Students' and teachers' experiences of participating in the reflection process "THiNK"

Formation of Interpersonal Competencies Through Interprofessional Simulation: Nursing and Medicine

AIM

The aim of this study was to analyze the process of interpersonal competencies formation in nursing and medical students who participated in a standardized interprofessional clinical simulation.

BACKGROUND

Interprofessional education in health sciences has had an important impact on the development of relational qualities centered on the patient.

METHOD

The study followed a qualitative interpretive approach with students. Students who participated in clinical simulation activities were asked about their experiences and their learning process with respect to interpersonal competencies. A thematic analysis of the data was performed.

RESULTS

Three themes emerged: 1) approaching the practice with uncertainty and fear of new relationships, 2) reflecting on decisions while recognizing distinctive roles, and 3) recognizing the human sense of practice while developing skills for caring and curing.

CONCLUSION

Students underwent this process and learned about empathy, communication, critical reflexive thinking, and teamwork.

A concept analysis of facilitating presence through guided reflection for transformative learning in nursing education

AIM

The aim of the study was to report an analysis of the novel concept, facilitating presence through guided reflection for transformative learning.

DESIGN

A concept analysis.

METHODS

Search included keywords 'presence', 'reflective practices', 'nursing education' and 'concept analysis'. 65 peer-reviewed articles between 2000-2020 were included.

RESULTS

The final definition of the main concept is an interpersonal, co-constructed, intersubjective and intentional process to accompany nursing students in deep, constructive learning to discover new meanings and perspectives through self-inquiry and critical reflection on experiences. The nurse educator actively listens and intimately connect in the moment to create a safe environment. This leads to the nursing student's ability to learn to see what is important to the other and to respond by doing what can be done and/or by being who the other needs one to be.

PATIENT CONTRIBUTION

This concept will help to streamline the practice of presence ultimately enhancing the quality of patient care.

From Relational Uncertainty to Interpersonal Sensitivity: A Substantive Grounded Theory for Nursing Education

AIM

The aim of our study was to understand how nursing students develop interpersonal competencies during a faculty-supervised practicum.

BACKGROUND

Researchers have studied the interpersonal competencies of nursing students in a fragmented way.

METHOD

A constructivist grounded theory approach was used for the study.

RESULTS

Four categories emerged from the data: Coping With Practicum-Related Challenges and Insecurities, Learning to Identify the Interpersonal Dimension of Nursing Care, Pedagogical Influence: Promoting (De)constructive Processes for Learning and Care, and Transforming the Self as a Nurse Through Interpersonal Relationships. A core category, From Relational Uncertainty to Interpersonal Sensitivity: A Transition of the Nursing Self Within Reflective Environments of Practice, also emerged.

CONCLUSION

The interpersonal competencies of nursing students develop in reflective environments within practicums because of interactions with patients and under the influence and modeling of the educator. Acknowledging the importance of interactions with the educator and patients within practicums can contribute to promoting more thoughtful follow-up processes from educators.

Correlates, motivating factors, and barriers of engaging in regular self-reflection among public health students in higher education-A mixed methods approach

Despite the wide implementation of self-reflection in higher education, the body of literature has predominantly focused on students from the clinical health sciences rather than public health. The objective of this study was to evaluate the correlates as well as to explore the motivating factors and barriers of engaging in regular self-reflection among public health students in higher education. We used a mixed methods approach (explanatory sequential design), comprising a cross-sectional survey (quantitative phase) followed by in-depth interviews (qualitative phase). We evaluated the association between reflection frequency as well as the perceptions and facilitators in reflection using the modified Breslow-Cox proportional hazards regression model. Prevalence ratio (PR) was generated. Thematic data analysis was carried out to analyse the qualitative data. Quantitative findings revealed being a regular reflector was positively associated with being more motivated to learn when one applied self-reflection (adjusted PR 1.60, 95% CI 1.17-2.20), the perception of being more prepared for a public health career in the future (adjusted PR 1.28, 95% CI 1.02-1.60), as well as being given enough opportunities to carry out self-reflection in the public health modules (adjusted PR 1.24, 95% CI 1.05-1.45). Qualitative findings revealed most students started their self-reflection mainly due to extrinsic factors such as institutional support, social support, teacher influence and environmental influence. Of these, the most prominent was teacher influence, indicating that they are key agents in promoting self-reflection. Students expressed that it would be important to cultivate intrinsic motivation to sustain their practice of self-reflection along the learning journey such as for the development of career-related professional skills. Other than intrinsic motivation, environmental influences were also important to promote continual reflection among students such as the availability of ample opportunities. Prominent barriers to address included external student factors such as the imbalanced power relationship between teacher and student, and internal student factors such as the perception that self-reflection was too cumbersome and time consuming.

