THE SELF-REFLECTION AND INSIGHT SCALE: A NEW MEASURE OF PRIVATE SELF-CONSCIOUSNESS

A Mixed-Methods Study Exploring Coping Self-Insights Associated with Resilience

Self-insight has been associated with psychological resilience; however, less is understood about the role coping-specific self-insights play in strengthening resilience. This study used a convergent mixed-methods approach to investigate the coping self-insights triggered by self-reflection on coping experiences and their effects on perceived resilience. Australian ministry workers (n = 79) provided up to five qualitative self-reflective workbook entries, and quantitative online self-report survey responses before and six months after training. Hierarchical regression analyses of weighted quantized coping-specific self-insights on perceived resilience were conducted. Results suggest two pathways for the strengthening of resilience. A set of three self-insights related to greater perceived resilience appear to reinforce and sustain resilient beliefs across six months to increase perceived resilience. Another set of four self-insights is related to lesser perceived resilience after six months. It is suggested that the first set of self-insights may enhance beliefs that support resilience in the mid-term, whereas the second set may promote self-awareness that reduces perceived resilience in the mid-term. These findings support further exploration of coping self-insights, and the use and on-going testing of self-reflection resilience training.

Exploration of Student Experiences and Perceptions of Self and Peer: Implications for Tailoring Supports

INTRODUCTION

Doctor of Physical Therapy (DPT) students have reported learning new behaviors, enhanced self-awareness, and personal and professional growth during their first year of DPT school. The purpose of this study was to explore in greater depth, through semistructured interviews, the student perceptions of self-identity and social identity.

SUBJECTS

Seventeen early second-year DPT students from 3 universities.

METHODS

This investigation is an extension of a larger multisite study. Qualitative interviews were employed to enable the use of a constructivist lens to explore the importance of personal context in participants' experiences during the first year of DPT school.

RESULTS

Students across programs shared similar characteristics and experiences. Three themes emerged: DPT students share common perceptions of themselves and classmates; sociocultural experiences shaped their actions and perceptions of self; and students recognized the need to change to be successful. The voices of the older second-career students and racially minoritized students were uniquely different from other participants.

DISCUSSION AND CONCLUSION

Doctor of Physical Therapy student experiences are similar across programs except for older students and racially minoritized students. Early professional identity formation was noted as well. A richer understanding of the personal characteristics, influential sociocultural factors, and student perceptions of self and classmates could enable educators to customize supports and educational strategies to help students understand the role their past and present experiences play in shaping their professional identities.

The paths of career aspiration for intern nursing students: A fuzzy-set qualitative comparative analysis

AIM

This study was conducted to explore the combination of different conditional variables that led to high career aspiration of intern nursing students.

BACKGROUND

A severe shortage of nurses exists nationwide, and nurses' low career aspiration contribute to high turnover rates and hinder the high-quality development of the nursing field. Nursing students undergoing clinical practice will become the backbone of future nursing staff. Enhancing their career aspiration is crucial for developing nursing career education and stabilizing the nursing team.

DESIGN

This was a cross-sectional study. Using the cluster sampling method, 521 intern nursing students from Henan and Anhui in China were selected as participants from December 2023 to January 2024.

METHODS

This study employed the fuzzy-set qualitative comparative analysis (fsQCA) to explore the configuration for paths of leading to high career aspiration among intern nursing students. General information questionnaires, career aspiration scale, clinical practice maladjustment scale, self-reflection and insight scale were used as measures in this study.

RESULTS

The results showed that students' origin, professional attitude, GPA, self-reflection and insight, relationship with preceptors and clinical practice maladjustment have a combined effect on career aspiration. This study found that eight configuration combined into four models could explain 75.9 % of high-level career aspiration (solution consistency = 0.786; solution coverage = 0.759).

CONCLUSION

The level of career aspiration among intern nursing students is the result of the combination of different conditional variables. Using a configurational perspective to intervene in nursing students with various characteristics is expected to enhance the career aspiration of intern nursing students.

Stepping back or stepping in: A qualitative investigation of self-distanced versus self-immersed stressor reflections with competitive swimmers

High performance sport consists of stressor events which can disrupt an athletes' functioning and negatively influence performance. The way in which one reflects upon stressor events and develops insights regarding how they coped is essential to overcoming similar experiences in the future. We conducted a pilot randomised controlled trial with a qualitative analysis to explore the coping insights among 48 highly trained/national level swimmers in the lead up to major swimming competitions, who reflected on stressor events from self-distanced or self-immersed perspectives over a 3-week period. Using the self-reflection and coping insight framework as a guideline, we captured divers coping insights across both groups. Irrespective of the group to which they were assigned, athletes showed positive signs towards re-interpreting their stressor experience and embracing the stressor event, whereas consideration of individual values and adoption of a future-focus viewpoint were areas lacking. The emotionality described by athletes in their written reflections varied across both groups and influenced the development of coping insights. Our findings indicate a necessity to examine the emotionality associated with unique stressor events and consider integrating reflection strategies, while also enhancing the operational definitions within conceptual models of stress reflection protocols.

How to reflect on clinical practice

RATIONALE AND KEY POINTS

This 'How to' article explains how to reflect on clinical practice using reflection-on-action and a reflective model to help ensure the nurse gains comprehensive learning from an experience or incident to enhance their professional development and patient care. • Reflection is a vital element of nursing practice and has a wide-ranging purpose including, for example, self-inquiry into experiences to find meaning, gain insight and prompt action, recognition of emotional responses to care situations and exploring wider issues, such as healthcare culture. • Reflection-on-action involves a retrospective critical exploration of an experience or incident to identify learning points and may be engaged in alone, with one other person, for example during clinical supervision, or in a group activity. • There are a range of reflective models that can be used to structure a reflection, the main components of which generally include a description of the event, reflection on its meaning and identification of learning. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: • How this article might improve your practice when using reflective techniques. • How you could use this information to educate nursing students or your colleagues on the appropriate methods for reflecting on clinical practice.

Exploring the applicability of a multifactor mindfulness scale in the Chinese college context

The development of a precise and comprehensive mindfulness measurement tool is a compelling area of research due to its lack at present. This study examines the utility of a multifactor mindfulness scale, particularly the Chinese version of the Comprehensive Inventory of Mindfulness Experiences (CHIME), among Chinese college students. Prior to formal testing, 410 subjects completed the CHIME-37, providing feedback for refinement. During formal assessment, 1,785 subjects participated, with 490 students retested after 2 months. The validity of the CHIME-37 was evaluated using various scales, including subjective well-being, psychological well-being, peace of mind, self-reflection, insight, emotion regulation, depression-anxiety-stress, and sickness questionnaire. In exploratory factor analysis of Sample 1 (n = 838), CHIME revealed 8 factors, explaining 70.696% of the variance. Confirmatory factor analysis in Sample 2 (n = 947) confirmed the 8-factor model's validity. Internal consistency coefficients ranged from 0.848 to 0.914, with test-retest reliabilities ranging from 0.746 to 0.885, and split-half reliabilities ranging from 0.795 to 0.898. Total and dimension scores correlated positively with subjective well-being, psychological well-being, emotion stability, and cognitive reappraisal (p < 0.01) but negatively with physical and mental illnesses, depression-anxiety-stress, and expressive inhibition (p < 0.01). The revised CHIME demonstrates robust reliability and validity, establishing it as a suitable tool for measuring the mindfulness levels of Chinese college students.

