Definition of Reflective Practice
Question:
Discuss about the Teaching professionalism to Saudi nursing students.
Reflective practice is a term that is widely used in nursing and healthcare industry. Recent evidences are of the opinion that healthcare professionals use reflection as their valuable tool to identify their weakness and strength. These help them in taking initiatives to overcome the barriers and come out victorious in different critical situations (Donalsdon et al., 2016). According to researchers, reflective practice can be defined as the continuous cycle where the healthcare professionals can get the opportunity to reflect on their daily practices and hence develop their professional skills. This ensures enhanced nursing care and greater patient safety. This ensure enhanced nursing care as they get the scope of developing a better understanding of the actions they undertake which in turn results in better development of the attributes required in healthcare (Grinslade et al., 2016). The nurses should develop the ability of examining themselves in the actions and experiences with the outcome of developing their practice and clinical knowledge. Reflective practice is essential for all level of nursing professionals starting from students to that of practicing nurses and nurse managers. Some of the main skills that are very important for effective reflection are open mindedness, courage as well as willingness to accept (Anderson, 2016). They should have the capability to accept criticism in a positive way and thereby take part in effective reflection. Reflection is also seen to turn the knowledge, skills and attitudes of healthcare professionals into their future actions and thereby increase the elf awareness of the professionals. This is of great importance because as the nurse becomes more aware of his or her own activities, strengths and capabilities, he or she can be able to practice human care in better ways (deVries & Timmins, 2016). Different number of sources can be used by the healthcare professionals that can provide them an insight about the aspects that they need to develop in the future days. Therefore, these assignments would be mainly based on the different aspects of reflective practice and how these aspects are helpful for the nurses to develop as healthcare professionals. It will shed light in the benefits of reflection, the skills and attributes required during reflection, models used in reflection and many others.
Reflective practice has huge number of benefits that had made it an important part in curriculum for nursing students and in continuous professional development courses for the senior nurses. This procedure helps in enhancing self-esteem of the individuals through proper learning with the integration of theories and practices. It also encourages holistic, individualized as well as flexible approach of caring (Eng & Pai, 2015). It also leads to acceptance of professional responsibility by the nurses for whom they tend to become more serious and careful in their practices. It also helps in providing opportunities for rapid as well as progressive refocusing of work activity. It also gives the scope to nurses for understanding and exploring the nature and boundaries of their roles as well as other health professionals (Johns, 2017). Moreover, it also gives scope to practice effectively and improve clinical knowledge and skills. These mainly take place as reflective practice enhances the opportunity for evaluation of their own performance, acknowledging their strengths, identifying their own learning needs. It also encourages nurses in ways that make them to take conscious attempt to identify and thereby learn what is happening (Lestenader, Leheto & Engstorm, 2016). Viewing clinical situations with different perspectives, motivating nurses to be a self-directed learner, enabling nurses to identify their learning needs, fostering their responsibility and accountability in their activities and improving decision-making are some of the benefits that reflective practice incorporates. Nurses get scope of reviewing both positive and negative experiences that in turn encourages critical thinking procedures (Scmhidt & Brown, 2016). With the help of reflections, the nurses can develop their practices from descriptive to more critical as well as analytical practices. It also helps in development of autonomy and skill. It provides a tool as well as mechanism through which they can communicate and at the same time justify the importance of practice and develop knowledge (Scheel et al., 2017). Researchers are therefore of the opinion that effective reflection can promote professional development within the nurses which will help them to care for the patients in effective ways by reducing the chances of errors and patient dissatisfaction (Brown & Schimdt, 2016).
Importance of Reflective Practice in Nursing
The nurses can take two types of reflection. These are called reflection in action and reflection on actions. Reflection in action happens in the moment of practice and reflection in action happens after the practice.
