Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “reflection”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 109 records · Page 6Linked to original sources
PubMed2005

A method for assessing reflective journal writing.

Reflection is widely accepted as a learning tool and is considered integral to professional practice. Journal writing is advocated in facilitating reflection, yet little is written about how to assess reflection in journals. The purpose of this study was to develop and test a method of assessing the elements of reflection in journals and to determine whether, and to what level, reflection occurs in journals. Twenty-seven physical therapy students maintained written reflective journals throughout three of their four eight-week clinical affiliations. The students were introduced to concepts of reflective practice with definitions of terms and reflective questions before their second affiliation. A coding schema was developed to assess the journals. Three raters assessed forty-three journals. The text of each journal was analyzed for evidence of nine elements of reflection, and each journal was categorized as showing no evidence of reflection, evidence of reflection, or evidence of critical reflection. Descriptive statistics were used to demonstrate evidence of reflection. Reliability between each pair of raters was assessed using percent agreement, phi coefficients, and gamma statistics. Interrater reliability of all raters was assessed using intraclass correlation coefficients (ICC[2,1]). Results showed that the raters assessed 95.3%-100% of the journals as showing at least one element of reflection. The percent agreement between rater pairs for the nine elements of reflection ranged from 65.1% to 93.0%, the phi coefficient ranged from 0.08 to 0.81, and the ICC(2,1) values used to assess reliability among the three raters on each element ranged from 0.03 to 0.72. Averaging the assessment of the three raters for the overall journal, 14.7% of the journals were assessed as showing no evidence of reflection, 43.4% as showing evidence of reflection, and 41.9% as showing evidence of critical reflection. The percent agreement between rater pairs for the overall assessment of the journals ranged from 67.4% to 85.7%, the gamma statistic ranged from 0.88 to 0.98, and the ICC(2,1) among all raters was 0.74 (95% confidence interval, 0.61-0.84). These results represent an acceptable level of agreement for use of this method of assessment for educational purposes. The coding schema developed provides a mechanism to assess evidence of reflection in written journals, which will enable instructors to evaluate student competency, obtain a baseline for facilitating reflective practice, and assess their own efficacy in facilitating reflection among students.

Adult↗
PubMed2004

Reflection, the way to professional development?

BACKGROUND: Many studies have focused on reflection and the advantages that can be gained from the practice of reflection among Registered Nurses (RNs) but, what are the implications of the nurses' reflections, what do they reflect about, and how do they deal with their reflections? AIMS AND OBJECTIVES: The aim of this study was to describe the RNs' experiences of reflection in relation to nursing care situations, and to understand how RNs use reflection in their daily work. What are the implications of the nursing care situations that the RNs' reflect upon? What consequences did the practice of reflection have in nursing care situations in relation to the RNs professional development? DESIGN AND METHOD: The study was carried out with interviews and the phenomenographic method. Interviews were carried out with four RNs. The choice of informants was made with purposive sampling with the aim of finding informants who could bring the kind of knowledge that was necessary for the study. RESULTS: The qualitative differences regarding the RNs' experiences of reflection were categorized as follows: to reflect (to think back--consider, mirroring, to reflect before and reflect after, to use experiences), nursing care situations (ethical considerations, to have courage, to use one's imagination, empathy) and consequences (to meet the unique, empathy, development). Finally, the findings were implicated in the model of professional development. CONCLUSION: By using reflection as a tool, many advantages can be gained in the development of nursing care. Encouraging RNs to reflect upon nursing situations, in order to promote the nurse's professional development, will imply better nursing care for the patients. The model for professional development implies a simplified representation of the thoughts pertaining to professional nursing development. RELEVANCE TO CLINICAL PRACTICE: The relevance for clinical practice will be to understand the contents of the RNs reflections, to recognize the advantages of reflective practice and how and when to use such measures. Furthermore, to show how the model for professional development can be used in order to create a framework for evaluating these observations and consequently, for expressing tacit knowledge.

Attitude of Health Personnel↗
PubMed2006

Experiential learning in women's health: medical student reflections.

CONTEXT: Reflection on clinical experience is used by medical students to enhance the development of clinical practice skills and professional behaviours in the area of obstetrics and gynaecology. It is applied through small-group reflective tutorials, writing reflective summaries and one-to-one discussion of reflections with staff. OBJECTIVE: To identify the levels of critical reflection achieved and explore the emergent themes in students' written reflections. METHODS: Thematic analysis was undertaken to document the recurring emergent themes on which students chose to reflect and the depth of reflection students achieved. RESULTS: Most students reflected on clinical, communication and reasoning skills, lack of medical knowledge, and the development of their own and others' professional practice. The 4 levels of reflection students demonstrated were: listing, where students only state the clinical experience; describing, where students describe the clinical experience, including what they did well and what they did not; applying, where students discuss what they need to change and how to develop, and integrating, where students apply reflection to future clinical practice. Few respondents demonstrated the ability to reflect to the level of integration except with facilitated discussion. DISCUSSION: The range of experiences on which students reflected was appropriate. The information obtained from the emergent themes has been useful for programme development. At the end of the process students were still not reflecting at the level of integration. This affirms that reflectivity is a skill that develops throughout life. Evaluating the level of reflection achieved and discussing this explicitly with the student may be instrumental in helping the student develop his or her reflective capacity further.

