Experiential Learning Program to Strengthen Self-Reflection and Critical Thinking in Freshmen Nursing Students during COVID-19: A Quasi-Experimental Study

This article focuses on the unique needs and concerns of nursing educators and nursing students in the face of the COVID-19 pandemic. During social distancing, interacting with other human beings has been restricted. This would undermine the experiential learning of nursing students. Hence, it is important to develop and evaluate an experiential learning program (ELP) for nursing education. A pre-test and post-test design were used. The study was conducted in a university in Central Taiwan. A total of 103 nursing students participated in the study from February to June 2019. The study intervention was the experiential learning program (ELP), including bodily experiences and nursing activities with babies, pregnant women, and the elderly. After the intervention, the students completed the self-reflection and insight scale (SRIS) and Taiwan Critical Thinking Disposition Inventory (TCTDI) as outcome measures. An independent t-test showed that there was a significant difference between pre-test and post-test in both SRIS and TCTDI (p < 0.01). The Pearson product-moment correlation analysis showed that SRIS and TCTDI were significantly positively correlated (p < 0.01). ELP has a significant impact on the self-reflection and critical thinking of first-year nursing students, which can be used as a reference for the education of nursing students. During these turbulent times, it is especially vital for faculties to provide experiential learning instead of the traditional teaching concept.

El diario del estudiante de enfermería en la práctica clínica frente a los diarios realizados en otras disciplinas. Una revisión integradora

El presente artículo es una revisión integradora de la literatura cuyo objetivo fue identificar, en revistas nacionales e internacionales indexadas en las bases de datos Isi Web of Knowledge, Eric, PubMed, EbscoHost, Scopus, SciELO, Cuiden, Cuidatge y Scirus, en el periodo comprendido entre 1995 y 2011, datos que contribuyeran a determinar cómo la escritura del diario reflexivo ayuda al estudiante de enfermería durante sus prácticas clínicas, así como a establecer diferencias y similitudes con los diarios realizados por estudiantes de otras disciplinas. Se llevó a cabo una revisión amplia de la cual se seleccionaron 54 artículos científicos con base en criterios de inclusión y exclusión, sin descartar ninguna metodología de investigación e incluyendo aquellos que analizaran el diario del estudiante, fueran o no del ámbito de la enfermería. Se concluye que la escritura del diario reflexivo que realiza el estudiante de enfermería durante sus prácticas clínicas tiene beneficios tales como la mejora de la comunicación con el paciente, fundamental para el cuidado. La escritura del diario debería ser incluida en todos los planes de estudio de grado en el ámbito de las prácticas clínicas.

Reflective practice groups for nurses: a consultation liaison psychiatry nursing initiative: part 1--The model

In the present study, we outline the evolution of a process-focused reflective practice group (RPG) model for nurses working in clinical settings. The groups were initiated at Redcliffe and Caboolture hospitals by the consultation liaison psychiatry nurse and author. An associated article provides an evaluation of these RPG. The literature review identifies the key themes and theories on which the model is based, and the article outlines the process and practicalities of facilitating RPG in critical care, midwifery, and oncology specialties over a 3-year period. The model proposes that the effectiveness and sustainability of RPG arises from adequate preparation and engagement with prospective participants. Group rules, based on principles of confidentially, supportiveness, and diversity, were collaboratively developed for each group. Facilitation utilized a group-as-a-whole approach to manage process and stimulate reflection. While the purpose of RPG was a reflection on interpersonal aspects of nursing, contextual workplace issues were frequently raised in groups. Acknowledgement and containment of such issues were necessary to maintain clinical focus. The literature highlights facilitator credibility and style as crucial factors in the overall success of RPG, and it is proposed that reflective practice as a process-focused model for groups succeeds when nurse facilitators are trained in group process and receive concurrent supervision.

'Do not ask who I am...': confession, emancipation and (self)-management through reflection

AIM

This study explores and extends some recent Foucauldian critiques of reflection and clinical supervision in nursing.

BACKGROUND

Although reflection is often accepted uncritically, several writers have claimed that it is being employed (albeit perhaps unwittingly) as a management tool to facilitate the governmentality of the workforce by establishing conditions whereby so-called reflective practitioners monitor and regulate their own practice in an essentially self-repressive way.

EVALUATION/EXAMINATION

We evaluated these critiques and extended them with reference to Foucault's later writing, particularly on the 'care of self'.

KEY ISSUES AND CONCLUSIONS

Our exploration of these critiques prompted us to distinguish between two different projects of reflection, which we term the ontological and the epistemological. The ontological project regards the aim of reflection as personal growth under the direction of an enlightened guide, and we argue that there is a real danger that such an approach might degenerate into what one critic has termed 'a subtle but persuasive exercise of power'. The epistemological project, on the other hand, is concerned with an exploration by practitioners of their own methods of thinking about their practice, and as such, has the potential to become truly emancipatory.

Constructing a New Approach to Developing Evidence-Based Practice with Nurses and Older People

PURPOSE

Providing evidence-based nursing care to older people is central to the international development agenda. This paper is a report on the first 5 years (2000-2005) of a participatory research project, the purpose of which was to collaborate with practitioners and older people to develop approaches to promote the attainment of evidence-based nursing care across Scotland.

DESIGN

Many theoretical influences shaped the design of this action research study including realistic evaluation, participatory social learning theory, and descriptions of communities of practice. Multiple methods of data collection were used during four action cycles. The inaugural community of practice comprised 30 nurses, a second group of 30 nurses joined midway, followed by a third group of 15 nurses, and finally, an older person-carer community of 21 members was established.

FINDINGS

Project outputs included the construction of an internet-based, practice-development college. A procedural model for developing and demonstrating care guidance drawn from a diversity of evidence and reflective of an agreed set of principles was piloted and endorsed by the national standard setting agency. A preliminary version of a promising approach to practice development, "the Caledonian Model," was delineated for future testing and refinement.

CONCLUSION

This work indicates the merits of using participatory research to find solutions to the challenge of promoting evidence-based practice. Evaluation data suggest that in combination, the approaches developed in this project empower nurses to work with older people to champion developments even in seemingly unfavorable conditions.

Reflective practice in nursing ethics education: international collaboration

BACKGROUND

The Internet provides the opportunity for international comparative study and collaboration when learning about ethics in clinical nursing practice.

AIM

This paper aims to discuss Internet links developed between US and UK postregistration nursing students who were reflecting on clinical practice in order to explore how political and organizational structures of the health care system affect ethical decision-making.

DISCUSSION

An analysis is presented of the stages in developing an exchange course for students from these countries, which involved various combinations of classroom-based teaching, on-line discussions and international visits by students and teachers during its evolution. The strengths and weaknesses of the different methods are considered, and future developments identified.

CONCLUSION

The Internet collaboration resulted in postregistration nursing students using reflection on practice in the study of ethics in clinical practice and an understanding of how systems structures and procedures affect ethical decision making. Internet-assisted teaching offers opportunities for collaboration, and student participants demonstrate sophisticated critical thinking in ethical decision-making. Issues of access barriers and motivation remain challenges to wider use.