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Published on: February 16, 2011
"I will go if I don't have to talk": Nursing students' perceptions of reflective, debriefing discussions and intent
Elizabeth Andersen1, Lise Olsen2, Jacqueline Denison3
1Faculty of Health and Social Development, School of Nursing, University of British Columbia, Okanagan Campus, Arts Building - Art 142, 1147 Research Road, Kelowna, British Columbia V1V 1V7, Canada.
Background/Objectives:
The ability to be a reflective practitioner is recognized by nursing regulatory bodies as a component of professional competence and becoming a reflective practitioner is an essential part of learning to become a nurse. In this multi-site study, we explored undergraduate nursing students' beliefs, capacities and intentions to participate in reflective, debriefing discussions facilitated by clinical instructors. At the same time, we tested the effectiveness of a period of rest and an intervention designed to refresh and inspire them.
Design:
A randomized crossover design.
Sample:
Our analyzed sample consisted of 106 students; 87.7% were female and 65.1% were less than 20 years old.
Method:
This study was guided by the Theory of Planned Behaviour and consisted of five steps: instrument development, recruitment, random assignment to intervention, data collection at two time points using four tools, and data analysis. One hundred and forty-one first year nursing students used a learning management system to sign up to one of 15 potential clinical groups; maximum 10 students per group. Eight groups were randomly assigned to an intervention during post-clinical discussions; seven groups participated in the usual post-clinical discussions for the same length of time. After six weeks, the groups 'crossed-over' (switched).
Results:
Students had a negative attitude towards routine discussions that occur after clinical practice experiences which did not significantly improve despite a period of rest and an intervention. Most did not feel in control and felt social pressure to participate. Additional results revealed that most students arrived at reflective post-clinical discussions with an underlying intent not to talk. Intent to remain silent (not participate) did not significantly improve despite a period of rest and intervention.
Conclusions:
The context and timing of the routine discussions may dramatically influence students' decision-making regarding intent to participate. Reflective processes require time and routine reflective debriefing discussions could be delayed until later in the week after students have had a chance to absorb and assimilate their experiences.
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