Cultivating insight and engagement: exploring the role of Trait Emotional Intelligence in Chinese art education

Background

The present study focuses on the unique role of insight and Trait Emotional Intelligence in the realm of art education in China. Insight, traditionally associated with clinical outcomes such as mastering symptoms, developing adaptive behaviors, and enhancing quality of life, is newly contextualized in this study within the framework of art education. The expansion of insight research into areas like Social Psychology reflects its relevance beyond clinical settings, particularly in educational environments where creativity and emotional intelligence are pivotal.

Aim

In Chinese art education, insight is crucial not just for personal growth but also for professional development, integrating the understanding of emotions, culture, and artistic expression. This study explores how Trait Emotional Intelligence fosters insight and engagement in art students, underscoring its transformative impact on their educational and professional journey in the art world.

Methods

Using a sample of Chinese art education students at University level (N = 881), that answered a quantitative self-report questionnaire, statistical procedures are applied to test the relationships between Trait Emotional Intelligence, Insight orientation, and students’ academic engagement.

Results

In the structural model, the path from Trait Emotional Intelligence to Insight Orientation was significant, indicating a positive relationship. Students’ Engagement was significantly predicted by Insight Orientation and Trait Emotional Intelligence.

Implications

This finding corroborates theoretical assertions that individuals with higher emotional intelligence are more inclined to have enhanced insight. The findings of the present study extend beyond the field of Art education, allowing us to provide a broad spectrum of social implications for Higher Education institutions.

Development of the Impact of Diagnosis Scale-Revised (IODS-R)

No tools quantify the experience, psychological, and practical impact of receiving a diagnosis from a non-deficit perspective. Autism is increasingly late diagnosed in adulthood. The Impact of Diagnosis Scale (IODS) was initially developed for borderline personality disorder. We aimed to develop a revised version suitable for autistic adults and potentially other diagnostic groups. Following a trial of a preliminary revision, the researchers and autistic research advisors co-produced an expanded pool of 46 items, scored on 7-point Likert-type scale, within 6 hypothesized domains. Scale reduction processes were applied to data from 125 formally diagnosed autistic adults. Following iterative rounds of factor analysis using maximum likelihood estimation with Promax rotation, 22 items were retained across 4 domains to comprise the IODS-R. The IODS-R adds new understanding to the experience of receiving an autism diagnosis in adulthood. It may be useful for evaluating diagnostic services and other diagnostic groups.

Activating values intervention: an integrative pathway to well-being

Introduction

The present study expands the existing knowledge base regarding positive psychology interventions (PPIs), by employing an integrative approach to explore the potential benefits of translating values into action.

Methods

Participants (n = 476) were randomly assigned to the Activating Values intervention, the affirmation-only, or the control (no treatment) group. The intervention involved participants choosing a life area they valued, affirming its importance, identifying a specific action related to that valued area, and then planning and carrying out that chosen action within the following week. Data was collected at baseline and three follow-up points: one, two, and three weeks after the intervention.

Results

Results suggest that the intervention contributes to the participants' well-being, including increased self-insight, sense of coherence, and prioritizing meaning, and decreased symptoms of psychopathology. Exploratory content analyses provide a deeper understanding of the content and frequency of activities chosen and the enabling conditions.

Discussion

The discussion explores the findings within this intersection as well as ramifications for brief, scalable interventions to support and promote well-being.

A randomized controlled trial comparing the effects of self-reflective writing focused on successful and unsuccessful coping experiences on resilience

Evidence supports the effectiveness of self-reflective training approaches for the development of resilience. Building this work, the objective of this study was to investigate the impact of the focus of coping self-reflective activities on resilience by applying a self-reflection approach to a sample of 254 Australian ministry workers. This randomized controlled trial included three attention-matched conditions: (1) self-reflective writing focused on successful coping, (2) self-reflective writing focused on unsuccessful coping or (3) written descriptions of stressor events alone. Participants were assessed across four time points: prior to, immediately post, 3-months, and 6-months after the intervention. Results demonstrated that self-reflective writing was more effective in enhancing perceived resilience than descriptive writing. Analyses also showed greater maintenance of beneficial effects in the successful self-reflection condition, compared to the unsuccessful condition. These findings support the use of self-reflection training to strengthen individuals' psychological resilience, particularly when focused on successful coping situations for those who initially experience more ruminative thought.

The Dimensional Conceptualization of Personality Disorders: Personality Organization, Personality Functioning, and Personality Disorders

Over the past several decades, significant criticism of the categorical classification system for personality disorders has highlighted the need to transition to a dimensional classification system. This study reviewed key issues involved in the potential conversion of the diagnostic system of personality disorders from a categorical to a dimensional model. The result suggests that Kernberg's concept of personality organization can be used to indicate the overall severity of personality pathology.

Validation of the Awareness Atlas-a new measure of the manifestation of consciousness

Consciousness has intrigued philosophers and scholars for millennia and has been the topic of considerable scientific investigation in recent decades. Despite its importance, there is no unifying definition of the term, nor are there widely accepted measures of consciousness. Indeed, it is likely that consciousness-by its very nature-eludes measurement. It is, however, possible to measure how consciousness manifests as a lived experience. Yet here, too, holistic measures are lacking. This investigation describes the development and validation of the Awareness Atlas, a measure of the manifestation of consciousness. The scale was informed by heart-based contemplative practices and the resulting lived experience with a focus on the impacts of manifestation of consciousness on daily life. Four hundred forty-nine individuals from the USA, Canada, India, and Europe participated in psychometric testing of the scale. Exploratory and confirmatory factor analyses were used for validation, demonstrating excellent validity in measuring manifestation of consciousness. The final model fit exceeded all required thresholds, indicating an excellent fitted model with a single dimensionality to measure the manifestation of consciousness comprised of four subscales: Relationship to Others; Listening to the Heart; Connection with Higher Self; and Acceptance and Letting Go. Number of years meditating and practicing Heartfulness meditation were positively related to the total and subscale scores. Test-retest reliability was excellent for the total scale, and good to excellent for the four subscales. Findings demonstrate that the Awareness Atlas is a well-constructed tool that will be useful in examining changes in manifestation of consciousness with various experiences (e.g., meditation, life-altering conditions).

A coping self-insight scale for adults: development and preliminary psychometric properties

BACKGROUND

Self-insights focused on the coping process are implicated in the refinement of capacities for resilience. To advance this research, we must identify key coping self-insights and develop a concise measurement tool.

OBJECTIVE

The purpose of this paper is to develop evidence for the construct dimensionality and validity of a measure of coping self-insight.

METHODS

Items measuring 13 coping self-insight dimensions were generated via consultation with theoretical work, subject matter experts, and pre-testing items for clarity. Thereafter, the dimensionality of items was assessed with undergraduate students (N = 232) and an online sample (N = 800) via exploratory and confirmatory analyses. Finally, a multi-trait, multi-method approach was used to test discriminant validity in a further sample of students (N = 228).

RESULTS

The initial item list was reduced to five key dimensions that balanced data-driven and conceptual considerations. Confirmatory Factor Analysis revealed moderate-to-strong correlations (r = .47-.80) among dimensions. We also demonstrated evidence of internal reliability, convergent, criterion, and discriminant validity. Invariance tests for sub-groups of interest (e.g., sex, sample type) frequently demonstrated metric or scalar invariance, except for age sub-groups.