Can a structured model of ethical reflection be used to teach ethics to nursing students? An approach to teaching nursing students a tool for systematic ethical reflection

BACKGROUND

Nurses encounter many ethical dilemmas in their practice. The ability to make good ethical decisions is a necessary competence in healthcare professions. International studies call for development and research on various methods to teach healthcare professionals ethics. This article describes an approach for learning how to be aware of and discover ethical dilemmas. By applying experienced narratives from healthcare practice and using question guidelines from a structured ethical model, nursing students learn to discover and find possible solutions for ethical problem in their practice.

AIM

The aim of this study was to describe second- and third-year nursing students' experiences by using structured ethical reflection as an approach to increase ethical awareness and deal with ethical decisions.

DESIGN

This study has a descriptive exploratory design. A three-day ethics seminar was carried out to help students learn how to recognize and explore ethical dilemmas in their practice.

MATERIALS AND METHODS

The data are collected from questionnaires used to evaluate the ethics seminar where 52 nursing students participated. The questionnaire contained open-ended and closed questions and was analysed using Braun and Clarke's reflexive thematic analysis. The empirical data were collected by 52 nursing students answering an evaluation questionnaire after the ethics seminar.

FINDINGS

Four themes were developed: Becoming aware of ethical dilemmas, Learning ethics by discussing knowledge and experiences with other students, Increased curiosity about ethics as a subject and Understanding the importance of critical ethical reflection work in clinical practice.

DISCUSSION

The process of learning how to understand the ethical principles in real-life nursing context continues progressing through the bachelor's program. Using group discussions and discussing examples of ethical dilemmas from practice help the students to a more comprehensive reflection process.

CONCLUSION

The nursing students experienced video lessons, group discussions and the use of a structured reflection model as a valuable approach in learning to recognize ethical dilemmas and how to deal with real-life ethical dilemmas.

Reflective writing pedagogies in action: a qualitative systematic review

OBJECTIVES

Reflective practice is a core value of nursing education and emphasizes the self as a source of learning. Writing and reflection are often viewed as inseparable. The goal of this qualitative meta-study is to explore the mechanisms writing stimulates to promote learning transformation for nursing students in both clinical and classroom contexts.

METHODS

A literature search using the CINHAL, Medline, ERIC, and Academic Search Complete databases, using systematic methods, identified 26 papers and dissertations which gathered narrative data from nursing students in pre- and post-registration undergraduate courses.

RESULTS

Three themes were found describing: 1) Evolving through time and space to reflect; 2) Surfacing and absorbing; and 3) Trust, judgement, and social desirability in the feedback process.

CONCLUSIONS

Transformative learning is promoted through forming a bond with faculty during the writing process to normalize emotions, create critical self-awareness, and providing a safe, non-judgemental space to reflect on their practice and their learning.

Developing reflective competence between simulation and clinical practice through a learning transference model: A qualitative study

OBJECTIVE

This study sought to understand the effects of a pedagogical resource combining a multi-moment debriefing model with reflective journaling that is designed to develop reflective competence.

DESIGN

A qualitative educational study was used with an instrumental case study design. Participating in the study were 32 nursing students who wrote 96 individual reflective journals in accordance with each moment (M1, M2, M3) of the proposed reflective practice resource. The journaling was conducted during both the clinical simulation activity and the period of clinical practice.

METHODS

The reflective journals resulting from the high-fidelity clinical simulation process were used to explore three moments of learning: debriefing immediately after simulation, post-scenario debriefing, and clinical practice. The typology of content analysis used was classical content analysis, which followed a deductive logic, since to assess reflection levels the 5Rs Reflective Writing Scale was used.

RESULTS

In the post simulation moment (M1), students produced a greater number of meaningful units associated with a level of strategic narrative reflection. During clinical practice however reflection was more analytical, with the highest level of reflection.

CONCLUSION

Nursing students developed reflective competence through an iterative process of reflective practice establishing a continuum between simulation experience and clinical.

Nursing Students' Experiences of Clinical Practices in Emergency and Intensive Care Units

Clinical practices are key environments for skill acquisition during the education of nursing students, where it is important to encourage reflective learning. This study sought to explore the experience of final year nursing students during their clinical placement in emergency and intensive care units and to identify whether differences exist between female and male students. Using qualitative methodology, a documentary analysis of 28 reflective learning journals was carried out at a public university in Northern Spain. Four themes were identified: "an intense emotional experience", "the importance of attitudes over and above techniques", "identifying with nurses who dominate their environment and are close to the patient in complex and dehumanized units" and "how to improve care in critically ill patients and how to support their families". The female students displayed a more emotional and reflective experience, with a strong focus on patient care, whereas male students identified more with individual aspects of learning and the organization and quality of the units. Both male and female students experienced intense emotions, improved their learning in complex environments and acquired attitudes linked to the humanization of care. However, the experience of these clinical rotations was different between female and male students.

