Paper
Friday, 21 July 2006
This presentation is part of : Diverse Studies of Nursing Education
Incorporating Reflective Practice into a Senior Capstone Course
Carole Ann McKenzie, CNM, PhD, Sue Thompson, PhD, RN, and Jackie McVey, PhD, RN. College of Nursing and Health Sciences, The University of Texas At Tyler, Tyler, TX, USA
Learning Objective #1: analyze the use of reflective journaling in nursing education.
Learning Objective #2: apply reflective practice strategies to diverse educational and clinical roles
The purpose of this project was to use a scholarly approach to introduce reflective journaling into a capstone course in leadership/ management for pre-licensure and licensed BSN students. While previous student groups had effectively addressed key issues in their guided clinical reasoning journals, faculty recognized a lack of meaningful role awareness. Review of reflective practice literature revealed potential for increasing student engagement in patient care encounters to promote positive changes in patterns of nurse caring. Faculty presented reflective practice material in lecture, assigned readings, and clinical exercises, including concepts of personal accountability for role ownership and outcomes along with the importance of holistic nursing practice involving body-mind-spirit of both nurses and patients. Students were asked to select critical clinical experiences for reflective journaling using prompters on a reflective journal template. Guided questions focused on individual self- awareness along with patient communication, behaviors, and response. The crux of the journals was a decision making section that gave learners opportunities to compare present and past nursing care with potential future changes in practice. Student journal responses were impressively soul searching regarding patient needs and individual nurse caring. One theme that emerged was that of role dissonance. Many students commented on previous tendencies to overemphasize technical aspects of nursing and to save more overtly caring interventions for special situations. Faculty members used the journals to help students integrate role components of direct care, management, autonomy, and introspection. Faculty also found themselves using reflective practice strategies to examine their own role accountability and creativity in course design, teaching, and clinical supervision. Course faculty concluded that reflective journaling is an important experience for any nurse in job transition or role examination. It provides a framework for evaluating practice and beliefs regarding self in patient care and for increasing accountability.

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