CONCLUSIONS

Findings offer a starting point regarding the types of coping self-insights important for the emergence of resilience and a validated tool for future research.

Further development of the reflective practice questionnaire

Background

This article provides an update of the Reflective Practice Questionnaire (RPQ). The original RPQ consisted of 40-items with 10-sub-scales. In this article, the RPQ is streamlined into a 10-item single reflective practice construct, and a 30-item extended version that includes additional sub-scales of confidence, uncertainty/stress, and work satisfaction.

Methods

A total of 501 university students filled out an online questionnaire that contained the original Reflective Practice Questionnaire, and two general measures of reflection: The Self-Reflection and Insight Scale, and the Rumination-Reflection Questionnaire.

Results

Based on factor analysis, the RPQ was streamlined into a brief 10-item version, and an extended 30-item version. Small positive correlations were found between the RPQ reflective practice measure and the two measures of general reflection, providing discriminant validity evidence for the RPQ. The RPQ was found to be sensitive to differences among industries, whereas the general measures of reflection were not. Average reflective practice scores were higher for health and education industries compared to retail and food/accommodation industries.

The state-trait sense of self inventory: A psychometric study of self-experience and its relation to psychosis-like manifestations

The sense of self is a fundamental construct in the study of the mind, yet its psychological nature remains elusive. We introduce a novel 25-item inventory to investigate selfhood both as an enduring trait and a temporary state. We hypothesized two foundational aspects of the self: identity (related to self-referencing and continuity over time) and agency (the perception of controlling own's actions and thoughts). Results from two population studies highlight a singular self-trait factor combining agency and identity. In contrast, self-state measures revealed a bifactorial structure with a high-order factor and three lower-order subfactors: state-identity, state-agency, and state-technology. These factors were predictive of psychosis-like experiences, schizotypal traits, and hopelessness. Mediation analysis demonstrated that the negative association between the sense of self and hopelessness is mediated by depressive manifestations. Our research provides a tool to shed new light on the complexity of the sense of self and its mental health implications.

Mindfulness and impulsive behavior: exploring the mediating roles of self-reflection and coping effectiveness among high-level athletes in Central China

Introduction

In the highly competitive field of sports, impulsive behavior by athletes not only threatens personal and team harmony but also poses significant risks to their careers and public image. Despite these behaviors often becoming the focus of public attention, their underlying causes and prevention strategies remain relatively unknown. This study delves deep into the impact of mindfulness on athletes' impulsive behavior, revealing the mediating roles of self-reflection and coping effectiveness.

Methods

Using a combination of snowball and convenience sampling, a sample of 403 athletes from high-level sports teams in the Central China region participated in a questionnaire survey. The data were analyzed using Amos v.23 software.

Results

The findings indicate a positive correlation between mindfulness and coping effectiveness (standardized coefficient = 0.336, p < 0.001), as well as between self-reflection and coping effectiveness (standardized coefficient = 0.406, p < 0.001). There is a negative correlation between coping effectiveness and impulsive behavior (standardized coefficient = -0.476, p < 0.001). The positive impact of mindfulness on impulsive behavior (standardized coefficient = -0.371, p < 0.01) is mediated by self-reflection and coping effectiveness. The explanatory power of this study is R2 = 0.35.

Discussion

Mindfulness reduces impulsive behavior by enhancing self-reflection capabilities and improving coping effectiveness. Based on these substantive research results, to mitigate impulsive behavior in athletes, it is recommended that the National Sports Administration and coaches actively implement mindfulness training. Additionally, targeted psychological intervention strategies should be developed to enhance athletes' mental health levels and optimize their sports performance.

Predictive validity of a selection instrument measuring resilience: The INSPIRE resilience scale

Military personnel needs to be resilient to be able to remain effective, motivated, and in good mental and physical health. Military organizations select on resilience to determine whether candidates are psychologically fit for their job. The INSPIRE Resilience Scale (IRS) is such a selection instrument that aims to assess the psychological resilience potential of candidates in high-risk professions. A longitudinal predictive validity study was conducted in five European Defense organizations and in the Dutch National Police. The IRS was submitted in selection (N = 11,404), and criterion data about performance and health were collected in the second half of the first training year (N = 726). The results based on correlational and regression analyses showed that the IRS scores significantly predicted the criterion measures. Emotional stability, part of the IRS, turned out to be the best predictor. Results also showed that candidates who dropped out of training had significantly lower means on the IRS in selection than candidates who were still in training in the second half of the first training year. Overall, the IRS proved to be a valid instrument to assess resilience potential in candidates for high-risk professions. Selecting on resilience may therefore contribute to training success and reduction of health problems.

Group meditation, addressing stigma, and "mental health days": Recommendations for integrating self-awareness practices into genetic counseling graduate programs

Genetic counseling graduate programs provide a rigorous curriculum comprised of coursework encompassing counseling and medical genetics, fieldwork, and research experience. Students face similar emotional and mental demands as practicing genetic counselors while also experiencing stressors commonly associated with graduate study. Increased self-awareness may help combat these stressors. This mixed-methods study surveyed 154 genetic counseling graduate students to determine the types of self-awareness practices they would like to have included in their graduate training and surveyed 11 program faculty regarding the feasibility of implementing these practices. The students' most preferred practices were self-reflection (n = 73, 47.4%), support from peers, colleagues, and/or supervisors (n = 71, 46.1%), and mental health counseling (n = 71, 46.1%). Analysis of responses to open-ended questions capturing students' recommendations for programs yielded six recurrent themes: (1) Consistent, Structured Practice with Accountability, (2) Emphasis on Mental Health, (3) Practical Techniques, (4) Access to Resources, (5) Encouragement and Support, and (6) Barriers to Implementation. Many students suggested that programs should incorporate repetitive exercises that could be implemented on a schedule with an emphasis on consistency (Theme 1). Students also emphasized the importance of providing exposure to multiple examples of self-awareness practices, so they could find an approach that was most beneficial on an individual basis (Theme 3). These findings were shared with program faculty via a presentation at the Association for Genetic Counseling Program Directors annual meeting, and attendees were subsequently surveyed regarding self-awareness practices currently integrated into their curriculum, as well as the feasibility and likelihood of integrating new practices. Program faculty respondents indicated that most of the recommended practices were included in their curriculum already or would be feasible and likely to incorporate. These results provide insight into the attitudes of genetic counseling students toward structured practice in self-awareness and how genetic counseling graduate programs might integrate such practices into the curriculum.

Metacognitive monitoring in schizotypy: Systematic literature review and new empirical data

BACKGROUND AND OBJECTIVES

Deficits in metacognition, the ability to monitor one's own mental states, are key elements of the functional pathology of schizophrenia spectrum disorders. Little is known, however, about the integrity of metacognitive processes in subclinical schizotypy. The purpose of the present investigation was two-fold: First, we conducted a preregistered, systematic literature review to synthesize previous research efforts on the role of metacognition in schizotypy. Second, we investigated the relationship between self-reported dimensions of schizotypy and psychometric as well as behavioral measures of metacognition in a preregistered online study.

METHODS

A large sample (N = 330) completed a questionnaire battery and an episodic memory experiment; task-based metacognition was tapped via trial-by-trial confidence ratings.

