Reflective Practice: Developing Knowledge to Promote Practice-Based Evidence for Clinical Change

Tuesday, 23 July 2013: 2:10 PM

Gwen Sherwood, PhD, RN, FAAN
School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC
Sara Horton-Deutsch, PhD, CNS, RN
Environments for Health, Indiana University School of Nursing, Indianapolis, IN

Learning Objective 1: Identify the key aspects of reflective pedagogy that are used to guide and frame knowledge development to achieve evidence based practice.

Learning Objective 2: Examine the role of reflective practice in building practice based evidence to develop expert practice and professional maturity.


Reflective practice is rarely explored as a key component in knowledge development. The research process is the most commonly identified method for developing evidence based practice. Research arises in practice and returns to practice in the translation of findings. Reflective practice lies in the between space of examining experience from a spirit of inquiry to identify the questions that define the gaps in evidence base to generate questions, order events in the chaotic clinical environment, and learn from each experience to build one’s own practice knowledge.

Methods: This interactive session will involve participants in a case study approach to illustrate the reflective process to identify knowledge needed to determine best practice. Working individually and in small groups, participants will apply reflective practice using a set of questions to analyze the case to determine actions. Participants will record an experience of their own for reflective analysis for sense making and determine questions to initiate an evidence base practice process.

Results: Reflection is in the in-between space of critical findings and application in practice. Expert nurses reflect on and learn from experience, developing tacit knowledge that guides their practice; from the outside it appears intuitive, but closer examination finds experts develop reflection-in-action for recognizing cues in the situation. Through the reflective process they identify patterns and make choices for intervention. By modeling a case study approach participants can apply the reflective process to their own experience.

Conclusions: Nurses own their experience; reflection is a part of making sense of that experience so that nurses build their own practice knowledge. Systematic reflection on experience can provide systematic approaches to knowledge development through the personal way of knowing. Tacit knowledge takes into account nurses’ personal experience and how reflection helps integrate back into their own practice, develop professional maturity, and build expert practice.