Introduction: In recent years, the use of portfolios as learning and assessment tools has become more widespread across the range of health professions. Whilst a growing body of literature has acco...

The educational effects of portfolios on undergraduate student learning: A Best Evidence Medical Education (BEME) systematic review. BEME Guide No. 11

Background Effective clinical reasoning in nursing practice depends on the development of both cognitive and metacognitive skills While a number of strategies have been implemented and tested to promote these skills, educators have not been able consistently to predict their development Self-regulated learning theory suggests that this development requires concurrent attention to both the cognitive and metacognitive dimensions of reasoning in nursing care contexts

Aims  This paper reports on a study to explore the impact of self-regulated learning theory on reflective practice in nursing, and to advance the idea that both cognitive and metacognitive skills support the development of clinical reasoning skills

Methods  Integrative review of published literature in social science, educational psychology, nursing education, and professional education using the Cumulative Index to Nursing and Allied Health (CINAHL), Educational Resource Information Center (ERIC), and American Psychological Association (PsychInfo) Databases The search included all English language articles with the key words clinical reasoning, cognition, critical thinking, metacognition, reflection, reflective practice, self-regulation and thinking

Findings  Reflective clinical reasoning in nursing practice depends on the development of both cognitive and metacognitive skill acquisition This skill acquisition is best accomplished through teaching–learning attention to self-regulation learning theory A critical analysis of the literature in the areas of critical thinking and reflective practice are described as a background for contemporary work with self-regulated learning theory It is apparent that single-minded attention to critical thinking, without attention to the influence of metacognition or reflection, is but one perspective on clinical reasoning development Likewise, single-minded attention to metacognition or reflection, without attention to the influence of critical thinking, is another perspective on clinical reasoning development While strategies to facilitate critical thinking and reflective practice have been used in isolation from each other, there is evidence to suggest that they are inextricably linked and come together with the use of self-regulated learning prompts

Conclusions  Students and practising nurses are able to improve their cognitive and metacognitive skills in clinical contexts by using self-regulated learning strategies The self-regulated learning model in nursing is offered to support teaching and learning of reflective clinical reasoning in nursing practice contexts

Promoting cognitive and metacognitive reflective reasoning skills in nursing practice: self‐regulated learning theory

Reflective learning journals are recognized as a significant tool in promoting active learning among nursing students. Essentially, nurse educators strive to encourage students to think about past experiences, current situations, and expected outcomes of their actions so that they can explain what they do in the clinical setting and why. In other words, nurse educators seek to promote professional practice that is reflective rather than routine. The purposes in this paper are to discuss the application of two models of reflection to a set of reflective learning journals and to offer some recommendations for educators, researchers, and students. Using a three stage model of reflection (Scanlon & Chernomas, 1997), 52 nursing students explored managerial concepts. The major findings indicated that students may be categorized, according to Kember et al. (1999), as nonreflectors (i.e., lack evidence of deliberate appraisal), reflectors (i.e., demonstrate insight through analysis, discrimination, and evaluation...

Reflective learning journals: From concept to practice

The value of reflective journaling in undergraduate nursing education: A literature review

Reflective practice has become part of the discourse of nursing education classrooms, conferences, and journals, and are popular features of nursing continuing education programs. Yet, the idea of reflective practice has become increasingly more disparate. This critical analysis examines data-based studies and provides an overview of reflective practice, discusses common themes that emerged from the studies, and identifies implications for reflective practice in the field of nursing education.

Reflective practice: a critical analysis of data-based studies and implications for nursing education.

The writing of a reflective diary is viewed as an effective tool for promoting reflection and learning in students, and for self-assessment and evaluation of a clinical learning experience. This work is a study of 30 undergraduate nurses and their use of reflective diaries during a period of community health care practice. The theoretical basis of the study is based on Schon's work on reflection-in-action. The research tool, developed for the study of nursing practice by Powell, is based on Mezirow's levels of reflectivity. The findings are that, in the sample used, students do reflect on their practice according to Mezirow's levels of reflectivity, but that the highest number of reflections occur at the lower levels of reflectivity (94% of the total number of scores). However, although only 6% of the total number of scores were found at the higher levels of reflectivity, some 22 of the samples of 30 students did attain conceptual and theoretical reflectivity, the highest levels of reflectivity.

Gillian Richardson

Papers

Reflection-on-practice: enhancing student learning