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.

Healthcare providers' experiences of assessing and performing oral care in older adults

AIMS AND OBJECTIVES

The purpose of this study was to describe healthcare providers' experiences, knowledge and attitudes in relation to the assessment of oral health in older adults.

BACKGROUND

Oral health is an important element in the care of older adults. An increasing proportion of older people need the help and support of community-based healthcare services, which are responsible for providing oral health assessment for this group. Although oral care is an important part of nursing care, studies show that it is often an overlooked area in the care of older people.

DESIGN

An inductive qualitative description design was used.

METHODS

The participating healthcare providers were selected from a municipality in western Sweden. Purposeful sampling was employed and data were collected through focus-group interviews and were analysed with content analysis.

RESULTS

The analysis resulted in four categories: healthcare providers' knowledge and attitudes to oral health; routines affect flexibility; challenges in assessing and performing oral care and ethical dilemmas. The results showed that oral health was neglected because of several factors. Lack of knowledge, inadequate procedures and time constraints were most prominent. The healthcare providers' own attitudes affected the performing of oral health assessments. Ethical dilemmas related to the attitudes of those people in receipt of care and their relatives, and their integrity and autonomy, could be seen as complicating factors.

CONCLUSIONS

The healthcare providers expressed that they did not have the necessary knowledge of oral health that was required in their area of responsibility. In addition, they described their own attitudes as being important when attending to the patients' oral health.

IMPLICATIONS FOR PRACTICE

The healthcare providers themselves identified lack of knowledge and their own attitudes as being especially important factors in the oral care of older adults, and further research in this area is needed.

Nursing student and professor perceptions and assessments of the achievement of practicum competencies: A mixed method approach

Within the context of the European Higher Education Area's requirement of competency-based assessments, the objective of the present study was to evaluate the Nursing Degree Practicum experience at the University of Girona (Spain) and ascertain student and faculty perceptions of the degree of competency achieved as a result of the practicum. This cross-sectional, descriptive, study combined quantitative analysis of a questionnaire and qualitative analysis of focus group comments. In the quantitative part of the study, 163 fourth-year nursing students completed the questionnaire; the qualitative analysis was derived from a focus group of 5 students and 5 professors. On the questionnaire, overall practicum evaluation was 8.39 on a 10-point Likert scale; scores evaluating the nurse mentor/instructor and nursing professor were 8.43 and 7.98, respectively. The geriatrics practicum experience received the lowest overall score (7.81), while the surgical practicum received the lowest score on the adequacy of knowledge acquired in the classroom in previous courses (5.54). The best scores were earned by the mental health and intensive/emergency care practicum experiences (a mean of 9.05 and 8.70, respectively). Students and professors in the focus group agreed that the practicum met the Nursing degree program's competency goals, highlighting practical activity as the best methodology to evaluate competencies. Participants highlighted the importance of reflective practice and the role of the nurse mentor/instructor in student learning, and indicated that it is essential for the university and the health care centers where students take practicum courses to maintain a strong relationship and good communication. Finally, feedback from the nurse mentor/instructor and Nursing professor was very important to students, both to motivate them and to help them learn.

Nurses' experiences working with nursing students in a hospital: a phenomenological enquiry

Objective:

this paper explores the experiences of registered nurses working with Spanish nursing students within the hospital.

Methods:

a qualitative phenomenological approach was followed. Purposeful sampling was employed. Twenty-one registered nurses, from a public hospital located in Spain, were included in the study. Data were collected by means of unstructured and semi-structured interviews and were analysed using Giorgi's proposal. The Consolidated Criteria for Reporting Qualitative Research were followed.

Results:

three main themes described the experience of registered nurses: "The nurse's relationship with nursing students"; most nurses emphasized the importance of the first contact with students and they considered students' attitude to be key. "Defining the role of the student in clinical practice"; it is necessary to unify the nurse's role and interventions to avoid misleading students and establish priorities in clinical practice. "Building bridges between clinical settings and the University"; the need to establish a common ground and connection between the university and hospital clinical settings was emphasized. Nurses felt that the training program should also be designed by the clinical settings themselves.

Conclusions:

understanding the meaning of nursing students with registered nurses might gain a deeper insight into their expectations.