Do novice nurses utilize reflection for clinical reasoning?
Jennifer Slate, MSN, RN
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Statement of the Issue: Once practicing on their own, novice nurses experience a gap between practice and theory. These nurses are expected to care for increasingly sicker patients and must be able to bridge that gap in order to prevent failure to rescue. Clinical reasoning involves the art of noticing, interpreting, responding, and reflecting. According to the previous research, novice nurses are entering the profession without the ability of clinical reasoning and are at risk for missing crucial data.
Summary of the Literature: Previous research showed reflection in students in healthcare related fields as well as residency programs after graduation. Reflection is a metacognitive process that can increase knowledge in order to determine further actions. The literature showed those who adapted the process of reflection, whether written, self-reflection, or group reflections, developed increased professional competence, increased self-confidence, and an increase in the ability to view the ‘big picture’ of the clinical setting. None of the literature addressed if novice nurses continued to use reflection in their practice without prompting during a residency program.
Objectives: This study aimed to answer the following questions.
- If novice nurses, less than 18 months experience, utilize reflection without prompting in their practice?
- If so, does using reflection foster clinical reasoning in novice nurses?
Thesis Statement: The use of reflection in novice nurses would foster their ability for clinical reasoning resulting in increased professional competence and self-confidence.
Methodology: This phenomenological qualitative study examined novice nurses’ experiences with reflection by finding themes within semi-structured interviews. Giorgi’s method was utilized to analyze the themes. Tanner’s Clinical Judgement Model is the guiding theory.
Summary of Findings: The eight novice nurse participants of this study verbalized the use of reflection in their practice. Through their stories, they demonstrated fostering clinical reasoning skills. Keywords used to identify the themes showed reflection fostered pattern recognition, time management, and increased the self-confidence, as well as increased professional competence and the ability to see the ‘big picture’ in the clinical setting.
Confirmation of Thesis: This study confirmed the use of reflection without prompting in the novice nurse participants. Their use of reflection fostered their clinical reasoning resulting in increased professional competence, increased self-confidence, and increased ability to see the ‘big picture’ view of their patient.
Statement of Significance: This study filled a gap in previous research showing novice nurses, less than 18 months experience, are using reflection without prompting. The study also demonstrated that the use of reflection fosters their clinical reasoning.
Suggestions for Future Research: While this study demonstrated the use of reflection fostering clinical reasoning in the eight participants, future research with a larger sample size of different novice nurses could clarify if other novice nurses are also using reflection for clinical reasoning.
|Review Type||None: Degree-based Submission|
|Research Approach||Qualitative Research|
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