What is Reflection and its Benefits in Nursing Practice

Reflection is highly recognized as an essential part of professional nursing practice and a critical method to gain knowledge and study through practice. Even though there is no specific definition of reflection agreed upon, it is generally known as a deliberate process of thinking critically on clinical experience. The critical thinking brings insight development leading to potential practice change. According to scholars, reflection provides an opportunity for the nurses to build on the knowledge that they already have through clinical practice. Other benefits of reflections: to increase clinical judgment, to encourage strong skills of communications, to establish joint training and to improve the care offered to the patients (Banks, 2016). There exists a general assumption that nurses are competent in the reflection process. However, according to the recent findings, nurses too face challenges that require an organized insight to observe the change.

The idea of reflection is nothing new in the Australian Education system. The ancient philosophers such as Aristotle, Socrates initially embraced thinking as a way of gaining knowledge. Learning occurs as a result of the reflection of various experiences, allowing linkage created in beliefs, actions and thoughts. Reflection as an educational method is grounded to achieve particular clinical goals planned with facilitation in a group. Concerning the findings, reflective technique encourages learning through practice, increases readiness to relate new knowledge and to support practice change (Billet, 2019). A thoughtful way of teaching and learning helps learners to connect their practices to those of professional practitioners, therefore, ensuring improvement and development.

Reflective method of teaching and learning process has various positive impacts on the learners and the learning environment. Thinking helps a learner to realize his/her learning needs and seek guidance from the professionals in the area of nursing. As a student nurse, it provides an opportunity to identify and know from the experiences around. Learners see clinical situation s from a different opinion. Learners’ self-esteem increases through reflection. Both theory and practice easily integrate. Nursing students are encouraged to improve professional development, leading to proper care of the sick people (Barton & Hartwig, 2017). Critical thinking takes place in the reflection process. A holistic, flexible and individualized approach is applied while learning on how to handle patients. Nurses are motivated to become a self-directed learner. Reflection leads to accountability and responsibility of the nurses. Reflection enables learners to practice and to enhance their skills, hence proper performance (Chang & Daly, 2015).

The History and Impact of Reflective Method in Teaching and Learning

The reflective process offers a tool or away in which learners can justify and communicate the significance of the practice. Through experience, the reflective activity grows from a descriptive to an analytical and critical method. Development, diversification of skills and autonomy comes as a result of reflective practice. Nurses easily accept the responsibilities found in the nursing practice. Learners are in a position to reflect on both negative and positive experiences they encounter. Reflective leads to individualized theories found in nursing that impact practices and to develop knowledge in nursing. Learners can discover and know the nature and limit in their roles (Frawley, Larkin & Smith, 2017).

Students are provided with various techniques that help them in the reflective process including essays, journals and portfolios. These reflective tools help learners to develop reflection. Reflection as a tool for growth allows learners to stay up to date with current developments; it is also a method for both personal and professional growth. Since reflection is the ability to reflect on actions and to take part in the continuous process of learning. Reflective as a tool is very beneficial in solving the existing problems like understanding the cause of the problem and coming up with innovative ideas of addressing the challenges. The reflective practice as a teaching tool is designed to strengthen the nurse students to improve health results and to be agents of social change. It incorporates the stages of practical and technical reflection to enhance the exploration in the learning of nursing.

Inadequate professionals in the nursing sector have become a global issue. In Australia, nursing students are trained by part-time qualified nurses and full-time academics who are working in the Higher Education (HE).According to the Australian study’s findings, the reasons for this shortage are too much work, low salaries (Banks, 2016). Besides, individuals dissatisfied in the teaching job due to pressure emerging from the work environment, advocating for the curriculum change to establish educational methods which should be in line with the clinical tasks. Inadequate nursing educators lead to dependence on sessional employees who perform their duties on a part-time basis (Tollefson, 2018). Part-time educators give the university a responsibility of ensuring the relevance in the nursing job. However, an increase in the awareness of the threat to qualify in the learning and teaching process is quite alarming. Sessional educators usually do not have educational training, leading to a high risk of teaching out of date ideas to the learners. Although educators in the nursing sector are viewed to be going on with a conveying style. Causing a great concern on an area like; covering of content, too much curriculum content, which makes absorption of the content so hard for the learners. Confusion and uncertainty arise on the appropriate pedagogies to handle teaching strategies. The challenge of not emphasizing on the development of proper attributes like sympathy, kindness and social conscience also exist. Old faculty and the absence of a healthy nurse training pipelines are among the factors that facilitate the shortage of trained nurses in the educational sector to teach the required curriculum as expected (Siddamal, Budihal & Patil, 2017).

