and M.F. 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). Inclusion criteria for joining the study were: second-year students, undergoing clinical placement at the cardiology or neurology units. Andersen KL, Nilsen SR: Tilpasning til framtidens spesialisthelsetjeneste. 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]. This study shows that use of outpatient units for clinical placement in nursing studies has several challenges but also the potential for creating positive experiences for the students. My personal and professional development will allow me to facilitate and encourage the learning and development of other nursing students in the future. government site. Springer Nature. Therefore, more precise, consistent reporting on the outcomes of interventions to promote reflection would help educators and clinical supervisors decide which tools and approaches may fit their specific clinical practice and promote reflection among participants to develop care competencies.. Many of the respondents wished to improve their own expertise in order to give better treatment. The researchers were aware that inclusion of more informants might have provided additional data; it was however only these students who underwent this particular experience. Provided by the Springer Nature SharedIt content-sharing initiative. This study shows that preparedness and guidance during placement were imperative for making the week in the outpatient unit meaningful. ); bl.ude.uab@issat.a (A.T.). In Norway there has been a 6% reduction in hospital beds from 2010 to 2014 [2]. The informants were verbally informed and given written information stating the purpose of the study, that the data would be handled confidentially, and that they had the right to withdraw at any time without any consequences for them. The intention of clinical practice is to acquire basic nursing skills in a natural environment [4]. This allows time for reflection. Overall, the review found interventions, tools, approaches and the measurement of nurses reflection in clinical practice settings are highly varied. Nursing is the art of caring for the patient during illness. 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. Before and A.T.; resources, Y.A. Krueger and Casey (2015)s interview guide (Table 2) was used in order to conduct the interviews as follows: The components of each interview were transcribed and typed shortly thereafter. 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]. All authors read and approved the final manuscript. Careers, Unable to load your collection due to an error. AKG, AGG and AKR designed the study. The retrieved themes were given to peers for external review, and their suitability was checked and confirmed, and agreement was reached. 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. To ensure credibility, the researcher documented and published the whole study procedure, allowing others to do follow-up investigation. 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. One of the ways I accomplished this task was, at the beginning of the placement, ask the preceptor for a list of commonly used medication and then use the medication charts to create a list of any unfamiliar medications so that I could research and be able to provide the necessary information. which approach should be used? In: Valle R.S., King M., editors. As per the research carried out by Hwang et al. Newton and McKenna [23] argue that students are often not ready to understand the expertise and advanced treatments that take place in such specialist areas. PhD thesis. Informed written consent was given by all informants. Introduction and background. Relji N.M., Pajnkihar M., Fekonja Z. Self-reflection during first clinical practice: The experiences of nursing students. 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. The study followed the principles of the Declaration of Helsinki and the Norwegian Social Science Data Services [27, 28]. In order to learn, students need to feel a sense of belonging [15]. However the findings also revealed opportunities for making the placement a positive experience for the students. This study aims at exploring nursing students' perspectives on the facilitators of reflective practices in the clinical setting. Ruffinelli A., de la Hoz S., lvarez C. Practicum tutorials in initial teacher training: Conditions, strategies, and effects of reflective practice. Unauthorized use of these marks is strictly prohibited. Pre-registration nursing students enjoy a wealth of learning during community placements, develop invaluable knowledge and skills and gain exposure that may help them consider this dynamic field . The .gov means its official. Our results are also in line with Choperena et al. Lancet. Thus, the findings of the study highlight the importance of emphasizing the significance of professional values such as personal responsibility and intrinsic motivational factors. The questions were inspired by the content of these forms. As a result, the investigators worked on the study for over three months. Federal government websites often end in .gov or .mil. Nurse Educ Pract. The importance of preparing students for their clinical practice, including an ability to integrate theory into a clinical setting and to secure time for reflection, to promote learning and confidence, has been highlighted in several studies [1214]. [7] claim that good co-operation between clinical staff and nurse educators is necessary for providing a good learning environment for nursing students. Declaration of Helsinki - Ethical Principles for Medical Research Involving Human Subjects [https://www.etikkom.no/en/ethical-guidelines-for-research/medical-and-health-research/declaration-of-helsinki/], Norwegian Social Science Data Services (NSD) [http://pvo.nsd.no/prosjekt/sok?s=40573&innmeldt_fra=&innmeldt_til=&institusjon=0&side=1. As an education provider, a trainer should push students to gain more from other sources and patients who are similar to them [27]. 