To Prompt or Not to Prompt: Finding the Best Journaling Practice to Develop Cultural Competence

Background: Reflective journaling has been widely used as an education tool and data collection method. It is used in nursing education to aid students’ introspective thinking process to improve self-reflection, critical thinking, and cultural awareness. Refining these skills enables nurses to make meaning out of experiences in order to broaden their worldview and self-awareness. There are multiple journaling formats suggested, including open reflective journaling, prompted journaling, and freestyle journaling. Despite many opinions, there has been minimal definitive research to distinguish which style of journaling is most beneficial for data collection or pedagogical reflection.

Purpose: This study aimed to monitor individual experiences, emotions, and reflections to assess culture shock stages, coping, and changes in worldview for nursing students throughout a two-week trip to Ghana.

Theoretical Framework: Transformative Learning Theory. Journaling is used as a tool of critical reflection to help process new experiences and feelings that may alter one’s beliefs and worldviews in this culturally transformative experience in Ghana.

Method: This was a descriptive qualitative study. Reflective journaling was used as an educational and data collection tool for nursing students on three separate two-week trips to Ghana. Journal entries were read and coded for common topics using Atlas.ti. The first and second year, students were assigned open reflective journaling with a requirement for number of entries. The third year, students were given prompted questions to answer for every journal entry to help guide student reflections and ease data collection.

Results: An unexpected trend was discovered from varied journaling formats. The prompts created shorter entries with less rich and reflective substance. Some entries only allowed for two codes versus some with 28 codes in previous years. Entries were written in one word or one sentence format instead of full paragraph format as in the previous years.

Conclusion: Prompted journaling, a commonly recommended form of reflective journaling, inspired shorter, less rich, and less introspective journal entries compared to unprompted, open journaling. Further research is needed regarding an informative and educational journaling format for cross-cultural experiences.

Continuing Research: A fourth group of students recently came back from Ghana and most of a new set of unprompted journal entries has been gathered. They have not yet been coded, but the length and format alone shows longer, fuller entries than the prompted journals from the third year. This information will help us to understand and format appropriate introspective tools for cross-cultural educational journeys in the future in order to improve culturally competent nursing education.