Positive Impacts of the Reflective Method on Learners and the Learning Environment

Educators face a challenge of the feeling of isolation, insufficient time and lack of mentorship to participating in a discussion concerning ways of improving education. The disadvantage of this problem is those creative teaching methods and solutions to the issues related to cultural and clinical not adequately discussed. Therefore, the teaching activities based on evidence concerning nursing within Australia will remain stagnant (ASTNA, 2017). The Australian research study affirms that educators in nursing lack networks and mentors to assist in developing their teaching profession or offer them the scholarship programs. Places where innovations are taking place, the available resources are not adequately utilized. Neither are they equally shared in those areas (Ashwin, Boud, Coate, Hallett & Keane, 2015).  Based on the findings, educators on nursing is not addressing the problems faced by the students and the ones who have graduated. Lack of appropriate link with each other, improper planning of succession and little chances for the educators, familiarize with new teaching technologies, concepts based on research and the evaluation process.

Despite the Australian nurse educators forming an organization known as The Australian Nurse Teachers Society (ANTS), this body aimed to influence one of the Australian State (New South Wales). The organization assists in addressing the existing challenges that the nurse professions are facing. The organization effort of expanding its influence to become nationally is facing a significant problem of a small number of members who are in support. Additionally, financial constraints and scale to offer similar resources to the (ANTS) are becoming a significant challenge (Billet.2019). In achieving the initial goals of the organization since good membership and proper funding of the programs are critical issues in completing their placed target.

A significant need is coming up to reorient the nurse professionals to enable them to work smartly and collaboratively and to utilize their skills in research in solving clinical and educational challenges. Since through collaboration, they can share their creative ideas to help in giving proper solutions to the problem of the isolation feeling.

An organization that assists in addressing issues concerning nursing established. The National League for Nursing (NLN), found in the United States offers an example that Australia should borrow ideas. The organization formed a community of practice intending to advocate for education in nursing. It has provided several resources that help in sustaining the nursing educator to; develop capacity, issuing certificates to the educators, accrediting the providers. Conference held annually, funding of research activities and giving an award for research and teaching excellence. Australian Nurse Teachers Society (ANTS) started in 1972 with a target of being an independent professional organization concerning nurse education. Although it’s initial intention was to focus on impacting one state in Australia that is (New South Wales). The organization was recently trying to expand its influence nationally, to change a large group of nurse educators positively.

Use of Reflective Techniques in Learning

Nurse educators in Australia would gain from the idea of joining a community of practice (COP) like ANTS to link dispersed and a variety of nurse educators(Barton & Hartwig, 2017). The purpose of creating a shared intention through a community practice offers a significant theory to advance exchange and communication in nurse educator. The community of practice ensures an environment of sustainable professional discussion concerning areas of cognitive domains and performance issue. COP can shift the culture from the current division, and to embrace links between the isolated practitioners. Individuals with a feeling of communal ownership or belonging in the community tend to develop some identity with the culture. Sense of belonging is significant in unifying the profession to understand its distinctive knowledge and findings and works to increase it.

The vision of educators is to have a proper share of resources; shared knowledge and ability. To understand problems that keeps occurring in the community. Like, beneficial experiences to gain assurance and goodwill and to share stories aimed at enriching and expanding the population, tools that ensure efficient and practical work. Various risks require special attention when sustaining and establishing interaction among educators. For example, mentors should be recruited and offered motivation to support them.

Additionally, create awareness for them on the benefits of discussing values and crafts of establishing evidence on nursing and educational technology (Banks, 2016). For instance, a properly designed website that contains the necessary information can be shared and considered as a time-saver. The site established in a way that promotes face to face interaction for the sustainability of the communal feeling. A community of practice could lead to a shared knowledge base and new creative methods, which promotes every sector exchange, improvement and influence.