Reflection in action helps nursing professionals by providing them a particular procedure. Here, the nurses get the chance of reshaping what they are acting on while they are still engaged in the tasks. It is a kind of ongoing experimentation, which helps the nurses to find a viable solution. In this type of method, the nursing professionals do not have to use trial and error method but rather take actions that are more reasoned and purposeful in the immediate situations (Ramos et al., 2015). Researchers are of the opinion that reflection in action procedure is a hallmark for experienced professionals where they can examine and evaluate their own behaviors and that of others in the situation and thereby take initiatives to perform the needful to meet the requirement of the situation (Miraglia & Asselin, 2015). Several important skills are required by the individuals in order to successfully conduct reflection in action. The nursing professionals need to be participant observers in all situations that offer learning opportunities. The professionals should also attend to what they see and feel in the current situation. This can be achieved by focusing on the responses and thereby making connection with the previous experiences faced by them. Researchers are of the opinion that being “in the experiences” and “adopting a witness chance” at the same time by thinking as an outsider help to reflect successfully in this procedure (Pai, 2015).
Another procedure is called the reflection on action that is mainly done after the practice. Here the nurses get the scope of evaluating their own process of working after the situation has been over. Here, the nurses need to reflect on their actions, thinking back on what they could have done better in the situations to ensure safe practice and patient satisfaction. This is the most common form of reflection that actually involves carefully rerunning of the events that occurred in the past in the mind (Hawkins et al., 2017). The main purpose of this form of refection is that it gives the nurses the opportunity to value their strengths and at the same time develop different and more effective ways of responsible acting in the future. This form of reflection also involves close monitoring and evaluation of one’s own behavior in order to improve professional competence (Lu & Kitt , 2018). Examples of such types of reflections involve “ I could have handled the task more effectively if I had acted differently” or “ I did not take the right decision for which there arose a conflict between the two parties” and several others. This type of reflection gives the scope to the healthcare professionals to develop their clinical knowledge base as well as new set of skills and advancement of the previous skills. It is also helpful in changing or refining of the attitudes and values as well as in undertaking different clinical practice development initiatives.
Benefits of Reflective Practice
Researchers are of the opinion that effective reflection can only take place when nursing professionals have a set of skills. One of the most important skills that are required in developing nursing practice and safe treatment is self-awareness. It involves becoming aware of one’s own feeling in every situation and finding out what attributes are demanded by every situations (Daly, Speedy & Jackson, 2017). This skill helps nursing professionals to be involved in exploration and evaluation about how a situation has affected them and how the nursing professionals had affected the situations. Once the professionals develop self-awareness skills, they would be able to be more careful and responsible in their approach and hence would be able to handle critical issues successfully (Camarillo, 2016). The next skill is the description capability of the nursing professionals. This skill is exceptionally important for the nurses as it provides the ability to them to effectively recognize as well as recollect all the sequences of the situation effectively. Significant events and different types of key features of the experiences should be properly described, dissected and criticized for effective reflection. Successful description of the events in the mentioned way assures successful knowledge development (Dahl & Erikson, 2016). Proper description skills of the nurses would help to give a comprehensive yet concise account of the situations. The third skill important for effective reflection is the critical analysis skill. This capability would help the nursing professional in examining the components of the situation that is very important for properly understanding the requirement of the situation. After examining the components, nurses should learn to identify their existing knowledge, challenge assumptions and thereby imagining and exploring alternatives (Hodges, 2015). With proper critical analysis skills, nursing professionals will be able to conduct an in-depth analysis in comparison to just developing superficial ideas. Such in-depth analysis will help them to understand what attributes should have to be changes in themselves that would prevent the occurrence of negative incidences in the future and promote well being of patients through person-centered care. Another important skill that the nursing professional should also develop is the synthesis skills. This skill mainly helps the nurses to integrate new knowledge along with that of the previous knowledge that they already had (Hechemann, Schols & Halfens, 2015). With this skill, they can enhance their knowledge and can develop their practice that can have positive impact on the patients. Another important skill is the evaluation skills. The better the evaluation skills, the better will be their ability to make judgments on the value of different aspects.
