Helping Nursing Students Develop Professional Values, Morals, and Ethics through Reflective Practices

Friday, 17 March 2017: 3:05 PM

Elizabeth Ann Fiske, PhD
Department of Nursing, Appalachian State University, Boone, NC, USA

We want nursing students to be thoughtful, reflective practitioners and we want them to develop professional values, morals and ethics. At the minimum we expect civil, respectful behavior. Nursing programs typically include learning outcomes in the affective domain in their programs and accrediting bodies and professional organizations value this type of learning. Developing classroom activities to foster this type of learning can be difficult; however, a range of reflective, contemplative activities can be used. I will demonstrate and describe some activities used in the classroom.

Contemplative practices have been used for centuries to promote concentration and focus and also to develop a positive, compassionate outlook. Contemplative pedagogical strategies have been incorporated in the classroom as a means to improve attention, develop empathy and search for meaning. Simple contemplative activities can serve as proactive measures to prevent incivility among nursing students as well as to lay a foundation for future practice. These activities can create an environment of openness that in turn promotes understanding and valuing of different perspectives. Examples of how these strategies have been used to enhance learning over the past two years in an undergraduate nursing course will be discussed.

Student learning outcomes were met through purposefully selecting appropriate, relevant activities. A variety of activities used in the course will be described briefly. These activities included meditation, compassion practice, attending and exhibits on campus. Evaluation methods used, types of data collected and student outcomes will be discussed. The session will include discussion of ways to incorporate similar activities in other courses.

Use of meditation in nursing classes is not uncommon. Simply starting class with an exercise that helps students clear their minds of distracting thoughts helps students focus. Students close their eyes and are given prompts to focus on their breathing. They are encouraged to not get caught up in their thoughts and return their focus to their breathing. This practice can be used for five to ten minutes. Students are encouraged to slowly open their eyes. This short practice helps students develop awareness and focus more attentively on class. Quieting in this way can also set the tone for class as a calm, quiet environment.

Helping students see similarities shared by the class members can be a first step toward developing compassion. For this exercise students are asked to work in pairs. Without talking to each other they simply visually focus on each other while contemplating a series of statements read aloud by the instructor. The statements can include thoughts related to individual needs such as the need to feel respected and valued. Statements can also include common feelings all students experience at some point such as disappointments and misunderstandings. The exercise concludes with statements of wishes and hopes such as being healthy or having the strength to accomplish a task or goal. While this practice sounds simple, it can be very powerful.

Contemplative seeing is the practice of beholding something, usually a work of art, and contemplating it. Student impressions and interpretations of abstract visuals will vary and this practice can be a springboard to discuss difficult or controversial topics. Many different media sources can be used for this practice. I will discuss visual exhibits amd media presentations that students attended and share their reflections. The goal of this activity was not necessarily to interpret the art work and come to consensus but to foster open dialogue about difficult subjects.

There are several important recommendations for implementing any of these practices. Instructors should develop their own self-awareness through engagement with these practices prior to introducing them in to students. Many of the contemplative practices have religious roots and teachers need an understanding of the origins of each practice. All the activities used in class were purposefully kept secular. Allowing students to choose whether or not they want to participate is also essential to be respectful of students’ individual backgrounds. Faculty also need to be aware that these practices can elicit a variety of responses and appropriate support must be available if needed.

Students found the activities beneficial and the activities helped students achieve learning outcomes. Using a range of activities allowed all students to find at least one reflective practice that they enjoyed and planned to use again in the future. These activities can foster the reflective, professional behavior that we want to see exhibited by nurses.