Career stage-specific predictors of reflective ability among clinical nurses

To identify career stage-specific factors that influence reflective ability in clinical nurses and the relative strength of these effects.

Exploratory cross-sectional study.

Between August and September 2019, nursing professionals working at general hospitals (n = 1169) completed a questionnaire on reflective ability and its suspected influencing factors. Participants were grouped by career stage as defined by years of nursing experience. Each factor's predictive strength regarding different dimensions of reflective ability was analysed separately in each group via stepwise multiple regression.

Reflective ability was significantly influenced by support for personal growth from superiors and seniors among first-year participants and professional identity formation among those in their second or later years. Furthermore, it was significantly influenced by self-confidence in nursing practice in years 4-5, effort to improve knowledge and skills in years 6-9 and role model presence in years 10-19.

Career stage-specific predictors of reflective ability were related to nurses' environment and changes in the roles expected of them. Support measures aimed at improving this capacity should emphasize factors characteristic of the career stage(s) of nursing professionals.

Identifying the influencing factors of nurses' reflective ability can improve the same, deepen nurses' views on nursing, help them develop an intentional nursing practice and contribute to the improvement of the quality of nursing practice.

This study is the first to identify career stage-specific predictors of reflective ability in clinical nurses and the relative strength of their effects. Reflective ability was affected by growth support from superiors and seniors in first-year nurses and formation of nursing identity in second-year nurses. Additionally, nurses' environment and various roles affected their reflective ability. Hospitals should build an appropriate environment for nurses and develop the concept of 'oneself as a nurse' among nurses.

This study was conducted with the approval of an ethical review committee that included general citizens. Furthermore, the research results were reviewed by general citizens prior to dissemination, and we received their opinions as to whether the writing was sufficiently clear and whether the information required by the audience was included. We improved the content to be disseminated based on relevant opinions provided.