety of situations and events, not just . PhD thesis. The outcomes of a research in which student nurses in Saudi Arabia were interviewed through in-depth qualitative approaches are presented in this paper. Stewart, Raymet, Fatima and Gina are four students who share their learning journey throughout the chapters of the book. Nursing students in this study have identified both personal and external drivers to practice reflection. This is in line with findings in Adamson and Dewars study [25] which emphasizes that reflective learning and the use of stories about the experience of giving and receiving care can contribute to development of knowledge, skill and confidence in the students. Epub 2017 Apr 7. Data revealed that the students preparedness when entering the outpatient unit impacted on how they described the week. FOIA As a result, it suggests a guide for education in clinical practice could include consideration of the following: which tool will be appropriate? To ensure credibility, the researcher documented and published the whole study procedure, allowing others to do follow-up investigation. Received 2022 Jun 20; Accepted 2022 Jul 25. Chambers D, Thiektter A, Chambers L. Preparing student nurses for contemporary practice: The case for discovery learning. By using this website, you agree to our At the very end of the interviews, which were each 50min long, a verbal summary of the content was presented to the informants to ensure that their experiences had been correctly understood. McLeod G.A., Vaughan B., Carey I., Shannon T., Winn E. Pre-professional reflective practice: Strategies, perspectives and experiences. The interviews took place in a quiet room at the hospital, and, with the exception of a phone call, they were conducted without interruption. Time management in nursing. Nursing students receive a sense of efficacy and value when they identify a reflection occasion and succeed in their job in a stressful clinical learning setting. 2019 Feb;35:32-41. doi: 10.1016/j.nepr.2018.11.013. This essay is a reflection of my placement which I recently took at the Princess Royal University Hospital which is under the able guidance of King's College Hospital. Student Nurse Placement Reflection and Personal Development Plan. As per several pieces of research, reflection improves student-instructor interactions, bridges the theory-practice gap, deepens learning, and strengthens meta-cognitive abilities [11,12,13]. Study: Reflection as a learning strategy for the training of nurses in This article demonstrates the meaningful learning that resulted as a consequence of using critical reflection on practice. This theme had four main subthemes; Motivation to learn, Responsibility towards patients, Desire to develop, and Ethical Regard. [This is how I am - A study of student nurses moral development]. Halden: Hgskolen i stfold; 2013. The aim of this study was to explore students' experiences of structured learning activities using forms for unit-specific learning outcomes and targeted reflection during clinical placements in outpatient units. What are your impressions on the importance of reflection in clinical practice? Reflection in medical education can be implemented in multitude of ways, depending on the restrictions of the coursework. This factsheet introduces methods to identifying L&D needs, including how to carry out a capability analysis and suggests how to collect and make use of data. Medical trainers must encourage reflection by assessing students reflective work and identifying educational obstacles in medical curricula while utilizing handwritten or web-based portfolios. California Privacy Statement, The forms directed the students attention towards the patient and their experiences and the relationships between the nurses and the patient. The aim of the 17 included studies was to help students and supervisors to fulfil their jobs at the highest possible level, authors wrote. The aim of this study was to explore students' experiences of using structured learning activities as unit-specific learning outcomes and targeted reflection during clinical placements in an outpatient unit. government site. The first group consisted of five informants. One of the most essential elements of reflection practice, according to Lawrence et al. Ahmed M.H. When confronted with unfamiliar circumstances, learners started to ponder on clinical experiences and seek knowledge from various resources in order to minimize information gaps. Terms and Conditions, A new paper, Reflection as a learning strategy for the training of nurses in clinical practice setting: a scoping review, delved into the tools and approaches used for reflection as a learning strategy for nurses and nursing students in clinical settings. There are waiting periods between most procedures at outpatient units. Compared to the regular ward which was perceived as more active, the outpatient placement was described as a relatively passive learning environment. Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. As a result, the investigators worked on the study for over three months. FOIA What do we know about coaching in medical education? According to Lloyd et al (2007) the model of skill acquisition by Benner (1984) shows how a student progresses in theory and practice according to exposure through five stages, novice, advance beginner, competent, proficient and expert. This study shows that preparedness and guidance during placement were imperative for making the week in the outpatient unit meaningful. Milko / iStock. 2013;3(9):106. The recent reforms in the health care sector have changed the requirements for professional nursing competence in the clinical field. Reflection as a learning tool in graduate medical education: A systematic review. 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. The students were approached by the researchers who were not affiliated with their university, and did not teach them any classes. Licensee MDPI, Basel, Switzerland. Words which were interpreted to capture key experiences of the informants were highlighted in the text and assigned preliminary codes [19]. Informed written consent was given by all informants. Some students described how the effect of a structured learning process enhanced their placement at the outpatient unit. Outpatient units traditionally have a higher nurse-patient ratio. The questions in the form made me look away from all the equipment they have at the outpatient unit, they made me more focused on the patients and made me think more about how the patients were being informed.. Nursing students satisfaction with supervision from preceptors and teachers during clinical practice. My journey from the last 12 weeks and progress I had made this semester also my learning experience in this semester. By using a reflective model I am going to revisit this incident with the intention of learning from it to improve my future practice. 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]. Epub 2018 Dec 3. The data will be shared by the authors of this research paper upon request. One of the most important aspects in the clinical practice reflection process was students willingness to learn more about clinical care. Personal Reflection on Learning Outcomes of Professional Practice 1 - Recognise the importance of reflective practice and understand the process of reflection This outcome relates to the NMC Proficiency of 'Demonstrate the responsibility for one's own learning through the development of a Record of Achievement of practice and recognise when further learning is required'. [Influences on nursing studensconfidence and learning in clinical practice]. 2022 Mar;7 (3):e008007. Purposeful reflection is a tool that helps nurses gain self-knowledge and insight (Palmer, 2007). Moreover, the students who took part in this study have expressed the strong ethical and moral value of their work and the need to be up to the expectations of their personal, professional, cultural, and religious values in their work. (2019) who have also indicated the value of reflective practice among student nurses in enhancing their knowledge, skills, and intellectual abilities [21]. Student Nurse Reflection Examples - EduBirdie Third year student nurse, Darren - Nursing and Midwifery Council January 2008]. Reflection and learning in student nurses - PubMed Compassionate care: Student nurses' learning through reflection and the use of story. Unauthorized use of these marks is strictly prohibited. Reflection has been shown to provide valuable professional development. Sarah Byrne is a third-year nursing student in Trinity College Dublin Student Focus - Reflection - With experience comes confidence All rights reserved by INMO. Winkel A.F., Yingling S., Jones A.A., Nicholson J. and M.F. 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]. Levett-Jones T, Lathlean J. Belongingness: A prerequisite for nursing students clinical learning. Reflecting on health and wellbeing as a student nurse: a personal 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).

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