The guideline proposed is to get funding to sustain groups and the planned workshops. Example ANTS accepted to host the groups taking part in the national nurse educator meeting. The groups ‘need will be looked into to provide a topic of discussion in the following workshop. The congress scheduled to take place in every state of Austria. Educators (sessional) will be motivated to pay attention to creating and sharing solutions to the educational problems in nursing in Australia (Billet, 2019). The three challenges of nursing in Australia are; in the first years incident, clinical appointment and inclusion of the graduates. The issue initially viewed as relevant will be considered. To achieve the sense of belonging goal, shared intention and obtaining evidence base on educational nursing (Murray, 2015).  

Shortage of Nursing Educators and Its Consequences

The groups intend to establish a communal spirit by conducting workshops and supporting network in the working environment. Team or a person will be asked to sign an agreement, to present their rising or complete work on the practical situation. With the assistance of the manager in charge of the project, to regularly engage them to achieve their set objectives and to update the area with relevant resources and materials (Khusainova, Chirkina & Gabdrakhmanova, 2015). At different stages, the group members will be called upon to reflect on the process and to share their experiences. The significance of reflection is ensuring the team corrects the challenges and their aims achieved and the various needs mentioned by the members adequately addressed. The last stage of the members is when the results, accomplishment, activities and the problems discussed in the following ANTS national conference. This method will help the members to build confidence in the scholarly actions. It helps in spreading new information to assist the nursing student (Sherwood & Horton-Deutsch, 2015).

The ability to self-reflect supports the idea of practical work .Reflective learning as an education methodology considers the acronym SPROUT as a scheme to teach reflective practice (Tollefson, 2018). The sequence is rooted in the mental development process and is presented as an interrelated and staged process through a sequential acronym. S represents situation that describes the first step of SPROUT as an event. The learners are expected to describe what is important to the event that they are reflecting about. The second phase of SPROUT dab past experience requires a learner to remember the experience from initial situation. The multiple sources of information presented for clarity about ambiguous perspective takes as to the third stage named read and refer (Hazzan & Dubinsky, 2014). Self-actualization helps individuals to realize the morals, beliefs, values that directly influence situations. The journey of self-examination helps as understand others perspective of situation hence the face of other influencing factors. The understanding stage incorporates the information gathered in the previous stages as it explains the interrelations to the situations. The main aim of the reflective practice is to enrich personal growth hence better thinking, therefore this stage majors on the knowledge learnt and new ideas that promotes growth (Ellis, 2017). As the stage name suggests taking it forward, taking new knowledge as well as sharing is encouraged.

Participant stage; in accordance to the implementation of the acronym SPROUT ,reflective writing done by a section of the first year undergraduate student of nursing, the scripts were reviewed to confirm their relevance to the acronym and the meaning according to actual reflection. In addition, educators who had applied SPROUT in their educational environment were asked about their experience. The Southern Cross University Human Ethics Committee approved ethics that was to guide the reflective practice (Hampel, 2015). An evaluation method was deduced through qualitative design to sample and analyze the reflective scripts (Tallefson, 2018). The assessment environment required a learner to realize the learning outcomes, demonstrating practical capabilities proper nursing practical skills and applying knowledge from the prior study (Dervent, 2015). The concept of SPROUT was included during online lecture before the assessment day. The learners were expected to provide a reflection using SPROUT during a tutorial. Immediate feedback was given out. After the real world practical experience following SPROUT.

Challenges Faced by Nursing Educators in Australia

The nursing experience gave learners a range of situations to deal with including working in an ICU (Murray, 2015). The learners also got engaged in dealing with different equipment, nursing skills and technical issues. The activities covered are the first day students and those that had completed their practical experience. According to the educational requirements, students provided their feedback in an online form to meet the objectives (Ellis, 2017).