Reflection helps health care professional in many ways. The main purpose of learning is that they give scope to the nurses to engage themselves in professional development without having to join any specific workshops or training classes. Reflective practice makes nurses responsible and they are able to make decisions and resolve different types of uncertainties. This process of reflection also helps in empowering individuals or emancipating them as individuals ultimately helping in self-development (Middleton, 2018). Nurses get to critically review their own behaviors as well as that of others. Researchers state that reflection is an effective way of learning as it helps in the process of meta-cognition. Another purpose of reflection is to provide help to the nurses in developing ideas from observations. They can derive theories from generalizations that may be sometimes from thoughts, sometimes from practical situations and in other cases from a mixture of two (Abdolrahimini et al., 2015). The purpose of reflection goes through four important steps that are experience, reflection, abstraction as well as active testing. Reflection provides the purpose of deeper learning by looking into varieties of situations through different forms of lens. It also gives scopes to the healthcare professionals by giving them the scope to ask themselves searching questions that challenge the assumptions of the world around them. Therefore, reflection can be helpful in providing a bridge between practice and continuous professional development.
Types of Reflection: Reflection in Action and Reflection on Action
A large number of barriers may affect the smooth reflective practice of many healthcare professionals. It is extremely important for the healthcare professionals to recognize them and take initiatives against each barrier so that their development is not obstructed.
The first issue faced by the nurses is called the time constraint. With the increase of the diseases burden and more and more demand of caring patients in the healthcare centers, it has become nearly impossible to get time for personal activities. Nurses are suffering from burnouts and are suffering from physical and mental breakdown (Mcmillan, 2017). In such periods of time constraints, it has nearly become impossible for the nurses to participate in reflective practices and continuous professional development. For modifying their perspectives and transforming their reflective abilities, time is considered as an important factor. Absence of time can act as barriers for nursing professionals to engage in effective reflective practices (Ahmad et al., 2017).
The second issue that is also denoted by the researchers over years is the absence or lack of support from mentors. This barrier mainly takes place when the mentors cannot provide sufficient time for the nursing students to help them process their recalled events. Every nursing professional require mentors in their initial phases until they become experts in reflective practice (Hunt, 2018). The mentors usually help the nurses in providing guidance about how they should proceed with the tasks actively. When nurses cannot come under proper guidance, they cannot get ideas about how to conduct reflective practices. Therefore, lack of proper mentors or inability of mentors to teach properly can act as barriers.
Another important barrier that can also act as effective barriers in reflective practice is their limited power to start any form of changes. Many of the researchers have shown that in the interviews many of the nurses have complained about restricted power and dignity in the healthcare centers. Although nurses feel that reflective practice greatly enhances healthcare knowledge, it cannot help in acting as effective agent for change as the nurses have limited power for initiating any changes (Patricia, 2018). Many researchers had stated that the power struggle that thrives between the nurses and physicians is a major barrier. From the different open-ended interviews conducted by professionals, it was seen that the nurses felt devalued and belittled by those who experience more power and are on the higher ranks of the hierarchy. This is considered to be one of the most important barriers as it results in prevention of the nurses from discussing their thoughts as well as their ideas that impeded the dissemination of the important knowledge (Burrell, 2014).
Other than these, other major barriers include lack of culture and awareness in reflecting among different preceptors as well as healthcare nurses in different clinical placements. Uncertainty of using an unfamiliar learning approach, lack of motivation and commitment, lack of supportive environment – all result in acting as challenges for which nurses cannot become experts in professional learning (Carnahan et al., 2018). Therefore, it is extremely important for the nurse leaders and nurse managers to take an active participation in overcoming such barriers and making it easier for the nurses to undertake reflective practice. This is not only fruitful for the professionals but is also helpful in developing an overall working and safety culture in the healthcare organizations.’
