This reflective practice project focused on how nurses in mid-level management were influenced by a graduate school assignment on reflective examination of critical role interactions. Findings were part of a larger study that focused on the use of reflective practice strategies to guide role transition (Bridges, 2003, 2004;  Meleis, 1975) for undergraduate and graduate nursing students anticipating new or revised work responsibilities.  

Reflection focused on the process of internalization of experiences and their meaning.

Graduate students in a nursing administration course completed a reflective journal and a  

reflective leadership paper, with criteria based on Johns’ work  (1993, 2004).  Critical incidents discussed centered on management and leadership situations that were unresolved or role disparities.

A qualitative, retrospective approach was utilized to analyze the narrative data.  Nurses involved in the course assignments reported a wide variety of insights that reflected the same three themes in the larger study. Those themes were Perspectives, Emotional Experiences, and Engagement in the Reflective Process. All of the students had epiphany moments of clarity that assisted them in moving forward in their administrative career.

Several gave examples of profound experiences that helped them clarify their roles and to resolve ongoing collaborative issues such as conflict within the health care team. One student initiated orientation and staff development programs based on reflective group processes.

Data results suggest that guided reflective strategies help nurses resolve key issues in health care management and administration. Ongoing placement of study results within nursing practice and research literature support the importance of reflective practice in developing role accountability and reducing role disparity. The development of accountability is seen as an internal process (O’Grady & Malloch, 2006) and is a step in leading nurses to excellence.