An evaluation of the reflective method of learning or teaching is a tool that assists learners to build up reflection. Assessment of students’ nursing and cognitive knowledge and the practical part is of great importance. A project-based on thought considered as the most suitable method to tackle the areas of questions (Jackling, Natoli, Siddique & Sciulli, 2015). A lot of discussions on the evaluation of reflective learning in nursing literature have occurred. Until now, no tool can be easily identified in conducting the evaluation process. The point of the debate focuses majorly on whether reflective accurately show the process of development and learning or is the method relevant to the questions assessed. The items are; are we determining the reflection process? Or the impact that it brings to an individual? According to some scholars, people with excellent academic writing ability are at a great advantage when evaluating a written reflective. Another scholar states that students tend to write what their lecturer wants to hear (ASTNA, 2017).

In conducting the assessment process, several models of reflection put into consideration. The models played a critical role in giving the assessment structure overall. The target was to find a model which was most appropriate for the nursing students in the first year. These students were viewed to be new to the reflection process. The main aim of applying several models was to focus on the collaboration of the learners’ thoughts, behaviors and their feelings. The model had word structure with clarity, with no ambiguity used in the assessment process (Dervent, 2015).

The assessors considered the first-year student to be persons with less knowledge in theory and the experience in clinical that would help them in finding clues while issuing answers. Among the four widely applied methods, the appropriate way recovered from the pilot review done by three principal lecturers (Tallesfon, 2018). A situation analyzing patient’s client’s condition in a provided clinical practice took place. Individual lecturer assumed the students’ role and documented their reflection under every section of the four models discussion of the previous lectures use of more than one model occurred (Hampel, 2015).  In the findings, two professional educators had experience in the Gibbs model currently considered in times of assessments in the clinical practice (Frawley, Larkin & Smith, 2017).

Recommendations for Improving Nursing Education in Australia

However, the Gibbs model was of less preference since it is ambiguous. For instance, the use of ‘good’ or ‘bad’ could easily distort the student’s way of thinking. John’s model suited the students in a postgraduate program, considered to be at a high level of reflection. Borton’s model was considered very complex, providing students with several confusing choices. In the end, all three lecturers preferred Stephenson’s model because of its clarity and straightforwardness, therefore suitable for nurse students in the first year. Conclusion on the two questions in Stephenson’s model relating to cultural and social matters was above the learner’s scope because of their low professional experience (Joustra & Moloney, 2018).

In the entire discussion, lecturers realized two essential segments which are relevant to the first-year nursing students. Despite the placed need of doing away with the assessments conducted in the Higher Education, a decision reached upon in having both formative and summative assessments (Lopes, Viegas & Pinto, 2019). These evaluations significantly help the educators to understand the progress of learners based on the outcome (Gray, Kitson-Reynolds & Cummins, 2019). Evaluation increases lecturers experience and knowledge in evaluating reflection. The summative assessment focused on knowing the extent of learner’s achievement, following the objectives in the curriculum. The formative evaluation aims to enable students to learn by offering performance details (Hazzan & Dubinsky, 2014). The result of the student’s formative assessment well recorded. It is known as the vital informer of proper teaching. Grading of the learners demonstrates the lectures skills in that particular area (Price & Harrington, 2018). The main target of formative evaluation is to motivate students in having the ability to reflect on practice, to develop the writing skills and to offer a chance on the application of knowledge-based theory to a practical situation (Morgan et al., 2015). On the other hand, the formative evaluation typically not graded, but it assists in knowing the learner’s progress through the learning process. The feedback based on formative assessment helps the lecturers to realize the areas that require attention and improvement to achieve the set target (McKimm, Forrest & Thistlethwaite, 2017).

The goal of the summative evaluation is to allow the student to have a self-reflection based on their thoughts, encounters, knowledge and feelings. Even though the summative assessments face different challenges, summative assessment is commonly used in an experiential learning environment (Barton & Hartwig, 2017).

Conclusion

Both formative and summative evaluation aims to be a source of learning, enhance the practice of reflection and to store the student’s details of academic progress of achievement at all the stages of learning. Therefore evaluation should be a core issue that enables the lecturers to understand every learner at an individual level. To address the learners needs after realization to make the learning process enjoyable and relevant to the learners. Provision of feedback is essential in showing learners the kind of progress they have in nurse education. If it was impacting their lives positively, confirmed through how they carry out themselves in the practical context. Learners should also ensure that the learning outcomes used in positively impacting society.

References

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