Skills and Attributes Required for Effective Reflection
Different researchers have proposed a large number of reflective models and frameworks over time that is used by healthcare professionals in their reflective essays and journals. These models help the professionals to follow a proper framework that provides a structured process for guiding the act of reflection. The healthcare professionals may use any of the models with which they are most comfortable and assist the professionals in learning from the experiences. Some of the renowned models that are often used by the different professionals are Gibbs reflective cycle, john’s model of structured reflection; Kolb is learning cycle, Driscoll’s cycle, Stephenson model, Goodman’s theory of reflection.
One of the most important reflection frameworks that are often used by nursing professionals is called the Gibbs reflective model. This model mainly includes six important stages of reflection. An example will be provided which would help in understanding the six important stages and how each of the stage would be helpful in conducting proper reflections.
The first step is the description stage. In this stage, the nursing professionals should describe the events in a detailed manner. Once during my night shift, a patient was admitted in the emergency unit. She had bruises all over the body and was admitted by her friend. She was bleeding heavily and her fiancée stated that her bruises should be taken care of as she is having blood loss from them at a constant rate. He stated that the patient had been suffering from bipolar disorders and has rapid mood swings. The patient had tried to harm herself several times and even had a physical fight with her friend who tried to take the weapon from her hand. When the patient entered, she was sobbing heavily. Presence of her fiancés had helped her to cool down. After requesting them to wait outside, I immediately attended the bruises and tried to dress the wounds. As there was no physician on the night shift in the emergency department, I decided to provide her a mild sedative to make her calm. However, I was not sure how to handle the situation alone and therefore to maintain her safety, applied physical restraints on her. Later in the middle of the night, she started shouting and wanted me to open her restraints. I got very scared as I could not understand what to do in that moment. The restraints resulted in further bruises on her wrists and feet for which my mentor later criticized me.
The second stage is called the feelings stage. In this stage, the healthcare nurses need to reflect their feelings that they developed at that moment. This steps helps them to recollect the feelings which they were going through when they were facing the critical situation. I was going through a very strenuous moment at that time. I was alone on the shift. I could not decide what to do at that moment. I was feeling helpless. I could not decide how to protect the patient from further injury. At that moment, my prime aim was to save the life of the patient form any danger. The only way I thought could protect her was physical restraints. I got very scared at that moment as the patient had become fierce and was throwing objects. It was the first time I had faced such a strenuous situation. I got very scared. I was at my wit’s end and my mind totally stopped working. I was feeling that such harmful behavior is not only risky to me but also for the patient herself. My fear did not allow me to think rationally and critically and hence, a physical restraint was the only method that I thought to be most suitable at times.
Models used in Reflective Practice
The next stage is the evaluation stage. This stage mainly requires the healthcare professionals to evaluate the entire incident and point out the bad things of the good things, which were associated with the incident. The entire incident had a very negative impact on the patient. She was already stressed from certain personal events in her life and was having rapid change of mood. The application of the restraints had resulted in affecting her emotionally and physically. She did not wanted to be restrained and had not given me permission either. I had gone against her permissions and put restraints on her. In spite of her requesting reportedly I did not open her restraints. This had affected her emotionally as she felt that her dignity was affected. She also felt that she was not respected and was not asked for consent before putting her on restraints. Moreover, she was also physically bruised which resulted in clogging of blood in many of the areas of her bodies especially in the wrists and the feet. Therefore, being a healthcare professional I was supposed to maintain her safety but the intervention I took that time to maintain her safety was proved to be the most insensitive practice conducted by me.
The next stage is the analysis stage. In this stage, the healthcare professionals need to analyze the situation and make proper senses. This situation showed me that I had not applied by critical thinking skills. I had to analyze critically the situation and should have thought about the negative instances that are associated with the use of restraints. From this entire situation, I realized that although I had done the course of emergency care of patient for 6 months I was not well prepared. In strenuous moments, I could not analyze situations critically. Moreover, I also analyzed from the situation that I have no proper decision making skills. Taking decisions in critical situation by utilizing far sightedness skills, outcomes of situations and thinking for proper alternatives is an attribute that is very important for healthcare professionals. Besides, I later realized from this situation that I also suffered from conflicts of different ethics of healthcare. On one side, I was trying to maintain beneficence by providing interventions that ensure safety of patients and on the other hand, I was trying to maintain dignity and autonomy of patients. Although I settled for maintaining beneficence by protecting the patient from self-harming herself and myself, I broke the other ethical rule. Therefore, I understood that I suffer from ethical dilemmas in crucial times and cannot take initiatives that would help me develop interventions that would to overcome any ethical dilemmas.
