Unpeeling the Onion: Deconstructing the Effectiveness of Two LTA Approaches to Reflective Learning

Authors

  • Margaret Conlon Edinburgh Napier University
  • Brian Henry Gould Edinburgh Napier University

DOI:

https://doi.org/10.14297/jpaap.v1i2.76

Keywords:

Reflection, pedagogy, undergraduate students, mental health

Abstract

Selecting the most effective methods of integrating reflective practice into undergraduate nursing programmes remains a challenge for educators. This paper explores two pedagogical approaches of reflective learning in an undergraduate mental health nursing programme, with particular focus on developing the core attributes of self-awareness, empathy and compassion. The discussion is explored within the context of nursing in Scotland, which is undergoing transformative change including adapting to an all degree route to nurse regisration. Seismic changes such as these are occurring at a time when the nursing profession generally, and nurses individually, face regular criticism for poor care and lack of compassion. This discussion paper will focus on the necessity of reflective pedagogy in undergraduate nursing programmes in which the expectation is to

create both critically aware and insightful individuals who are able to function in a health care culture that is predominately resource poor, time orientated and outcome focused. Although centred on mental health nursing, the paper also comments on the transferability and relevance of the teaching and learning approach to other professions in which human engagement is the key focus. The competing tensions of reflective practice and economically driven health care organisations alongside the significant professional challenges of emotional competency of nursing are discussed. This provides a background to the exploration of the examples of reflective pedagogy that may also be applied to other health and social care professions.

Author Biographies

  • Margaret Conlon, Edinburgh Napier University

    Margaret Conlon is a lecturer in the undergraduate mental health nursing programme of Edinburgh Napier University. A practice background working in children and young people’s mental health services then led onto her developing an interest in widening student nurses’ experience in practice. Margaret’s interest in inter-professional working grew through leading a pilot for organising practice placements in a way that extends student learning beyond acute care placements.

  • Brian Henry Gould, Edinburgh Napier University

    Brian Gould is a lecturer in mental health nursing at Edinburgh Napier University with an interest in pedagogical approaches that engage students in developing a clear professional identity. Interests also include reflective practice, problem based learning, curriculum evaluation, mental health nurses’ responsibilities under mental health legislation, and the devolvement of clinical leadership.

References

Brookfield, S. (1990). Using Critical Incidents to Explore Learners’ Assumptions. In Mezirow, J. (2009). Fostering Critical Reflection in Adulthood: A guide to Transformative and Emancipatory Learning. California: Jossey-Bass.

Bulman, C. & Schutz, S. (2004). Reflective practice in nursing (3rd ed.). Oxford: Blackwell Publishing.

Care Quality Commission. (2012). The State of Health Care and Adult Social Care in England. London: Care Quality Commission.

Cooke, M. & Matarasso, B. (2005). Promoting reflection in mental health nursing practice: A case illustration using problem-based-learning. International Journal of Mental Health Nursing, 14(4), 243-248.

doi: http://dx.doi.org/10.1111/j.1440-0979.2005.00388.x

Coward, M. (2011). Does the use of reflective models restrict critical thinking and therefore learning in nurse education? What have we done? Nurse Education Today, 31(8), 883-886.

doi: http://dx.doi.org/10.1016/j.nedt.2011.01.012

Dewey, J. (1933). How we Think. New York: Prometheus Books.

Dyer, M. A. & Taylor, S. M. (2012). Supporting professional identity in undergraduate Early Years students through reflective practice. Reflective Practice: International and Multidisciplinary Perspectives, 13(4), 551-563.

doi: http://dx.doi.org/10.1080/14623943.2012.670620

Epp, S. (2008). The value of reflective journaling in undergraduate nursing education: a literature review. International Journal of Nursing Studies, 45(9), 1379-1388.

doi: http://dx.doi.org/10.1016/j.ijnurstu.2008.01.006

Eraut, M. (2004). The emotional dimension of learning. Editorial. Learning in Health and Social Care, 3(1), 1-4.

doi: http://dx.doi.org/10.1111/j.1473-6861.2004.00062.x

Fleming, P. (2007). Reflection – A neglected art in health promotion. Health Educational Research, 22(5), 658-664.

doi: http://dx.doi.org/10.1093/her/cyl129

Fowler, J. (2008). Experiential learning and its facilitation. Nurse Education Today. 28(4), 427-433.