2012;51(7):38995. HHS Vulnerability Disclosure, Help As author2 was also a nurse educator for the informants, author1, who was unknown to the informants, was in charge of the interviews. Consequently, to facilitate nurse students' development into professionals, learning support is needed where the focus is on understanding caring and becoming caring nurses. There are many reflective models . Students attempt to obtain information that may be applied in a variety of clinical contexts by reflecting on clinical training [23]. In order to obtain rich and meaningful data, probing questions were sometimes asked by both researchers to extend or narrow the field of interest (e.g. 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. Outpatient units traditionally have a higher nurse-patient ratio. This sense has led students to reflect on their clinical experiences and knowledge as they want to be completely responsible for their patients and doing them good. Federal government websites often end in .gov or .mil. Data were analyzed by means of content analyses. What does the term reflection mean to you? Four of them undertook clinical placement at the cardiology unit and three of them at the neurology unit. One aim of the reforms in nurse education is to produce reflective practitioners. When nurses reflect, they purposefully "bend back" their attention in a focused attempt to discover personal . 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. The students expressed their urge to enhance their critical thinking, decision making and practical skills so that they evolve into highly competitive nurses in the labor market. In: Sluttrapport S-Hi. 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. 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. What levels of reflection are identified or achieved: low (descriptive), middle (application), or high (evaluative)? Data revealed that some of the students lacked comprehensive understanding about being part of this specific project, of the terms used and about the forms. and M.F. The scoping review included 17 studies from around the world, conducted between 2007-2020 . Time management in nursing. The researchers protracted engagement with the data and good communication with the respondents have developed the credibility of the findings. The interviews started by obtaining biographical data and with open dialogue during which the informants were encouraged to talk freely about their experiences (e.g. The first group consisted of five informants. One of the most essential elements of reflection practice, according to Lawrence et al. (2018) on nursing staff, there was a link between reflection, intellectual growth, and career development; additionally, it was discovered that reflection improves mental wellbeing. The transcriptions were anonymized and coded where each participant was assigned pseudonym from S1 to S21. Self-reflection looks inward and listens to the whispers. Elevating the Patient Experience : Advancing Towards Person-Centred Care - Practice #3: Off-Ward Experience Shadowing [https://www.advisory.com/sitecore%20modules/web/~/media/ABI/Research/GCNE/Studies/2012/PatientExperience.pdf]. This is consistent with findings in Lewallen and DeBrews studies [13, 21]. ; formal analysis, Y.A., B.A., L.B. Informal reflection has many benefits but can result in superficial learning. Students could decline to be further contacted. Qual Health Res. Data were collected by means of focus group interviews during spring 2015. 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. Concurrent data analysis allowed the generation of meaningful hypotheses through concurrent interviews, thus enabling the production of a complete understanding of the occurrences. Conventional content analysis following Hsieh and Shannon [19], also described as inductive category development [20], was used. Students may not feel adequately prepared for the multiple challenges, and it can be difficult to know how to approach this. The art of caring should therefore be emphasized both in theory and in clinical practice. Purpose Statement The forms directed the students attention towards the patient and their experiences and the relationships between the nurses and the patient. Compared to the regular ward which was perceived as more active, the outpatient placement was described as a relatively passive learning environment. 2013:17. . The study sample was made up of 21 male nursing students from one nursing school at a major university at Saudi Arabia, where 3 (14.28%) where in the second semester of their first year, 4 (19.04%) where in the first semester of their second year, 5 (23.80%) from the second semester of the second year and another 5 (23.80%) from the first semester of their third year. Faculty of Health and Social studies, stfold University College, P.O. Publishers Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. 1Emergency Department, Al-Amal Psychiatric Hospital, Qassim, Buraydah 52326, Saudi Arabia; as.vog.hom@hamalaslasy, 2Medical Surgical Nursing Department, College of Nursing, University of Hail, Hail 55476, Saudi Arabia; as.ude.hou@iwagabla.b, 3College of Nursing, King AbdulAziz University, Jeddah 22252, Saudi Arabia; as.ude.uak@riakbabl, 4Department of Nursing, Qassim University, BSN, RN, Riyadh 52571, Saudi Arabia; as.ude.uq@hamalasla.f, 5Faculty of Health Sciences, Beirut Arab University, Beirut 11-5020, Lebanon; bl.ude.uab@inati.dammahom (M.S.I. April 25, 2023. This shows that new concepts and the use of new forms must be explained in detail, since an understanding of what to do is an important part of being prepared. Karanikolos M, Mladovsky P, Cylus J, Thomson S, Basu S, Stuckler D. Financial crisis, austerity, and health in Europe. 