Reflective practice in thermoregulatory nursing care

This article demonstrates how the use of a reflective model can aid organisation and rationalisation of thoughts that, in turn, results in improved nursing care of patients with fever.     

Reflective practice: a guide

Reflective practice is an important concept to the development of nursing as a profession. Nurses need to become reflective practitioners, especially within the current changeable climate. Many practitioners however, find reflective practice confusing and feel unsure how to proceed. This paper attempts to remove some of the mystery surrounding this issue. The skills needed for reflection are identified from a review of the literature. These include self-awareness, critical analysis, synthesis and evaluation. A suggested activity for developing reflective skills is provided as well as a format for keeping a learning diary.     

Reflective practice and nursing.

Reflective practice is a frequently used but in-frequently defined concept in nursing at the present time. Part of the reason for the lack of definition lies in the fact that there is no theory of practice. This paper lays the foundations for a theory of practice and paves the way for one useful way in which the relationship between theory and practice can be understood. It is suggested that thoughtful practice is often mistaken for reflective practice, but that the latter can only exist where practice is not taken for granted and so the outcome of practice is more learning from experience. The paper also maintains that for reflective practice to be practised within the profession it is necessary both to have the structures within which it can be encouraged and the theoretical foundation whereby efficient practice need not only be judged in terms of 'value for money'.     

Reflective practice: a critical incident

Reflection identifies one's professional capabilities, increases knowledge of self and improves understanding and management of patients. Conducting reflective practice is conducive to professional development and growth. A complex medical and nursing management of a psychiatric emergency is illustrated through this critical incident. Psychiatric nurses play a key role in deescalating the aggressive behaviour of psychotic patients. Through reflection, the basic tools of psychiatric nurses are reviewed and the prime components of psychiatric therapy are discussed.     

Reflective practice in the Accident and Emergency setting

The object of this paper is critically to analyse the issue of reflective practice within the writer's own professional arena. The writer is a senior nurse within an Accident and Emergency (A & E) department.It has long been recognised that a gap exists between theory and practice in nursing. There has been much discussion in the nursing literature about the development of the reflective practitioner and how reflection in practice can assist in closing the theory-practice gap.Nurses have always experienced great difficulty in identifying a theory of practice.Jarvis (1992) states that reflective medicine is a frequently used but infrequently defined concept in nursing at the present time. For both qualified nurses and students alike, reflection can be utilised as a learning process to help them expand and develop their clinical knowledge and skills to directly benefit client care (Dewing 1990).Schon (1987) has identified reflection as a process of knowledge acquisition originating in practice and best suited to solving complex practice based problems. Reflection is an active process of exploration and discovery which often leads to unexpected outcomes (Boud et al 1985).Reflection that occurs in the process of an experience is referred to as reflection-in-action (Schon 1987). Nurses have the ability to think about their actions while they are carrying them out and change the actions should the professional's assessment of the situation change (Schon 1983). Reflection can lead to new understanding and appreciation which can be put to use in future experiences (Dewing 1990).This paper will commence with a brief explanation of how nurse education is developing reflection and experience to assist the student nurse to close the theory-practice gap.     

Reflective inquiry in nursing practice or 'revealing images'

Reflective inquiry in nursing practice or 'revealing images' Nurses live and work in complex practice worlds; worlds of shrinking resources and expanding needs. Reflection through journaling offers unique opportunities to gain insight into practice. What might we learn from one's journal? A reflective journal can be a source of interplay between the self as written and the self as other. Likewise, the journal may act to situate ourselves in practice, while at the same time enabling us to illuminate how and in what ways our understandings have become distorted. The extent to which one's journal is educative depends upon the manner in which one chooses to use it as a transformative tool, a tool that might well be described as a process of healing and enlightenment. In order to illustrate the reflexive nature of journaling, this paper is presented as a play reading, where a conversation about practice stories between the different aspects of the nurse's self is depicted. In adopting a play reading, an alternative pedagogical tool is used to illustrate different methodologies exemplifying the emergence of how and in what ways we develop and reconstruct our understanding in nursing.     

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.     

Reflective practice in speech-language pathology: A scoping review

Abstract

Purpose: Within the profession of speech-language pathology, there is limited information related to both conceptual and empirical perspectives of reflective practice. This review considers the key concepts and approaches to reflection and reflective practice that have been published in the speech-language pathology literature in order to identify potential research gaps.

Method: A scoping review was conducted using Arksey and O’Malley's (2005) Arksey, H., & O’Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 8, 19–32.[Taylor & Francis Online] , [Google Scholar] framework.