doi: http://dx.doi.org/10.1016/j.nedt.2007.07.007

Gould, B., & Masters, H. (2004). Learning to make sense: the use of critical incident analysis in facilitated reflective groups of mental health student nurses. Learning in Health and Social Care, 3(2), 53-63.

doi: http://dx.doi.org/10.1111/j.1473-6861.2004.00063.x

Graham, I. (2000). Reflective practice and its role in mental health nurses’ practice development – a year-long study. Journal of Psychiatric and Mental Health Nursing, 7(2), 109-117.

doi: http://dx.doi.org/10.1046/j.1365-2850.2000.00269.x

Hargreaves, J. (2004). So how do you feel about that? Assessing reflective practice. Nurse Education Today, 24(3), 196-201.

doi: http://dx.doi.org/10.1016/j.nedt.2003.11.008

Heron, J. (2001). Helping the Client: A creative practical guide (5th ed.). London: Sage.

Higgins, D. (2011). Editorial: Why reflect? Recognising the link between learning and reflection. Journal of Reflective Practice, 12(5), 583-584.

doi: http://dx.doi.org/10.1080/14623943.2011.606693

Horton-Deutsch, S., McNelis, A. M., & O’Haver Day, P. (2012). Developing a reflection-centered curriculum for graduate psychiatric nursing education. Archives of Psychiatric Nursing, 26(5), 341-349.

doi: http://dx.doi.org/10.1016/j.apnu.2011.09.006

Johns, C. (1995). Framing learning through reflection within Carper’s fundamental ways of knowing in nursing. Journal of Advanced Nursing, 22(2), 226-234.

doi: http://dx.doi.org/10.1046/j.1365-2648.1995.22020226.x

Kennedy, D. (2009). Recasting the role of reflection in the theatre of learning. Nurse Education Today. 29(6), 573-574.

doi: http://dx.doi.org/10.1016/j.nedt.2009.02.011

Koole, S., Dornan,T., Aper, L., De Wever, B., Scherpbier, A., Valcke, M., Cohen-schotanus, J., & Derese, A. (2012). Using video-cases to assess student reflection: development and validation of an instrument. BMC medical education 12, 22.

doi: http://dx.doi.org/10.1186/1472-6920-12-22

Lipscomp, M., & Ishmael, A. (2009). Humanistic educational theory and the socialization of preregistration mental health nursing students. International Journal of Mental Health Nursing, 18(3),173-178.

doi: http://dx.doi.org/10.1111/j.1447-0349.2009.00603.x

Manning, A., Cronin, P., Monaghan, A., & Rawlings-Anderson, K. (2009). Supporting students in practice: an exploration of reflective groups as a means of support. Nurse Education in Practice, 9(3), 176-183.

doi: http://dx.doi.org/10.1016/j.nepr.2008.07.001

Moon, J. (2001). PDP Working Paper 4: Reflection in Higher Education Learning. London: Higher Education Academy.

Moon, J. (2007). A Handbook of reflective and experiential learning theory and practice. London: RoutledgeFalmer.

Moon, J. (2010). Using Story: in Higher Education and Professional Development. London and New York: RoutledgeFalmer.

Moon, J. (2012), Critical Thinking: An Exploration of Theory and Practice. Retrieved from http://napier.eblib.com/patron/FullRecord.aspx?p=324955

Nelson, S. (2012). The lost path to emancipatory practice: towards a history of reflective practice in nursing. Nursing Philosophy, 13(3), 202-213.

doi: http://dx.doi.org/10.1111/j.1466-769X.2011.00535.x

NHS Education for Scotland. (2008). The National Framework for Pre-registration Mental Health Nursing Programmes in Scotland. Edinburgh: NHS Education for Scotland.

NHS Education for Scotland. (2009). A Capability Framework for Working in Acute Mental Health Care. The values, skills, and knowledge needed to deliver high quality care in a full range of acute settings. Edinburgh: NHS Education for Scotland.

NHS Scotland. (2011). Keep Going: Progress toward implementation of the refreshed action plan for Rights, Relationships and Recovery, the review of mental health nursing in Scotland. Edinburgh: NHS Scotland.

Norrie, C., Hammond, J., D’Avray, L., Collington, V., & Fook, J. (2012). Doing it differently? A review of literature on teaching reflective practice across health and social care professions. Reflective Practice: International and Multidisciplinary Perspectives, 13(4), 565-578.

doi: http://dx.doi.org/10.1080/14623943.2012.670628

Nursing & Midwifery Council. (2008). The code: Standards of conduct, performance and ethics for nurses and midwives. London: NMC.

