reflective writing nursing students

reflective writing nursing students

The Importance of Reflective Writing for Nursing Students

1. Introduction

This change in focus to a more introspective approach may be alien to some students. It may be their belief that reflection involves learning from mistakes or going back over an event and thinking about how it could have been done differently. Johns (1995) believes that a mature understanding of reflection is never separate from theory. For students who find writing difficult, maintaining a reflective diary can overemphasize written expression at the cost of real engagement with reflective activity. Warner (2003) studied the use of creative and reflective diary as an assessment during a clinical practicum. She believed that while the experience was positive for some students, it signified another task for the less able writer.

The ability to become a reflective practitioner will be a quality that will become increasingly important from the studies as they progress. This ability is vital as it will enable the nurse to learn from experience, and it is this learning from experience that will underpin the development of professional judgment. This judgment is critical to safe, high-quality decision making in a healthcare environment. There are a number of ways to promote reflection. The use of narrative and creative writing has been employed by nurse educators to develop reflective practice. Whether the use of this practice is beneficial to the student is still disputed between education providers. This paper will critically explore the use of reflective writing for student nurses.

2. Benefits of Reflective Writing in Nursing Education

Reflective writing is understood to be a learning activity that requires the individual to have a look at the position or practical experience and come to understand and examine it, in order to turn the knowledge into a practical form of learning (Boud et al., 1985; Boyd and Fales, 1983). This process contributes an extra dimension to deepen the nature of knowing and makes practical knowledge within the event. Through reflection, an individual might generate an understanding, thus changing it into something meaningful. This would eventually lead to changes in clinical and conceptual understanding of the event. Reflection is seen as an influential resource to effect positive changes in the healthcare profession. It is one way of fostering self-development and moving towards professional growth. Reflection on practice in professional life might become an endeavor to identify and resolve dissonance between practice and beliefs, so that a nurse is able to act on it with conviction. Changes in the current healthcare culture are directing nurses to employ their critical thinking skills, which have prompted the requirement for nurse education to acknowledge and develop that skill in their students. One such approach to evoke critical thinking in pre-service nurses is reflective writing.

Reflection has many benefits and is now widely promoted in nursing education. Reflection before and after a situation is vital to enhance learning, professional development, or clinical judgment. Reflective practice has been recently acknowledged as a significant competency for nurses. For still others, it is an attitude, a way of thinking, that underpins autonomous practice and continues to develop personal and professional competence (Chapman et al., 2006). Foster and Hawkins (2005) state that it is the process of internally examining and exploring an issue of concern, triggered by an experience, which creates and clarifies meaning in terms of self and results in a changed conceptual perspective.

3. How to Engage in Reflective Writing as a Nursing Student

The next stage can involve a discussion with colleagues; however, this is not always possible if the incident has been distressing and the nurse is seeking to reflect with a view to changing their actions. The reflection can then be extended to considering what was done well and analysis of the result. This often will reveal good and bad practice and can affirm what should and should not be repeated. The reflective process will end with exploration of the new knowledge of self or insight as mentioned previously. This is a very basic method and is just the starting point. As reflection becomes a habit, more appropriate methods and this style of reflecting can be adapted to suit different scenarios.

It is commonly said that reflection starts with a description of what happened. It is advised that when one first starts to use reflection as a tool that it may be helpful to use a journal to write down a description of the event or experience. This will allow the nurse to clarify in their own minds the specifics of the incident so it is fresh in their memory and can be documented accurately. Following this section, writing down any thoughts or feelings during the event can allow the nurse to see whether there is a connection between the thoughts and actions at the time. This is often the case when a nurse feels that an action was ‘instinct’ but is unable to justify it later. This can also be done on the guideline-based reflective template mentioned in previous sections.

The detailed nature of the steps involved in the reflective process could disguise the reality that it is a very personal activity. There is no right or wrong way to reflect as each nurse will have their own style and will find methods that are specific to them. Therefore, the information provided here is to be used as a rough guide and should be adapted to suit your learning style.

4. Examples of Reflective Writing in Nursing Practice

In nursing, examples of when reflective writing through narratives and reports may be more beneficial than through models or frames of information is through past experiences or significant events. Using reflection in the writing process allows you to open up and expand on a particular event that occurred. This may have been a positive, negative, or even a life-changing experience. According to Johns (1995), this reflection on a past occurrence or on an experience still presents as the best way to learn from events, thus moving on to similar events with a more able and professional manner. A reflection at this level of writing will give a deeper account of the difficulties faced around the event, with consideration as to what was going through yours and others’ minds at the time. An example that would be well-documented through a narrative would be a patient who was assigned to your care during a clinical placement, where you have learned through university teaching that they were suffering from a particular condition. At some stage during that day, you feel you’ve not given the best care or treatment to help that patient and find it difficult to understand why your visit to reflective writing can also be used as a learning method for the profession or practice. An example of how this would benefit a nurse would be with a midwife trying to master the advice and techniques to offer the best breastfeeding position to a new mother. This skill can take some time to master, and the midwife in question may be called away to another task before fully mastering the technique. By writing a learning diary, the midwife could see this as a learning experience and make a record of what was done, what was learned, and what the result was. As recommended by Tilley and Callister (2008), reflecting on the experience will improve critical thinking skills, and through identifying inherent knowledge and the gaps of information, the practitioner will be able to achieve a better outcome next time through applying the knowledge to an altered given situation.

5. Conclusion

The use of reflective writing is now widely recognized as a critical component of student learning in a wide range of subject areas. The potential benefits are considerable, and there is an extensive and well-documented literature. The practice of nursing is promoted as a scientific process and is taken for granted to be so. As cited in Driscoll (1994), there is now an increasing emphasis on nursing as a ‘knowledge-based profession’. It is argued that the link between theory and practice is essential if nurses are to generate a knowledge base. The use of theory and the perspective of nursing as a knowledge-based practice fits well with narrative-based learning. The linking of theory and practice is a complex process, and Schon’s model for reflective practice is a means to enhancing this process. His model encourages learners to compare practice with scientific knowledge, enabling learning and professional development to be an integrative process. A range of educational strategies will be needed to facilitate the proficiency of effective reflective practice, and it is important to consider the significance of ongoing personal and professional development of educators.