Conclusion:
The next stage is called the conclusion stage. This stage mainly describes what else the healthcare workers could have done in that particular situation to avoid the consequences that occurred. This is one of the most important stages of reflection as it helps the healthcare professionals, the right initiatives he should have taken in the crucial moment. With the help of my mentor, I understood the different interventions which I needed to take in such situation. I should have frequently assessed client’s behaviors for identifying any signs of hyperactivity and agitation. Experts are of the opinion that early detection of escalating mania prevent the possibility of self-harm or harming others and thereby decrease the need of seclusion of physical restraints (Frank et al., 2015). I should have undertaken a calm and form approach as it helps in providing a structure and controlling the client who is out of control. Moreover, I should have used short, brief and simple sentences. This is mainly because short attention span limits the understanding of the clients to small pieces of information (Mccormick, Murray & McNew, 2015). Rather than shouting on the patients, I should have neutral and should not have argued with the patient. Researchers advise so because the patients suffering from bipolar disorders can use inconsistencies and value judgments as justification for their arguing and escalating mania. One of the important steps that I could have taken is to redirect the agitation of the patient and her violent behaviors with physical outlets in an area of low stimulation like in case of using punching bag. This is helpful as it helps in relieving pent up hostility and relieved the patient from muscle tension (Yesefu et al., 2015). I should have also decreased the environmental stimuli such as like providing a calming environment as it helps in decreasing escalation of anxiety and maniac symptoms. I could have encouraged the client to express her feelings in a calm and composite manner and established bond with her by being friendly and trustworthy. Talking about feelings and providing her with coping solutions could have helped her to rely on me as a well-wisher preventing her chances of self-harm. All these would have helped me to handle her effectively rather than using physical restraints. I could have also disclosed the issue of absence of staff with the family members and asked their help for constant monitoring of the patient until I could have arranged for help from other departments. This could have reduced the necessity of physical restraints use for maintain her safety .
Application of Reflective Practice in Nursing Education
The last stage of this cycle is called the action plan stage. In this stage, the healthcare professionals should decide what the initiatives that would take if such situations occur again. If such a situation occurs again, I would never let fear to control my activities. I would have stayed calm and would though of the situation critically. I should taken decisions that are in benefit for the patients at that particular moment and in the future. I would immediately inform her family members who are present and keep her under constant monitoring. I should communicate with her compassionately with a soft but confident approach for developing trust in the patient. Once the patient relies on me, the danger can be avoided. Moreover, I should never use physical restraints. I would take the interventions discussed by my mentor so that I do not get involved in legal and ethical complications.
John proposed this model in the year 1995 that is based on five cue questions. These questions mainly help in breaking down the experiences and thereby reflecting on the different outcomes.
The first stage of the reflection is called the ‘description of the events’ stage. In this stage, the healthcare professionals need to disclose the experience in details and denote the different significant factors. It was during my initial days of being promoted as a head nurse in the emergency department. I had no proper experiences of leading teams. I was assigned to lead the nursing professionals in the rehabilitation ward as the head nurse had been on leave and there was admission of a very crucial patient who had undergone severe accidents. The patient was an old woman who had not taken her insulin in proper doses and on the right time. She had a fall on the staircase resulting in wounds and bruises and severe pain in her limbs and back. Because of the fall, she had mini stroke that had impaired certain parts of her speeches. There was a complete loss of teamwork among the healthcare members. This affected the health of the patient. There was no proper communication among the team members. This resulted in medication error like repeated medication administration resulting in double doses. There were also instances when the physiotherapist and speech therapist visited the patient together and got engaged in a struggle. The junior and senior nurses of the team suffered from complexes and did not bond with each other. Every of the healthcare professional used to write their observation without conducting any meetings, as all were busy in their own respective fields. Whenever I confronted them, they played blame games. Finally, I was called by the higher authority and was criticized as my contribution as a head nurse because the patient’s family complained about me. They complained that the team is not providing patient centered care to the patient affecting her health and leading to prolonged treatment.