Nursing & Midwifery Council. (2010). Standards for Pre-registration Nurse Education. London: NMC.

O’Donovan, M. (2006). Reflecting during clinical placement – Discovering factors that influence pre-registration psychiatric nursing students. Nurse Education in Practice, 6, 134-140.

doi: http://dx.doi.org/10.1016/j.nepr.2005.10.005

Olofsson, B. (2005). Opening up: psychiatric nurses’ experiences of participating in reflection groups focusing on the use of coercion. Journal of Psychiatric and Mental Health Nursing, 12(3), 259-267.

doi: http://dx.doi.org/10.1111/j.1365-2850.2005.00827.x

Patterson, C. (2012, 10 April). A crisis in nursing: six operations, six stays in hospital – and six first-hand experiences of the care that doesn’t care enough. Independent.

Plack, M. M., Driscoll, M., Blissett, S., McKenna, R, & Plack T. P. (2005). A method for assessing reflective journal writing. Journal of Allied Health. 34(4), 199-208.

Platzer, H., Blake, D., & Ashford, D. (2000). An evaluation of process and outcomes from learning through reflective practice groups on a post-registration nursing course. Journal of Advanced Nursing. 31(3), 689-695.

doi: http://dx.doi.org/10.1046/j.1365-2648.2000.01337.x

Pryce, A. (2002). Refracting experience: Reflection, postmodernity and transformations. NTResearch, 7(4), 298-311.

doi: http://dx.doi.org/10.1177/136140960200700411

Raingruber, B. (2003). Video-Cued Narrative Reflection: A Research Approach for Articulating Tacit, Relational, and Embodied Understandings. Qualitative Health Research, 13(8), 1155-1169.

doi: http://dx.doi.org/10.1177/1049732303253664

Royal College of Psychiatrists. (1999). Guidance on staffing of child and adolescent in-patient psychiatry units. London: RCP.

Russell, T. (2005). Can reflective practice be taught? Reflective Practice, 6(2),199-204.

doi: http://dx.doi.org/10.1080/14623940500105833

Scottish Executive. (2003). Mental Health (Care and Treatment) (Scotland) Act 2003. Edinburgh: Scottish Executive.

Scottish Government. (2006). Rights, Relationships and Recovery. The Report of the National Review of Mental Health Nursing. Edinburgh: Scottish Government.

Scottish Government. (2010). Rights, Relationships and Recovery: Refreshed. The Report of the National Review of Mental Health Nursing. Edinburgh: Scottish Government.

Shattell, M. M., Starr, S. S., & Thomas, S. P. (2007). ‘Take my hand, help me out’: mental health service recipients’ experience of the therapeutic relationship. International Journal of Mental Health Nursing, 16(4), 274-284.

doi: http://dx.doi.org/10.1111/j.1447-0349.2007.00477.x

Spalding, N. J., & Phillips, T. (2007). Exploring the use of vignettes: from validity to trustworthiness. Qualitative Health Research, 17(7), 954-962.

doi: http://dx.doi.org/10.1177/1049732307306187

Stoddart, B., Cope, P., Inglis, B., McIntosh, C., & Hislop, S. (1996). Student reflective groups at a Scottish college of nursing. Nurse Education Today, 16(6), 437-442.

doi: http://dx.doi.org/10.1016/S0260-6917(96)80051-7

Taylor, B. J. (2010) Reflective Practice for Healthcare Professionals (3rd ed.). Maidenhead: Open University Press.

Trueland, J. (2008). Scotland leads in developing frameworks for mental health nursing practice. Mental Health Practice, 11(7).

White, S., Fook. J, & Gardner, F. (Eds.). (2006). Critical Reflection in Health and Social Care. Maidenhead: Open University Press.

Williams, A. (2013). Critical reflective practice: exploring a reflective group forum through the use of Bion’s theory of group processes. Reflective Practice: International and Multidisciplinary Perspectives, 14(1), 75-87.

doi: http://dx.doi.org/10.1080/14623943.2012.732942

Willis Commission. (2012). Quality with Compassion: the future of nursing education.

Wong, F. K. Y., Kember, D., Chung, L. Y. F., & Yan, L. (1995). Assessing the level of student reflection from reflective journals. Journal of Advanced Nursing, 22, 48-57.

doi: http://dx.doi.org/10.1046/j.1365-2648.1995.22010048.x

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Published

2013-12-01

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Reflective Analysis Papers