Related Experiment Video
Updated: Nov 22, 2025

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Reflective journaling of nursing students on weight bias
Tracy L Oliver1, Rebecca Shenkman2, Lisa K Diewald2
1Villanova University M. Louise Fitzpatrick College of Nursing, 800 Lancaster Avenue, Villanova, PA 19085, United States of America.
Background:
Self-reflection, combined with clinical experience, has been shown to enhance clinical and didactic knowledge among undergraduate nursing students. Reflective journaling is a valuable educational tool that builds critical thinking skills and raises self-awareness through the purposeful inspection of beliefs and attitudes. However, there are little data available on reflective journaling during clinical education exploring weight bias as part of a weight sensitivity training program.
Objectives:
The study aimed to explore the use of reflective journals as a tool to raise self-awareness and self-reflection of weight bias as part of a weight sensitivity training program.
Settings:
The project was conducted at a four-year pre-licensure baccalaureate nursing program with third-year clinical students in a private Catholic university in southeastern Pennsylvania, USA.
Participants:
All third-year students enrolled in a medical-surgical clinical practicum were eligible to participate from August to December 2017.
Design & Methods:
For this qualitative study, data were collected during the 15-week medical-surgical clinical practicum, in which students completed five journal entries. De-identified data were analyzed using thematic analysis.
Results:
A total of 98 students, 18 years of age and older consented, and 280 journal entries were analyzed. Four themes emerged from a majority of the journal entries: 1) increased self-awareness of personal weight bias; 2) acknowledgment of obesity as a chronic disease and not a choice; 3) insufficient resources or training may perpetuate weight bias; and 4) opportunity for weight sensitivity training to improve patient care.
Conclusions:
Through reflective journaling, nursing students were able to periodically self-reflect on their personal weight bias as it pertained to caring for patients with obesity. This introspective self-reflection as part of a weight sensitivity training may lead to not only improving clinical competencies in patient care but also in reducing weight bias in clinical practicum.
Related Concept Videos
Accountability and Responsibility of a Nurse I
Accountability and Responsibility of a Nurse II
For example, a nurse demonstrating respect and compassion might listen attentively to a patient's concerns, provide...
Nursing Ethical Principles II
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's...
Nursing Evaluation
Nursing Assessment
The nurse collects all aspects of the patient's health in the initial assessment, establishing priorities for ongoing focused assessments...
Nursing Process for Patient and Caregiver Teaching III: Evaluation and Documentation
Nurses can use several methods to evaluate patient outcomes. For example, oral questions can assess cognitive learning,...

