Engaging Students in Reflective Practice

Reflective practice is an abstract concept for many students.  It is the responsibility of faculty to guide students in ways to assess the motives behind their practice and with reflection, critically examine means of improvement in clinical competence.

In an effort to guide students toward the habitual practice of reflective thinking, clinical courses use one case for each lecture that unfolds at cogent points throughout the lecture.   The case is intended to provide both scientific knowledge about the care of the patient being presented and the demonstration of ways to improve care of the patient through reflective thinking. The lecture culminates in the presentation of questions intended to assist students in the evaluation of the rationale for care management of the patient in the scientific domain as well as professional and caring domains. 

In addition to engaging the students with active learning related to clinical competence, the students are asked a series of questions intended to guide students through the reflective process related to the case.  Sample questions include: What were we trying to achieve with this patient?   What assumptions did you make about this patient as the case unfolded? What did we do right?  What are the possible outcomes for this patient based on our care management?  Was the communication with the patient in this case effective?  How did your past professional and personal experiences influence your thoughts about this patient?

Faculty attempt to present cases based in their own practice and that may not have been handled as perfectly as they should have been but were the reality of the case.   Emphasis is placed on making adjustments to care that simultaneously are evidence-based and adaptive practice based on reflection so the care management matches the needs of the patient.  

Currently, evaluation of the program is informally recorded by faculty as it is reflected in assigned case analyses from student clinical practice that are personal examples of professional development, indicated by enhanced discussion of nursing theory and values in professional practice in assignments.