The use of reflective practice on critical incidents, in a neonatal setting, to enhance nursing practice

Improving nurses' knowledge, attitude, and performance in relation to ethical codes through group reflection strategy

BACKGROUND

The most basic responsibility of nurses that even precedes their therapeutic role is respect for professional ethics in providing clinical care. The present study was conducted to determine the effect of group reflection on the knowledge, attitude and performance of nurses in relation to ethical codes.

METHODS

The present blinded, before-after, educational trial was conducted on 86 nurses working at a general hospital in the south of Iran who were randomly divided into a intervention (n = 44) and a control (n = 42) group. Data were collected before and after the intervention using three tools, including a knowledge test, an attitude rating scale and a performance questionnaire. In the intervention group, the intervention given consisted of four sessions of group reflection, and the control group received a single lecture on ethical codes.

RESULTS

The mean changes in the nurses' score of knowledge after the intervention compared to before differed significantly in both intervention and control groups (P < 0.001), but there was no significant difference between the two groups in terms of the mean changes in the score of knowledge (2.73 ± 3.45 in intervention group vs. 2.57 ± 3.36 in control group, P = 0.83). Although the mean score of attitude differed significantly between the intervention and control groups in the posttest (34.7 ± 8.44 in intervention group vs. 29.95 ± 9.09 in control group, P < 0.014), the two groups were not significantly different in terms of the mean changes in the score of attitude in relation to ethical codes before and after the intervention (P < 0.14). Moreover, the two groups were significantly different in terms of the mean changes in the scores of performance in the two stages (9.07 ± 16.84 in intervention group vs. 0.67 ± 20.01 in control group, P < 0.001).

CONCLUSION

Group reflection can improve the knowledge, attitude and performance of nurses in relation to ethical codes. Although lectures can help improve nurses' knowledge and attitude in this area, they have no significant effects on their performance.

TRIAL REGISTRATION

Iranian Registry of Clinical Trials (No: IRCT2016070317546N6, registration date: 10 October 2016), https://www.irct.ir/trial/16112.

Critical Incident Techniques and Reflection in Nursing and Health Professions Education: Systematic Narrative Review

BACKGROUND

The terms critical incident technique and reflection are widely used but often not fully explained, resulting in ambiguity.

PURPOSE

The aims of this review were to map and describe existing approaches to recording or using critical incidents and reflection in nursing and health professions literature over the last decade; identify challenges, facilitating factors, strengths, and weaknesses; and discuss relevance for nursing education.

METHODS

A systematic narrative review was undertaken. MEDLINE and the Cumulative Index to Nursing and Allied Health Literature were searched using MeSH terms, returning 223 articles (2006-2017). After exclusions, 41 were reviewed.

RESULTS

Articles were categorized into 3 areas: descriptions of the development of an original tool or model, critical incidents or reflection on events used as a learning tool, and personal reflections on critical incidents.

CONCLUSIONS

Benefits have been identified in all areas. More attention is needed to the pedagogy of reflection and the role of educators in reflection.

Self-reflection during first clinical practice: The experiences of nursing students

BACKGROUND

Self-reflection can be used as a tool for describing student experiences and have a significant impact on their learning. It enables nursing students to develop the ability to identify and analyse their problems and find possible solutions.

OBJECTIVE

To present students' self- reflection in their first clinical practice as their first stage of our nursing study program.

METHODOLOGY

The research was based on a naturalistic philosophical paradigm using a qualitative methodological approach. The research took place at one of the Slovenian universities with an undergraduate nursing education program. Purposive sampling was chosen. The data were obtained through written self-reflection diary entries collected between March and June 2016. A thematic analysis was selected for data analysis. Ensuring that all ethical considerations were covered, seventeen students in the first clinical practice were included.

FINDINGS

Three main thematic themes were identified that define the experience of students in their first clinical practice: (1) emotional experience, (2) interpersonal relationships, (3) learning.

CONCLUSIONS

The research has found that the experiences and the perceptions of students in the first clinical practice are mainly expressed emotionally. Self-reflection helps students to express emotions and feelings to reliving and to identifying problems and also, to understanding themselves better. Further research should be focused on the importance of the students' self-reflections in their professional and personal growth.

To pass or to fail? Understanding the factors considered by faculty in the clinical evaluation of nursing students

Making the decision to pass or to fail a nursing student is difficult for nurse educators, yet one that all educators face at some point in time. To make this decision, nurse educators draw from their past experiences and personal reflections on the situation. Using the qualitative method of critical incident technique, the authors asked educators to describe a time when they had to make a decision about whether to pass or fail a student in the clinical setting. The findings describe student and faculty factors important in clinical evaluation decisions, demonstrate the benefits of reflective practice to nurse educators, and support the utility of critical incident technique not only as research methodology, but also as a technique for reflective practice.