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. Lawrence C., Mhlaba T., Stewart K.A., Moletsane R., Gaede B., Moshabela M. The hidden curricula of medical education: A scoping review. Vrd i Norden 2010. The model will be applied to the essay to facilitate critical thought, relating theory to practice where the model allows. The authors read the interviews right through each by themselves in order to obtain a sense of the whole. 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. official website and that any information you provide is encrypted Learn how your comment data is processed. Newton JM, McKenna L. The transitional journey through the graduate year: A focus group study. Chambers D, Thiektter A, Chambers L. Preparing student nurses for contemporary practice: The case for discovery learning. In order to secure as open-minded an approach as possible, the researchers discussed their own preconceptions on the topic and made efforts to put these aside during the data collection and analyses. Over the past decade, there has been a reduction of hospital beds in most European countries. Tellingly, none of the 17 studies examined included the same combination of elements. Stewart, Raymet, Fatima and Gina are four students who share their learning journey throughout the chapters of the book. The authors declare that they have no competing interests. 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. 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. Article The decrease in the number of hospital beds in parallel with the increase in the number of nursing students has created a challenge in terms of providing the best possible learning facilities under given conditions in hospitals. Immediately after the interviews, notes were made by author1 to capture the setting and reflections in respect of the informants emotional responses. For example, one of the students shared, one time I had a patient who is 19 years old this made me put myself in their shoes and pay attention to more details regarding the case and the management as his case was truly critical and I was thinking I can be in his place at any moment in life this make me think a lot about my work and the value of careI felt I want to read more about it afterwards and I did (S2). A previous collaboration project between stfold University College (Hi) and stfold Trust Hospital (S) in Norway aimed to try out a rotation programme between traditional wards and outpatient units. This has led to a sustained investment in outpatient treatment facilities and ambulatory care [2]. Lautebach and Becher (1996) relate self-reflection to caring for the self. and transmitted securely. 8600 Rockville Pike To pass or to fail? Nursing students in this study have identified both personal and external drivers to practice reflection. 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. In the future, educators, preceptors and students need to continue developing the concepts and forms. The study has a qualitative explorative design. FOIA Mayring P: Qualitative Content Analysis. The .gov means its official. Reflection is a powerful tool for enhancing learning and knowledge acquisition and is essential for teachers and students. The age of the informants, six women and one man, ranged between 20 and 41years (mean 28, median 22). When comparing results between studies, authors should explicitly state the foci or themes reflected on, as well as the length of the intervention period and the level of students educational experience.. J Nurs Educ Prac. In an advanced clinical setting with complex technology and treatments, it can be difficult for inexperienced nursing students to actively seek knowledge. [How does the curriculum in the Norwegian nurses' education system contribute to an academic professional competence?]. The complex technologies in some of these units represent a challenge for students who have limited existing knowledge or experience. 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]. Reflection has been more prominent in educational facilities over the past years, and it is now recognized as a component in gaining competency. It also enables you to learn more deeply about a variety of situations and events, not just . The researchers who interviewed the students were two males and one female, where all three of them had experience in conducting qualitative research. Terms and Conditions, Box 700, NO, 1757, Halden, Norway, Ann Karin Helgesen&Anne Grethe Gregersen, Nursing Department, stfold Trust Hospital, P.O. Students also find the procedure of reflection difficult and feel that it does not occur spontaneously, therefore, it needs a safe and secure atmosphere in which they may cultivate reflection with the assistance of professionals. 2012;12(3):1649. A new model for organizing practical training]. 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. Correspondence to Lfmark et al. To maintain this association, it is important that the clinical placement offers an environment where this can be taught. The phenomenological data analysis has given rise to the following themes and subthemes as stated in Table 4: The first theme that emerged from analyzing the verbatim of the participating students pointed towards intrinsic drivers for reflection, where students have felt something within them that have triggered them to go back and think more deeply about their clinical experience and learn from it. Students also viewed Spinal Cord and Nerves Anatomy week 2 Week2 notes for Reflection in Action: Developing Reflective Practice in Health and Social Services. 