The next phase is the reflection phase. This phase helps the nurses in identifying what they were trying to achieve and the different consequences associated with the trials. From the entire incident, I understood that there was no proper teamwork and therefore it was affecting the health of the patient. I tried to solve things between the nurses and other professional by interacting with them but they were constantly blaming each other. I was trying my best to find out the main source of the problem between the members but I had no proper leadership skills. Therefore, even if I was trying to make things better, I failed miserably in taking proper initiatives.
The third stage is called the influencing factors. In this stage, the nursing professionals need to identify the factors that affected their decision-making. The main factor that affected my decision-making was my novice and improper initiates that I took to overcome the situations. Although I was concerned about the situation, I could not understand what initiatives I need to take, as I had no proper practical and theoretical knowledge of effective leadership. Moreover, I also asked them to open up about each other where they blame each other than accepting their mistake. I realized that there was no proper communication and bonding among the members. However, my lack of knowledge of handling such issues and fear to be perceived in a wring sense by other affected my decision-making. I had not critical reasoning skills and confidence to lead a multidisciplinary team. These factors affected decision-making.
The next stage mainly helps the nursing professionals to understand what other steps could she had taken and what would have been the consequences then. The first initiative that I could have taken is the arrangement of training sessions. Proper mentors should have been allocated who would have helped the professionals in developing knowledge on effective communication and proper team working on patient safety (Weller & Civil, 2017). I could have also arranged for meetings where every member would provide constructive feedback about others that would help in developing unity. I should have encouraged both the senior and junior nurses in informal communication activities so that they develop bonding among themselves. Effective bonding and relationship building would help in overcoming blame games and would help in providing better patient care (Weller, Boyd & Cumin, 2014). Moreover effective discussion sessions about the health of patient with all members of multidisciplinary teams and knowing each of their suggestions are important in taking correct decision of the health of the patients. These would have assured proper patient care and maintenance of her safety (Casimiro et al., 2015).
The last stage is called the learning stage. This stage helps the individual to identify what would change as the result of the experience. It also states how the experience has changes their way of thinking. I developed knowledge that teamwork requires effective communication, bonding, and trust, open discussions of stressful situations and exchange of effective feedback (Rosen et al., 2014). Therefore, as the head nurses, I would try to take initiatives that would boost all the factors thereby helping in maintaining uninterrupted communication and proper teamwork. This would ensure patient safety.
Conclusion:
Reflective practice can be defined as the actions taken by nursing professionals for successfully engaging themselves in procedures of continuous learning. It mainly helps the nurses to manage different impacts of caring for patients on a daily basis. It helps in making sense of the events, situations and workplace that take place in the healthcare organizations and thereby critically analyzing the events to learn about the best or worst parts of the incidents. This is then followed by taking initiatives that would help in promoting successful patient care in the future. It helps in building skills like self-regulation and self-awareness. These give the ability to understand emotions, strengths, values, goals, and weakness and thereby help in recognizing their impact on others. Reflective practice also helps nursing professionals to learn from their mistakes, be more confident, improves their quality of care, develops clear thinking and decision-making skills, builds characters and educates nurses. There are two types of reflective learning. Reflection on action helps the nurses to reflect about their activities after the incident. Another is reflection in action that helps the nurses to reflect about their activities while they are conducting the task in the moment. Healthcare professionals follow different models of reflection as framework for writing reflections. These are Gibbs reflective cycle, john’s model of structured reflection; Kolb is learning cycle, Driscoll’s cycle, Stephenson model, Goodman’s theory of reflection. Reflection has become an integral part of nursing practice as it helps in development of knowledge and skills of nurses and thereby helps to ensure patient safety and satisfaction largely.