RESULTS

In keeping with findings from our literature review, higher schizotypy was associated with diminished introspective insight and an overly self-referential and maladaptive metacognitive style in metacognition questionnaires. Importantly, low task-based metacognitive efficiency was predictive of high levels of cognitive disorganization, whereas task-related overconfidence (i.e., increased metacognitive bias) was linked with positive schizotypy.

LIMITATIONS

Due to the comparatively small number of k = 20 studies meeting our inclusion criteria, the systematic literature review provides only preliminary indications for potential conclusions. Furthermore, control over potential disturbing influences in the experimental study was limited due to its online format.

CONCLUSIONS

Overall, we provide evidence for specific metacognitive deficits in schizotypy and discuss a potential continuity of preserved and impaired aspects of metacognitive monitoring along the psychosis continuum.

Reliability and validity of the Self-Reflection and Insight Scale for psychologists and the development and validation of the revised short version

Self-reflection is broadly considered a core competency for psychologists; however, there is an absence of measures of self-reflection, limiting the extent to which self-reflection can be assessed in both research and practice contexts. Whilst the Self-Reflection and Insight Scale (Grant et al., 2002) has been validated in a range of formats with different populations, it has not yet been validated with psychologists. Further, the psychometric properties of a short version of the scale (Silvia, 2021) have not been examined for use with psychologists. This study tested the factor structure, internal consistency and convergent and divergent validity of the Self-Reflection and Insight Scale with registered psychologists (N = 123), finding both the full scale and short version to have sound psychometrics. However, as there were low loading items across both versions of the measure, and the short version also excluded high-loading items, the SRIS-Revised (SRIS-R) was formed through model improvement, retaining a total of 14 items. This revised version of the scale captures high loading items without redundancy of low-loading items, resulting in a measure that parsimoniously captures the construct of self-reflection as relevant to psychologists. The SRIS-R demonstrated good internal consistency (α = .882), convergent, divergent and construct validity. Scores on the SRIS-R were used to test whether there was a correlation between self-reflection and years of professional registration, with this not being significant.

Mental Pain Correlates with Mind Wandering, Self-Reflection, and Insight in Individuals with Psychotic Disorders: A Cross-Sectional Study

Understanding the cognitive processes that contribute to mental pain in individuals with psychotic disorders is important for refining therapeutic strategies and improving patient outcomes. This study investigated the potential relationship between mental pain, mind wandering, and self-reflection and insight in individuals diagnosed with psychotic disorders. We included individuals diagnosed with a 'schizophrenia spectrum disorder' according to DSM-5 criteria. Patients in the study were between 18 and 65 years old, clinically stable, and able to provide informed consent. A total of 34 participants, comprising 25 males and 9 females with an average age of 41.5 years (SD 11.5) were evaluated. The Psychache Scale (PAS), the Mind Wandering Deliberate and Spontaneous Scale (MWDS), and the Self-Reflection and Insight Scale (SRIS) were administered. Statistical analyses involved Spearman's rho correlations, controlled for potential confounders with partial correlations, and mediation and moderation analyses to understand the indirect effects of MWDS and SRIS on PAS and their potential interplay. Key findings revealed direct correlations between PAS and MWDS and inverse correlations between PAS and SRIS. The mediation effects on the relationship between the predictors and PAS ranged from 9.22% to 49.8%. The largest statistically significant mediation effect was observed with the SRIS-I subscale, suggesting that the self-reflection and insight component may play a role in the impact of mind wandering on mental pain. No evidence was found to suggest that any of the variables could function as relationship moderators for PAS. The results underscore the likely benefits of interventions aimed at reducing mind wandering and enhancing self-reflection in psychotic patients (e.g., metacognitive therapy, mindfulness). Further research will be essential to elucidate the underlying mechanisms.

Reflecting on insight and insights into reflection: a systematic review of insight and reflection in post graduate medical education

BACKGROUND

Clinicians recognize insight as important for safe independent medical practice. Clinical education literature focuses on self-reflection. The aim of this review is to describe how clinical educators conceptualize reflection and ask is it analogous to how clinicians conceptualize insight?

METHODS

Using PRISMA guidelines, a systematic review of the literature around insight and reflection in postgraduate medical education was undertaken. A thematic analysis of the concepts of insight and reflection was performed.

RESULTS

A total of 75 reports were included in the analysis. The literature focussed predominantly on reflection with little discussion of insight. Three main themes were generated: episodic reflection; cyclic reflection; reflection as a state. Reflection as a state seemed to be the professional quality most often aspired to but was less well defined in terms of educational interventions. When more than one model was described, it was often with a reflective state being the ideal that episodic or cyclic reflection may approximate. It is not clear that it is possible to progress up the hierarchy.

CONCLUSION

We present a novel description of a hierarchy from discrete episodes of reflection, to cyclic processes that involve reflection, through to a state in which the practitioner is reflective. There is no unified understanding of how an individual ascends this hierarchy, or a cohesive description of what insight is for an independent medical practitioner. This review highlights the need for research into how practicing clinicians conceptualize and characterize insight in their training and practice.

Self-Reflection, Emotional Self Disclosure, and Posttraumatic Growth in Nursing Students: A Cross-Sectional Study in South Korea

During the Coronavirus disease 2019 pandemic, several studies were conducted on mental health among various populations; however, only a few studies have focused on post-traumatic growth (PTG) in nursing students. By understanding the PTG involved in coping with emotionally challenging situations, educators, and institutions can prepare nursing students to navigate the demands of their profession and ultimately provide more empathetic and effective patient care. This study aimed to explore whether self-reflection and emotional self-disclosure are associated with PTG. A total of 195 nursing students completed the self-report questionnaire. This study used standardized instruments, including the self-reflection scale, emotional self-disclosure, and the Posttraumatic Growth Inventory (PTGI). Data were analyzed using descriptive statistics, a t-test, Pearson's correlation coefficient, and hierarchical regression analysis using the SPSS/WIN 25.0 program. The factors influencing PTG included self-reflection (β = 0.36; p < 0.001), emotional self-disclosure (β = 0.24; p < 0.001), grade (β = -0.18; p = 0.008), and religion (β = -0.15; p = 0.013). The explanatory power of these four factors was 31.4%, and self-reflection was found to have the greatest influence on PTG. The results indicated the need for self-reflection and emotional self-disclosure promotion programs to improve PTG, especially for senior and non-religious students.

The Effect of Holistic Nursing Competence on Work Engagement, Self-Reflection and Insight in Nurses

This study aimed to examine the effects of holistic nursing competence on work engagement, self-reflection and insight in nurses. This descriptive and cross-sectional study was conducted with 309 nurses working in Turkey. Data were collected using the "Descriptive Information Form", "Holistic Nursing Competence Scale (HNCS)", "Utrecht Work Engagement Scale (UWES)", and "Self-Reflection and Insight Scale (SRIS)". Pearson correlation analysis and multiple linear regression analysis were used to analyze the data. We found that the HNCS had a moderate positive relationship (r = 0.411, p < 0.05) with the UWES, and a weak positive relationship (r = 0.324, p < 0.05) with the SRIS. In the model established by multiple regression analysis, the effect of the HNCS, age, marital status, position, and performing the profession willingly on work engagement explained 33.7% of the variance. In another established model, the effect of the HNCS, gender, and having children on self-reflection and insight explained 11.5% of the variance. Our findings revealed the effect of holistic competence on nurses' positive attitudes about their work engagement and self-reflection in practice. We recommended developing awareness-based programs for nurses to increase their holistic nursing competence.