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. https://doi.org/10.1186/s12912-016-0167-1, DOI: https://doi.org/10.1186/s12912-016-0167-1. Levett-Jones T, Lathlean J, Higgins I, McMillan M. The Duration of Clinical Placements: A Key Influence on Nursing Students Experience of Belongingness. The time scheduled for the interviews was changed shortly before they were due to take place and two students failed to notice the change. 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. By using a reflective model I am going to revisit this incident with the intention of learning from it to improve my future practice. For instance, one of the students said my work as a nurse is guided not only by professional ethics but also by moral and cultural values too, which makes me in need to always relate my practice and performance to, so that I can be sure that I am doing the right thing I mean I would want to be treated in a dignified manner if I was ever in the place of the patient (S1). Forum: Qualitative Social Research 2000, 1(2). A similar experience was also shared by another student, I mean with clinical training you get to detect where exactly is your knowledge and skills are lacking and this should make you feel that you need to fill these gaps this can only be done by reflecting on where did you go wrong or where you could have done better or thinking about which aspects of patient care you still do not know much about this motivation to learn more about patients and clinical care makes me want to reflect every piece of new knowledge on my practices (S21). More focus on outpatient care has also led to fewer opportunities for studying the continuity of a patients life situation. Data showed that the forms guided the students through their placements in the outpatient unit. More focus on outpatient care has also led to fewer opportunities for studying the continuity of a patients life situation. Background: Reflection increases meta-cognitive capacities, promotes student-instructor relationships, overcomes the theory-practice gap, and enriches learning. This problem arises in the face of complicated and unique situations that are difficult to resolve [30]. Colet P.C., Cruz J.P., Cruz C.P., Al-Otaibi J., Qubeilat H., Alquwez N. Patient safety competence of nursing students in Saudi Arabia: A self-reported survey. 81 Report Document Comments Please sign inor registerto post comments. The informants have given consent to publish. 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. Nonetheless, the required abilities for reflection are vague, and learning reflection is difficult. Holmsen TL: Hva pvirker sykepleierstudentenes trygghet og lring i klinisk praksis? Google Scholar. Please enable it to take advantage of the complete set of features! and M.F. Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. Nursing in the Australian Healthcare System (NUR1101) Introduction to Psychology II (PSYU1102) Software Testing (ITECH7409) Civil Procedure and Arbitration (200813) Newest Vector Calculus (MAST20009) Fraud and Cybercrime (3026ccj) Foundations of Property Law (LAWS12065) Foundations of Nursing Practice 2 (NURS11154) Corporations Law (LAWS13009) 1. 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. The literature suggests that developing a professional identity and an aspiration to learn are influenced by the length of the clinical practice [16]. The scoping review found most studies used physical tools and reflective dialogues in clinical settings. The data was analyzed using a standard qualitative content analysis technique. Witnessing change with aspiring nurses: a human becoming teaching-learning process in nursing education. Students take a more active approach to seeking knowledge when given structured learing activities during clinical placement in outpatient unit. The researchers alternated conducting the interviews to avoid the potential of a moderators domination; Each interview took between 20- and 25-min. According to another research, students require the assistance of the trainer in identifying difficulties that require reflection. Reflection is a vital skill in contemporary nursing with student nurses expected to engage in reflective learning from the very beginning of the nurse educational programme. This theme had four main subthemes; Motivation to learn, Responsibility towards patients, Desire to develop, and Ethical Regard. The majority of the students felt that their values have driven them to reflect on what they have practiced, how they dealt with the patient, the family, and their colleagues so that they can detect any wrongdoing and make sure to avoid such encounters in the future. Contemp Nurse. Other students were well prepared for the new experiences, as they had read and used the forms ahead of the week in the outpatient unit in order to be alert. The aim of the 17 included studies was to help students and supervisors to fulfil their jobs at the highest possible level, authors wrote. Students who were registered in a bachelor nursing degree at the targeted university, had at least one semester of clinical training program, and were prepared to partake and discuss their insights met the studys inclusion criteria. The importance of skill development in nursing education is vital as it promotes self-awareness and develops best practice (Dolphin, 2013; Vaughan, . Being prepared, which was one of the categories, incorporated the subcategories being able to understand what to do, being at the right place at the right time and being alert for new experiences. The current study was undertaken to explore the nursing students perspectives on the facilitators of reflective practices in the clinical setting. This research received no external funding.
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