References:
Ahmad, E. R., Al Qahtani, N. H., Nafee, H., & Al-Eraky, M. (2017). Teaching professionalism to Saudi nursing students using guided reflection on clinical vignettes. Journal of Nursing Education and Practice, 8(1), 1.
Anderson, R. C. (2016). The man in the yellow slicker: A clinical chaplain’s reflection management on nursing and patient care. Nursing2017, 46(6), 45.
Beentjes, T. A., Goossens, P. J., & Jongerden, I. P. (2016). Nurses’ experience of maintaining their therapeutic relationship with outpatients with bipolar disorder and their caregivers during different stages of a manic episode: a qualitative study. Perspectives in psychiatric care, 52(2), 131-138.
Brown, J. M., & Schmidt, N. A. (2016). Service–Learning in Undergraduate Nursing management Education: Where is the Reflection?. Journal of professional nursing, 32(1), 48-53.
Brown, L. (2014). Make your reflection count. Nursing Standard, 29(4).
Burrell, L. A. (2014). Integrating critical thinking strategies into nursing curricula. Teaching and Learning in Nursing, 9(2), 53-58.
Camarillo, J. I. (2016). Nurses of Asia: Reflection from Asian Oncology Nursing Society Conference 2015. Asia-Pacific journal of oncology nursing, 3(1), 13.
Carnahan, R. M., & Letuchy, E. M. (2018). Bipolar Disorder in Nursing Homes: Impact on Antipsychotic Use, Diagnosis Patterns, and New Diagnoses in People with Dementia. The American Journal of Geriatric Psychiatry, 26(1), 2-10.
Casimiro, L. M., Hall, P., Kuziemsky, C., O’Connor, M., & Varpio, L. (2015). Enhancing patient-engaged teamwork in healthcare: An observational case study. Journal of interprofessional care, 29(1), 55-61.
Dahl, H., & Eriksen, K. Å. (2016). Students’ and teachers’ experiences of participating in the reflection process “THiNK”. Nurse education today, 36, 401-406.
Daly, J., Speedy, S., & Jackson, D. (2017). Contexts of nursing: An introduction. Elsevier Health Sciences.
de Vries, J., & Timmins, F. (2016). Care erosion in hospitals: problems in reflective nursing practice and the role of cognitive dissonance. Nurse education today, 38, 5-8.
Donaldson, K., Spencer, C., Austin, N., & Moor, S. (2016). Working alongside mothers with opioid drug dependency: a reflection of nursing practice. Neonatal, Paediatric & Child Health Nursing, 19(1), 13.
Eng, C. J., & Pai, H. C. (2015). Determinants of nursing competence of nursing students in Taiwan: the role of self-reflection and insight. Nurse education today, 35(3), 450-455.
Frank, E., Wallace, M. L., Hall, M., Hasler, B., Levenson, J. C., Janney, C. A., … & Kupfer, D. J. (2015). An Integrated Risk Reduction Intervention can reduce body mass index in individuals being treated for bipolar I disorder: results from a randomized trial. Bipolar disorders, 17(4), 424-437.
Garneau, A. B. (2016). Critical reflection in cultural competence development: A framework for undergraduate nursing education. Journal of Nursing Education, 55(3), 125-132.
Grinslade, S., Zile-Tamsen, V., Carol, M., Winkelman, T. A., Larcara, M., Lazzaro Steeg, L., & McDonald, P. W. (2016). A Metacognitive learning Strategy that Guides Intentional learning and Reflection in Nursing Education.
Hawkins, A., Frander, E., Young, M., & Deal, K. (2017). Reflection on Retention: An Evaluation Study on Minority Students’ Success in an Online Nursing Program. Perspectives In Learning, 16(1), 5.