The Impact of Chinese Primary School Teachers' Sense of Work Meaningfulness on Organizational Commitment: A Chain Mediation Model

Purpose

This present study aims to explore the effects of work meaningfulness on primary school teachers' self-reflection, self-efficacy and organizational commitment and their mechanisms of action.

Methods

This study used a meaningfulness, self-reflection, self-efficacy, and organizational commitment measures. A total of 417 teachers from urban, rural, and mountainous elementary schools were recruited to complete the survey including the measures of work meaningfulness, self-reflection, self-efficacy, and organizational commitment. In this study, descriptive statistics were run using SPSS 26.0 and the relationship model between variables was tested with the SPSS macro program PROCESS.

Results

The study found that work meaningfulness and self-efficacy independently predicted primary school teachers' organizational commitment, but self-reflection did not significantly predict organizational commitment. It was found that there was a significant positive correlation between the four studied variables of work meaningfulness, self-efficacy, self-reflection, and organizational commitment with correlation coefficients ranging from 0.24 to 0.57. The study also found that work meaningfulness can directly predict elementary school teachers' organizational commitment, and work meaningfulness can also indirectly predict elementary school teachers' organizational commitment through self-efficacy and self-reflection.

Conclusion

The results of this study are useful for understanding the value of enhancing the organizational commitment of primary school teachers from a social cognitive perspective, and have implications for how to build a stable, high-quality and dynamic primary school teaching force.

The Italian Validation of the Beck Cognitive Insight Scale: Underlying Factor Structure in Psychotic Patients and the General Population

Cognitive insight refers to the ability to question one's judgments and cognitive biases and is underpinned by specific metacognitive processes. The Beck Cognitive Insight Scale was developed to assess cognitive insight and includes two subscales, Self-Reflectiveness and Self-Certainty (SC). The present study aimed to investigate the underlying factor structure of the Italian version of the BCIS in patients with schizophrenia (SZ) and in the general population (GP) for the first time. A cross-sectional design was adopted and a GP sample of 624 subjects and an SZ sample of 130 patients were enrolled. In the SZ group, a two-factor solution was supported. The internal reliability of each factor was satisfactory. Two items were eliminated and one item moved from the SC to the SR subscale. In the GP group, a two-factor solution was highlighted. The internal reliability of each factor was satisfactory. However, four items of the SR subscale were deleted. The Italian-validated version of the BCIS shows different structures for the SZ and the GP and is characterized by different features concerning previous studies. This evidence suggests new interpretations of metacognitive processes in the two populations and implies specific therapeutic approaches.

Self-Awareness of Goals Task (SAGT) and Planning Skills: The Neuroscience of Decision Making

A goal's self-awareness and the planning to achieve it drive decision makers. Through a neuroscientific approach, this study explores the self-awareness of goals by analyzing the explicit and implicit processes linked to the ability to self-represent goals and sort them via an implicit dominant key. Thirty-five professionals performed a novel and ecological decision-making task, the Self-Awareness of Goals Task (SAGT), aimed at exploring the (i) self-representation of the decision-making goals of a typical working day; (ii) self-representation of how these goals were performed in order of priority; (iii) temporal sequence; and (iv) in terms of their efficacy. Electrophysiological (i.e., alpha, beta, and gamma band), autonomic, behavioral, and self-report data (General Decision Making Style and Big Five Inventory) are collected. Higher self-awareness of goals by time as well as efficacy and the greater activation of alpha, beta, and gamma bands in the temporoparietal brain area were found. Correlations reported positive associations between the self-awareness of goals via a time and dependent decision-making style and a conscientious personality, but also between the self-awareness of goals via an efficacy and rational decision-making style. The results obtained in this study suggest that the SAGT could activate recursive thinking in the examinee and grasp individual differences in self-representation and aware identification of decision-making goals.

Linking Career Exploration, Self-Reflection, Career Calling, Career Adaptability and Subjective Well-Being: A Self-Regulation Theory Perspective

Introduction

In the post-pandemic era, the cultivation of vocational adaptability among college students holds equal significance to fostering subjective well-being in the face of an increasingly daunting professional landscape. This intricate process can be influenced by exploratory expeditions into potential career paths, sincere introspection, and a profound sense of vocation.

Methods

Drawing upon Bandura's self-regulation theory, this research project employed structural equation modeling (SEM) to scrutinize the interconnectedness between career exploration, self-reflection, vocational calling, vocational adaptability, and subjective well-being within a sample of 1077 Chinese undergraduates.

Results

The findings demonstrated that career exploration and self-reflection positively predicted career adaptability and subjective well-being. In addition, career calling had a significant mediating effect in this model.

Conclusion

The findings of this study shed light on the significance of career exploration and self-reflection in fostering both adolescent career adaptability and subjective well-being. And are expected to provide a reference for the career construction and development of college students and career education in colleges and universities.

The Detection of Acute Risk of Self-injury Project: Protocol for an Ecological Momentary Assessment Study Among Individuals Seeking Treatment

BACKGROUND

Nonsuicidal self-injury (NSSI) is a major mental health concern. Despite increased research efforts on establishing the prevalence and correlates of the presence and severity of NSSI, we still lack basic knowledge of the course, predictors, and relationship of NSSI with other self-damaging behaviors in daily life. Such information will be helpful for better informing mental health professionals and allocating treatment resources. The DAILY (Detection of Acute rIsk of seLf-injurY) project will address these gaps among individuals seeking treatment.

OBJECTIVE

This protocol paper presents the DAILY project's aims, design, and materials used. The primary objectives are to advance understanding of (1) the short-term course and contexts of elevated risk for NSSI thoughts, urges, and behavior; (2) the transition from NSSI thoughts and urges to NSSI behavior; and (3) the association of NSSI with disordered eating, substance use, and suicidal thoughts and behaviors. A secondary aim is to evaluate the perspectives of individuals seeking treatment and mental health professionals regarding the feasibility, scope, and utility of digital self-monitoring and interventions that target NSSI in daily life.

METHODS

The DAILY project is funded by the Research Foundation Flanders (Belgium). Data collection involves 3 phases: a baseline assessment (phase 1), 28 days of ecological momentary assessment (EMA) followed by a clinical session and feedback survey (phase 2), and 2 follow-up surveys and an optional interview (phase 3). The EMA protocol consists of regular EMA surveys (6 times per day), additional burst EMA surveys spaced at a higher frequency when experiencing intense NSSI urges (3 surveys within 30 minutes), and event registrations of NSSI behavior. The primary outcomes are NSSI thoughts, NSSI urges, self-efficacy to resist NSSI, and NSSI behavior, with disordered eating (restrictive eating, binge eating, and purging), substance use (binge drinking and smoking cannabis), and suicidal thoughts and behaviors surveyed as secondary outcomes. The assessed predictors include emotions, cognitions, contextual information, and social appraisals.

RESULTS

We will recruit approximately 120 individuals seeking treatment aged 15 to 39 years from mental health services across the Flanders region of Belgium. Recruitment began in June 2021 and data collection is anticipated to conclude in August 2023.