Result: A total of 42 relevant publications were selected for review. The resulting literature mapping revealed that scholarship on reflection and reflective practice in speech-language pathology is limited. Our conceptual mapping pointed to the use of both multiple and generic terms and a lack of conceptual clarity about reflection and reflective practice in speech-language pathology. Two predominant approaches to reflection and reflective practice were identified: written reflection and reflective discussion. Both educational and clinical practice contexts were associated with reflection and reflective practice. Publications reviewed were primarily concerned with reflection and reflective practice by novices and expert practitioners.

Conclusion: Based on this review, we posit that there is considerable need for conceptual and empirical work with a goal to support university- and work-based educational initiatives involving reflection and reflective practice in speech-language pathology.     

Reflective practice and team teaching in mental health care

AIM: To develop and test new approaches to professional education that would address issues of team capacity and readiness to learn, thereby strengthening the ability to practise reflectively. METHOD: The time out and the debrief approaches to team training in core competencies were piloted with ten care teams in the north west of England. Pre- and post-training measures of competency were obtained to assess the effectiveness of the training. RESULTS: The results show that competence measures taken after attending the programme were significantly higher than those taken before training. Self-assessments and manager assessments supported this, indicating that the training had a positive effect on the overall capability of practitioners. CONCLUSION: The findings suggest that the innovative educational process created in this study could be used to support the structures of reflexivity and thoughtful practice. This educational process could be used to support practitioners to fully embrace work challenges.     

Reflective practice: a meaningful task for students

AIMS: To ascertain whether students found reflection to be a meaningful activity, whether there are perceived benefits associated with reflective practice and whether it is a valid process on which to assess the outcomes of a course relating to the competencies of specialist practice. METHOD: The attitudes of students attending a one-year degree course were examined using a focus group interview and a web discussion board. The evaluation of the focus group interviews and web-based discussion postings are discussed. FINDINGS: Reflective writing is considered a key component of portfolio assessment because it provides evidence of skills development and increasing clinical competence. There was no consensus on whether or not reflection is a meaningful activity. The students' learning style is pertinent to their perception of the usefulness of reflection. CONCLUSION: The findings indicated the scepticism with which some students approached the task, but they also identified that reflection had a positive impact on the practice of students more able to embrace the process in a meaningful way. There is scope to extend this work to examine the use of reflection in developing the growing body of practice knowledge that underpins nursing.     

反思学习法在手术室临床带教中的应用

目的探讨反思学习法在手术室临床带教中的应用效果。方法将96名手术室实习护士随机分为实验组（n=48）和对照组（n=48）。实验组采用反思学习法教学,对照组采用手术室传统方法教学。采用问卷调查和出科考试对2组的教学效果进行综合评价比较。结果实验组实习护士在提高沟通和语言表达能力、增加对手术患者的人文关怀、提高手术配合的能力、培养团队协作能力、提高自学能力5个方面均优于对照组（X2=15．10,17．14,8．49,19．10,6．98;P〈0．01）,实验组综合评价得分（92．3±4．2）分,对照组综合评价得分为（79．5±3．8）分,组间比较差异具有统计学意义（t=15．65,P〈0．05）。结论反思学习法能提高手术室临床带教的效果,培养和提高学生的人文素养和批判性思考能力。     

Reflective practice in nursing care: embedded assumptions in qualitative studies

Qualitative nursing researchers have long recognized that reflective practice (RP) seems to be a valuable tool in nursing care. The aim of the present meta-study was to analyse current qualitative research on RP in nursing care, in order to create and synthesize the knowledge and the understanding of registered nurses' RP. Using a meta-study synthesis approach, embedded assumptions were identified in qualitative studies that have influenced the way researchers have interpreted and made sense of RP in nursing care. Despite empirical focus in research on RP in nursing care, it was found that assumptions about RP were predominantly based on theory. The reflective movement within the practice of nursing care has mainly a constructivist epistemology, based on learning from experience. The individual nurse's RP capability is essential in providing and improving ethical and holistic nursing care.     

Reflective practice and clinical supervision: an interprofessional perspective

BACKGROUND: In the United Kingdom, the drive to encourage reflective practice through clinical supervision, as a means of ensuring quality of provision in nursing and other health care professions, is now well-embedded, not only in policy but also in practice. However, debate and critique of these concepts is limited. AIM: The aim of this paper is to draw on research, conducted with undergraduate occupational therapy students and qualified physiotherapists, in order to contribute to the debate about the functions of clinical supervision and reflective practice in nursing and other health care professions. DISCUSSION: Upholding the notion that clinical supervision has the potential to constitute a form of surveillance, we counter the assumption that it is inevitably confessional in nature. A social constructionist perspective is used to illustrate how clinical supervision might involve a complex interplay of factors that dispel notions of predictability, control and rationality. CONCLUSION: Despite acknowledging tensions, we argue that clinical supervision is both necessary and beneficial. It can be advantageous to individual practitioners and professional groups in enhancing practice and accountability, and promoting professional development.