Heckemann, B., Schols, J. M., & Halfens, R. J. (2015). A reflective framework to foster emotionally intelligent leadership in nursing. Journal of nursing management, 23(6), 744-753.
Hodges, B. D. (2015). Sea monsters & whirlpools: Navigating between examination and reflection in medical education. Medical teacher, 37(3), 261-266.
Hunt, J. (2018). Acute burns management: personal reflections of a second year nursing student. Nursing Children and Young People.
Johns, C. (2017). Becoming a reflective practitioner. John Wiley & Sons.
Lestander, Ö., Lehto, N., & Engström, Å. (2016). Nursing students’ perceptions of learning after high fidelity simulation: effects of a three-step post-simulation reflection model. Nurse education today, 40, 219-224.
Lu, H., & Kitt-Lewis, E. (2018). Pedagogical differences: A comparative reflection between American and Chinese nursing education.
McCormick, U., Murray, B., & McNew, B. (2015). Diagnosis and treatment of patients with bipolar disorder: A review for advanced practice nurses. Journal of the American Association of Nurse Practitioners, 27(9), 530-542.
McMillan, F. (2017). Viewpoint And Reflection For The Nursing Workforce. Australian nursing & midwifery journal, 24(7), 28-28.
Middleton, J. (2018). Using reflection on reading for revalidation. Stroke, 7, 06.
Miraglia, R., & Asselin, M. E. (2015). Reflection as an educational strategy in nursing professional development: An integrative review. Journal for nurses in professional development, 31(2), 62-72.
Pai, H. C. (2015). The effect of a self-reflection and insight program on the nursing competence of nursing students: a longitudinal study. Journal of Professional Nursing, 31(5), 424-431.
Patricia Sadlon, P. (2018, January). The process of reflection: A principle?based concept analysis. In Nursing forum.
Ramos, F. R. S., Brehmer, L. C. D. F., Vargas, M. A., Trombetta, A. P., Silveira, L. R., & Drago, L. (2015). Ethical conflicts and the process of reflection in undergraduate nursing students in Brazil. Nursing ethics, 22(4), 428-439.
Rosen, M. A., Dietz, A. S., Yang, T., Priebe, C. E., & Pronovost, P. J. (2014). An integrative framework for sensor-based measurement of teamwork in healthcare. Journal of the American Medical Informatics Association, 22(1), 11-18.
Scheel, L. S., Peters, M. D., & Møbjerg, A. C. M. (2017). Reflection in the training of nurses in clinical practice settings: a scoping review protocol. JBI database of systematic reviews and implementation reports, 15(12), 2871-2880.
Schmidt, N. A., & Brown, J. M. (2016). Service learning in undergraduate nursing education: strategies to facilitate meaningful reflection. Journal of professional Nursing, 32(2), 100-106.
Sedki, M., Mendez, J., Bruer, S., & Levine, D. (2015). The importance of teamwork in healthcare for effective communicate and care of older adults. Journal of Interprofessional Education & Practice, 1(2), 71-72.
Shorey, S., Siew, A. L., & Ang, E. (2018). Experiences of nursing undergraduates on a redesigned blended communication module: A descriptive qualitative study. Nurse education today, 61, 77-82.
Weller, J., & Civil, I. (2017). Teamwork and healthcare simulation. Healthcare Simulation Education: Evidence, Theory and Practice, 127-134.
Weller, J., Boyd, M., & Cumin, D. (2014). Teams, tribes and patient safety: overcoming barriers to effective teamwork in healthcare. Postgraduate medical journal, postgradmedj-2012.
Yesufu-Udechuku, A., Harrison, B., Mayo-Wilson, E., Young, N., Woodhams, P., Shiers, D., … & Kendall, T. (2015). Interventions to improve the experience of caring for people with severe mental illness: systematic review and meta-analysis. The British Journal of Psychiatry, 206(4), 268-274.
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