CONCLUSIONS

The findings of the DAILY project will provide a detailed characterization of the short-term course and patterns of risk for NSSI and advance understanding of how, why, and when NSSI and other self-damaging behaviors unfold among individuals seeking treatment. This will inform clinical practice and provide the scientific building blocks for novel intervention approaches outside of the therapy room that support people who self-injure in real time.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/46244.

The Impact of a Psychoeducational Group Program on the Mental Well-Being of Unit-Based Nurse Leaders: A Randomized Controlled Trial

This randomized controlled trial examined the impact of a psychoeducational group program on the mental well-being of unit-based nurse leaders, specifically nurse managers and assistant nurse managers. The program was developed around the themes of resilience, insight, self-compassion, and empowerment to fight burnout and enhance purposeful adaptive coping to reduce distress and improve mental wellbeing. The sample included 77 unit-based nurse leaders. Outcomes included post-traumatic growth, resilience, insight, self-compassion, empowerment, perceived stress, burnout, and job satisfaction. Paired samples t-tests and repeated measures ANOVA tests were conducted to compare outcomes at baseline to the follow-up timepoints of endpoint, one-month follow-up, three-month follow-up, and six-month follow-up. The intervention group participants showed significant improvement in post-traumatic growth between baseline and all follow-up timepoints compared to the waitlist control group. Among intervention group participants, there were also significant improvements in self-reflection and insight, self-compassion, psychological empowerment, and compassion satisfaction, as well as significant reductions in perceived stress, burnout, and secondary traumatic stress. This study extends existing evidence that this psychoeducational group program can be an effective intervention for improving and protecting mental wellbeing. Among nurse leaders, it can reduce stress and burnout and improve post-traumatic growth, self-reflection and insight, self-compassion, psychological empowerment, and compassion satisfaction.

Validation of the Korean version of the Reflective Practice Questionnaire in clinical clerkship of Korean medical students

PURPOSE

This study aims to verify whether the Reflective Practice Questionnaire (RPQ) developed by Priddis and Rogers is valid in the Korean context to identify the level of reflection of medical students in clinical practice.

METHODS

A total of 202 third- and fourth-year medical students from seven universities participated in the study. After receiving approval for use from the authors, a survey was conducted on the students through an adaptation process. The original scale consists of 10 factors with 40 items. The Self-efficacy in Clinical Performance Scale (SECP), Korean Self-reflection and Insight Scale (K-SRIS), and Reflection-in-Learning Scale (RinLS) were used to validate the scale. Exploratory factor, confirmatory factor, correlation, and reliability analyses were used for data analysis.

RESULTS

As a result of exploratory factor analysis, 10 subfactors were extracted (Kaiser-Meyer-Olkin=0.856, Bartlett's test: χ 2 =5,044.337, degrees of freedom=780, p<0.001). Among the 40 items, one that showed a high overlapping load for other factors was excluded. As a result of confirmatory factor analysis, the 10-factor structure model was found suitable (χ 2 =1.980, comparative fit index=0.859, Tucker-Lewis index=0.841, root mean square error of approximation=0.070). As a result of the criterion validity test, most of the subfactors of the Korean version of the RPQ (K-RPQ) showed a positive correlation with K-SRIS, RinLS, and SECP. The reliability of 10 subfactors was satisfactory, ranging from 0.666 to 0.919.

CONCLUSION

The K-RPQ was confirmed to be a reliable and valid tool to evaluate the level of reflection among Korean medical students in clinical clerkship. This scale can be used as a tool to provide feedback on each student's level of reflection in clinical clerkship.

Efficacy of Intellect's self-guided anxiety and worry mobile health programme: A randomized controlled trial with an active control and a 2-week follow-up

Digital self-guided mobile health [mHealth] applications are cost-effective, accessible, and well-suited to improve mental health at scale. This randomized controlled trial [RCT] evaluated the efficacy of a recently developed mHealth programme based on cognitive-behavioral therapy [CBT] principles in improving worry and anxiety. We also examined psychological mindedness [PM] as a mediator by which app engagement is thought to improve outcomes. The Intervention group completed a 2-week "Anxiety and Worry" programme with daily CBT-informed activities, while the active waitlist-control completed a matched 2-week mHealth programme on procrastination. Participants filled out the Generalized Anxiety Disorder [GAD-7], Patient Health Questionnaire [PHQ-9], and Psychological Mindedness Scale [PMS] at baseline, post-intervention, and 2-week follow-up. App engagement was measured at post-intervention only. Contrary to prediction, the Intervention group did not perform better than the Active Control group; both groups showed significant improvements on anxiety and depressive symptoms from baseline to follow-up. From post-intervention to follow-up, only the Intervention group showed further improvements for anxiety symptoms. Higher engagement with the mHealth app predicted lower anxiety and depressive symptoms at follow-up, and this relationship was fully mediated by psychological mindedness. This study provides evidence that [a] engaging in a CBT mHealth programme can reduce anxiety and worry, and [b] Psychological mindedness is a potential pathway by which engaging with a mHealth app improves anxiety and depressive symptoms. While overall effect sizes were small, at the population level, these can make significant contributions to public mental health.

Investigating the disruptiveness of the sharing economy at the individual consumer level: How consumer reflexivity drives re-engagement in sharing

The sharing economy represents an emerging technology-enabled socioeconomic system. Given its disruptive nature, the sharing economy not only challenges traditional marketing theories but also alters consumer norms and beliefs related to consumption concepts. Whether, when, and how the sharing economy transforms consumption remain important questions for managers to investigate. This study examines how sharing experiences influence consumers' critical self-reflection and shape their intentions to re-engage in sharing practices. With data collected from two surveys and four experiments (including three pretests and one main study), we show that consumers' perceived economic utility, social value, and sustainability potential in the sharing economy influence their intentions to re-engage in sharing practices, thus forming a loyal customer base. In addition, consumer reflexivity mediates this effect. We also show that past experience with business-to-consumer sharing practices moderates the proposed mediating effect. Overall, we demonstrate the disruptive impact of the sharing economy on individual consumers with meaningful managerial implications and contributions to marketing theories.

Restructuring insight: An integrative review of insight in problem-solving, meditation, psychotherapy, delusions and psychedelics

Occasionally, a solution or idea arrives as a sudden understanding - an insight. Insight has been considered an "extra" ingredient of creative thinking and problem-solving. Here we propose that insight is central in seemingly distinct areas of research. Drawing on literature from a variety of fields, we show that besides being commonly studied in problem-solving literature, insight is also a core component in psychotherapy and meditation, a key process underlying the emergence of delusions in schizophrenia, and a factor in the therapeutic effects of psychedelics. In each case, we discuss the event of insight and its prerequisites and consequences. We review evidence for the commonalities and differences between the fields and discuss their relevance for capturing the essence of the insight phenomenon. The goal of this integrative review is to bridge the gap between the different views and inspire interdisciplinary research efforts for understanding this central process of human cognition.

Autobiographical memory and the self on the psychosis continuum: investigating their relationship with positive- and negative-like symptoms

Autobiographical memory is severely impaired in schizophrenia, but previous work has largely treated both as unitary concepts. Here, we examined how various dimensions of autobiographical memory relate to different aspects of psychosis. Participants were recruited from the general population (Study 1, N = 264) and a university subject pool (Study 2, N = 305). We examined different measures of autobiographical memory and self (i.e., involuntary memory, autobiographical recollection, self-knowledge and self-awareness), at the trait level in Study 1 and both trait and state levels in Study 2, as a function of positive-and negative-like symptoms of psychosis. Across both studies, positive and negative dimensions of psychosis were found to be related to an increase in involuntary memories (i.e., the spontaneous recall of personal memories), and to lower self-concept clarity and insight. Positive and negative dimensions of psychosis correlated differently with autobiographical recollection characteristics, measured at both trait (Studies 1 and 2) and state levels (Study 2). Positive-like symptoms (in particular hallucination-proneness) showed a stronger and more consistent pattern of correlations than negative-like symptoms. These findings call for a dimensional approach to the relationship between autobiographical memory and psychosis symptoms in clinical and non-clinical individuals, to better understand the breakdown of autobiographical memory in the psychopathology of psychosis.

Self-Consciousness and Self-Awareness: Associations between Stable and Transitory Levels of Evidence

The theory of objective self-awareness predicts the assessment of stable or dispositional self-consciousness and transitory or situational self-awareness. The aim of the present research was to investigate potential associations between patterns of experiential self-description to scores on self-report measures of dispositional self-consciousness. A total of 64 Brazilian volunteers (Mage = 29.7, SD = 8.79, 64.1% female) responded to the Revised Self-Consciousness Scale, the Philadelphia Mindfulness Scale, and the Rumination-Reflection Questionnaire before participating in an experience sampling protocol. The protocol consisted of random daily requests for up to four self-description experiences across seven consecutive days. Participants recorded audio messages on their mobile phones in reply to each request describing their current experience. Reports were analyzed through a reflexive thematic analysis that produced twenty sub-themes accounting for descriptive markers of experience. Based on those descriptive markers, the qualitative data were then transformed into quantitative data for the situational self-awareness indexes. Evidence of association between self-consciousness and self-awareness was stronger for the awareness subscale in a positive correlation with affective situational self-awareness and in a negative correlation with mental representational transitory self-awareness. Although relational evidence has been provided, the data reinforced the theoretical distinction between self-consciousness and self-awareness.

Self-perceived competence and its related factors in nursing students at graduation: the role of self-efficacy

OBJECTIVES

This study aimed to investigate the level of perceived competence and explore the predictors of competence in nursing students at graduation.

METHODS

This cross-sectional study was conducted with students at the point of graduation (n=239). A sociodemographic form and three different scales assessing students' competence, self-efficacy, and self-reflection and insight were used to collect data. Visual Analog Scale (VAS) was used to assess students' satisfaction (i.e., the role as nursing students in the nursing program), job-related stress (i.e., perceived stress related to nursing program), and coping behaviors. The data were analyzed using descriptive statistics and hierarchical linear regression.

RESULTS

The mean scores of perceived competence, self-reflection, insight, and self-efficacy were 5.25 ± 0.96 (range: 1-7), 54.51 ± 7.83 (range: 12-96), 33.36 ± 5.40 (range: 8-48), 84.13 ± 12.27 (range: 0-100), respectively. Self-efficacy was the most significant associated factor of the entire group of variables in competence.

CONCLUSIONS

Scores of perceived competence of students were optimistic. Self-efficacy was the most important factor affecting competence; that is, the greater the self-efficacy, the better the perceived competence.

Effects of Debriefing on Motivation and Reflective Thinking of Nursing Students during In-School Practicum Using a Flipped Learning Model

Debriefing and flipped learning have been determined to be useful strategies for nursing education. Recently, it has been reported that applying debriefing and flipped learning together was helpful for educational outcomes. The objective of this study was to compare learning motivation and reflective thinking before and after debriefing during nursing practicums that applied flipped learning. We implemented a quasi-experimental procedure in the form of a pretest-posttest non-equivalent control group design (1 September to 22 October 2021). The participants comprised 63 nursing students in South Korea (33 in the experimental group and 30 in the control group). Each group took part in a nursing practice class, wherein the experimental group engaged in debriefing using flipped learning, while the control group engaged only in flipped learning. We then examined academic motivation and reflective thinking in both the groups, and found that reflective thinking was significantly higher in the experimental group (53.67 ± 5.71) versus the control group (50.80 ± 4.69) (t = 2.165, p = 0.034). However, there were no differences in learning motivation between the two groups (t = 1.864, p = 0.067). In sum, this study confirmed the benefits of this new teaching approach, in which debriefing and flipped learning were integrated and incorporated into a nursing practice class. Given our promising results, this approach can be applied in various cases to strengthen the clinical practice skills of nursing students.

The coping insights evident through self-reflection on stressful military training events: Qualitative evidence from self-reflection journals

Research has demonstrated that adaptive forms of self-reflection on stressor events and insight may strengthen resilient capacities. However, the coping insights that emerge during self-reflection are notoriously under-researched. In this research, we sought to explore the evidence for the self-reflective activities and coping insights drawn from the Self-Reflection and Coping Insight Framework and find evidence of new reflections or insights not captured within the framework. Qualitative analysis was used to examine weekly, written self-reflective journals completed by Officer Cadets involved in a randomised-controlled trial of Self-Reflection Resilience Training. Sixty-eight Officer Cadets who submitted their journals for analysis were included. Journals were analysed using a deductive thematic approach. Findings revealed that self-reflective activities occurred frequently over the course of the intervention. Coping insights were comparatively less frequent, but conveyed complex ideas about the self in the context of stressor exposure, broad principles about stress and coping, and nuanced interpretations regarding the interaction between the efficacy of coping approaches and broader contextual and intrapersonal factors. These findings demonstrate the critical role of coping insight during Self-Reflection Resilience Training, with implications for developing a validated self-report measure of self-reflective activity and coping insight.

Writing Yourself Well: Dispositional Self-Reflection Moderates the Effect of a Smartphone App-Based Journaling Intervention on Psychological Wellbeing across Time

Self-reflection is often viewed positively; paradoxically, however, it is also associated with distress, potentially because of its relationship with rumination. Focusing self-reflection on positive themes may be one way to promote adaptive self-reflection. This study examined whether the disposition to engage in self-reflection motivates use of a journal containing positively focused writing prompts and moderates the benefit gained from it, specifically when rumination is controlled for. For 28 days, participants (N = 152) accessed an app-based mental health intervention containing various features, including the aforementioned journal. Outcomes of self-regulation and psychological wellbeing were assessed, controlling for time spent using other app features. As expected, journaling was associated with improvements in psychological wellbeing but only when baseline self-reflection was average or higher. Journaling was also initially associated with improvements in self-regulation, but this was diminished after controlling for time spent using other app features. Findings suggest self-reflection could be a strength for fostering wellbeing when it is directed in a positive way.

Does Online Professional Development for Physical Therapists Enhance Clinical Practice and Patient Outcomes? Protocol for a Mixed Methods, Randomized Controlled Trial

OBJECTIVE

Online clinical mentoring has shown potential as a flexible professional development activity that enhances physical therapist practice. Online delivery can overcome time and distance barriers to participation in professional development. The impact of this learning activity on physical therapist practice and patient outcomes has not been rigorously tested. Thus, the aim of this study is to determine whether online clinical mentoring is more effective than asynchronous online lectures at improving physical therapist practice and patient outcomes. An additional aim is to explore the lived experience of physical therapist learners who participate in online clinical mentoring.

METHODS

In this mixed methods evaluation, 24 physical therapist learners will be randomized to 1 of 2 online professional development activities. Experimental group physical therapists will complete 6 online clinical mentoring sessions. Control group physical therapists will complete 6 online lectures. The primary outcome evaluated will be the effect on the physical therapist's patients, using the Patient-Specific Functional Scale. Physical therapist learner secondary outcomes are confidence, self-reflection, and satisfaction. Accounting for possible dropouts, a sample size of 216 patients was determined using a pragmatic sample of 24 physical therapists, power of 0.80, alpha of 0.05, and between-group differences of 1.0 (SD = 2.0) on the Patient-Specific Functional Scale. Consecutive, eligible patients under the care of the physical therapist learners will complete outcome measures at initial appointment and at 4 weeks follow-up. Linear mixed model regression analysis will be used to estimate treatment effects from the posttreatment group means at 4 weeks. Participants undertaking online clinical mentoring will complete semi-structured interviews that will be thematically analyzed using a phenomenological approach.

IMPACT

This research study will establish the effectiveness of online clinical mentoring to inform future professional development. The qualitative component will identify the potential mechanisms by which online clinical mentoring might be effective, thus informing future implementation of this professional development activity.

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.

A mixed-methods pilot study of a psychoeducational group programme for nurse managers during the COVID-19 pandemic

AIM

This mixed-methods pilot study aimed to measure the feasibility and acceptability of a psychoeducational group programme and determine its impact on mental well-being.

BACKGROUND

The programme was developed to promote self-care, growth and adaptive coping for nurse managers. The programme themes were resilience, insight, self-compassion and empowerment.

METHODS

The sample included 19 hospital-based nurse managers. Outcomes included post-traumatic growth, resilience, insight, self-compassion, empowerment, perceived stress, burnout and job satisfaction. Paired samples t tests were conducted to compare outcomes at baseline to follow-up. Qualitative interviews were conducted. Thematic analysis was used to code the qualitative responses by keyword, which were then aggregated into themes.

RESULTS

Participants reported higher post-traumatic growth and psychological empowerment after the intervention. The following six themes emerged most consistently from the qualitative interviews: feasibility of the programme, benefits of peer support, sources of stress, barriers to self-care, sources of strength and sustainability of effects.

CONCLUSIONS

The results support the acceptability and feasibility of the psychoeducational group programme.

IMPLICATIONS FOR NURSING MANAGEMENT

Health care organizations can support and promote the implementation of programmes to alleviate burnout and improve mental well-being amid the complex demands of nursing management (ClinicalTrials.gov: NCT04987697).

Employment Status of Nurses After a Psychoeducational Group Intervention: A Matched Case-Control Study

OBJECTIVE

This matched case-control study compared the long-term employment status of direct care nurses based on participation in a psychoeducational group intervention and calculated the estimated cost savings.

BACKGROUND

Chronic stress, in addition to lack of support and low autonomy, can lead to burnout among nurses. Burnout is a common reason for job dissatisfaction and turnover. Interventions combining education with therapeutic processing and peer support may lead to healing and growth in nurses already experiencing the effects of chronic stress and burnout. The COVID-19 pandemic also contributed to stress among nurses.

METHODS

Fifty-four direct care nurses who participated in the intervention were paired with 54 direct care nurses who did not participate, matched on the following variables: age, gender, race, work setting, and campus.

RESULTS

This study found a higher percentage of direct care nurses who participated in the intervention remained employed compared with the matched control subjects who did not participate.

CONCLUSION

At a relatively low cost compared with the cost of turnover by each nurse, the psychoeducational group intervention may provide an opportunity to improve retention among nurses.

Effectiveness of multiple scenario simulations of acute and critical care for undergraduate nursing students: A quasi-experimental design

BACKGROUND

Acute care and critical care are among the most challenging tasks in nursing, which requires information, knowledge, and skills across multiple areas. Scenario simulations can teach nursing students how to respond to these challenges in a safe environment, which can also reduce the stress of acute and critical care prior to exposure to a clinical setting. However, few studies have examined whether scenario simulations of acute and critical care can improve the abilities of nursing students.

OBJECTIVES

To examine the effects of acute and critical care scenario simulations for nursing students.

DESIGN

A quasi-experimental design.

SETTING

A department of nursing at a university.

PARTICIPANTS

A total of 88 senior nursing students enrolled in a course in acute and critical care nursing volunteered to participate.

METHODS

The experience provided by scenario simulations was guided by the best practice standards of the International Nursing Association for Clinical Simulation and Learning, which recommends outcome measures include a change in knowledge, skills, and attitudes. Students completed three self-assessment instruments before and after completion of the course: simulation learning effectiveness, self-reflection and insight, and satisfaction with the simulation format. Comparisons of pre-test and post-test scores on the self-assessment instruments evaluated the effects of the simulation learning.

RESULTS

Post-test scores for subscale of self-regulation for simulation learning effectiveness and insight were significantly higher compared with pre-test scores (t = -2.85, p < 0.01 and t = -5.23, p < 0.001, respectively). There was also a significant increase for learning satisfaction in post-test, compared with pre-test (t = -3.70, p < 0.001).

CONCLUSION

The use of scenario simulations for teaching acute and critical care nursing improved self-regulation, insight and learning satisfaction for undergraduate nursing students.

Insight orientation scale: A promising tool for organizational outcomes-A psychometric analysis using item response theory

Insight is a construct carried out into different theoretical orientations with increasing application out of the boundaries of clinical psychology. Recent studies have investigated insight also as a promising variable for organizational outcomes. Given the relevance of Insight in promoting change, this paper aimed at describing the psychometric analysis of one of the shortest, most agile, and most versatile tool for measuring some of the characteristics of insight, the Insight Orientation Scale (IOS), using Item Response Theory. To achieve this goal, we applied a Mixed Rash Model to the IOS. Data from 1,445 individuals were analyzed by the means of WIN-MIRA and Multilog. Based on the likelihood statistics (CAIC) we assumed a three-class solution for the IOS. Results also indicated that the greater part of items had good discrimination and threshold parameters. These findings confirmed psychometric stability of the IOS highlighting its measurement precision, supporting its utility in both research and practice.

Know Thyself! Predicting Subjective Well-Being from personality estimation discrepancy and self-insight

Discrepancies in views of the Self are suggested to be negatively related to well-being (Higgins, 1987). In the present study, we used a novel concept, Personality Estimation Discrepancy (PED), to test this classic idea. PED is defined as the computed difference between how one view oneself (Self-Perceived Personality) and a standard Big Five test (IPIP-NEO-30). In a pre-registered (osf.io) UK online study (N = 297; Mage = 37, SD = 14) we analyzed: (1) whether PED would predict Subjective Well-Being (SWB; Harmony in Life, Satisfaction with Life, Positive affect, Negative Affect) and Self-Insight, and (2) whether Self-Insight would mediate the relationship between PED and SWB. The results showed that underestimation of Extraversion, Conscientiousness, and Emotional Stability indeed is associated with both high SWB and high Self-Insight. However, these effects mostly disappeared when controlling for the Big Five test scores. Furthermore, Self-Insight largely (42.9%) mediated the relationship between the mis-estimation and SWB. We interpret these finding such that the relationship of mis-estimating one's personality with SWB and Self-Insight are mostly explained by the Big Five factors, yet the discrepancy is a dependent feature of scoring particularly high or low on certain personality traits.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-022-03396-1.