Attitude of Health Personnel↗
PubMed1999

Wideband reflectance tympanometry in normal adults.

Acoustic impedance/reflectance measurements were made at various ear-canal pressures in 20 subjects with a clinical acoustic immittance instrument and an experimental impedance/reflectance system. Measurements were made over a frequency range of 226-2000 Hz with the clinical system and 125-11,310 Hz with the experimental system. For frequencies < or = 2.0 kHz, tympanograms obtained with the two systems are similar, with patterns that progress through the same orderly sequence with increasing frequency. Eardrum impedance measurements were also similar. There are small gender differences in middle-ear impedance. Reflectance patterns (reflectance versus frequency) at ambient ear-canal air pressure are characterized by high reflectance at low frequencies, two district minima at 1.2 and 3.5 kHz, increasing reflectance to 8.0 kHz, and decreasing reflectance above that frequency. Ear-canal pressure increases reflectance at low frequencies, decreases reflectance in the region of the minimum, and increases reflectance slightly at high frequencies. Reflectance tympanograms (reflectance versus ear-canal pressure) progress through a sequence of three patterns. At low frequencies, reflectance tympanograms are "V" shaped, indicating that pressure increases reflectance. At frequencies near the minimum reflectance, the pattern inverts, indicating that pressure decreases reflectance. At high frequencies, the patterns are flat, indicating that ear-canal pressure has little effect. Results presented for one patient suggest that reflectance tympanometry may be useful for detecting middle-ear pathology.

Acoustic Impedance Tests↗
PubMed2000

Role of tapering in aortic wave reflection: hydraulic and mathematical model study.

Pressure and flow have been measured simultaneously at six locations along the aorta of an anatomically correct 1:1 scale hydraulic elastic tube model of the arterial tree. Our results suggest a discrete reflection point at the level of the renal arteries based on (i) the quarter-wavelength formula and (ii) the comparison of foot-to-foot (c(ff)) and apparent phase velocity (c(app)). However, separation of the pressure wave into an incident and reflected wave at all six locations indicates continuous reflection: a reflected wave is generated at each location as the forward wave passes by. We did a further analysis using a mathematical transmission line model with a simple tapering geometry (length 50 cm, 31 and 11 mm proximal and distal diameter, respectively) for a low (0.32 ml/mmHg), normal (1.6 ml mmHg) and high (8 ml/mmHg) value of total arterial compliance. Using the quarter-wavelength formula, a discrete reflection point is found at x = 33 cm, the level of the renal arteries, independent of the value of total compliance. However, local analysis comparing c(ff) and c(app) does not reveal a marked reflection site, and the analysis of incident and reflected waves merely suggests a continuous reflection. We therefore conclude that the measured in vivo aortic wave reflection indices are the result of at least two interacting phenomena: a continuous wave reflection due to tapering, and local reflections arising from branches at the level of the diaphragm. The continuous reflection is hidden in the input impedance pattern. Using the quarter-wavelength formula or the classical wave separation theory, it appears as a reflection coming from a single discrete site, confusingly also located at the level of the diaphragm. Therefore, the quarter-wavelength formula and the linear wave separation theory should be used with caution to identify wave reflection zones in the presence of tapering, i.e., in most mammalian arteries.

Animals↗
PubMed2004

Reflection in preregistration nursing curricula.

BACKGROUND: The concepts of reflection and reflective practice are increasingly popular themes in the nursing literature. Reflective practice has been advocated as a method for overcoming the divergence between nursing theory and practice, and as a means of articulating and developing knowledge embedded in practice. However, these claims are based more on theoretical debate than research evidence. In common with other regulatory bodies, the Irish regulatory nursing body advocates the need for reflective nurses, and curricula are being adapted to reflect this. These changes are taking place when there is still little guidance on the teaching or assessment of reflective practice. Given the lack of research on the topic and the need for evidence on which to base the teaching of reflective practice, a descriptive exploratory study was undertaken. AIM: The aim of this paper is to report how a group of nurse teachers perceived and interpreted reflective practice in preregistration nursing curricula in schools of nursing in The Republic of Ireland. METHODS: Data were collected using a postal questionnaire distributed to all schools of nursing involved in the preregistration diploma in nursing (n = 40). RESULTS: The results indicate variation between institutions in the number of hours allocated to the subject and where reflective practice was included in the curriculum. Emphasis was placed on theoretical models of reflection as opposed to the process or the skills required to become a reflective practitioner. Lecture and group discussion were the dominant teaching methods. Additionally, a number of teachers expressed dissatisfaction with the preparation they had received to teach the subject, and identified some of the challenges they experience when teaching reflective practice. CONCLUSIONS: The results provide a focus for further debate amongst nurse educators involved in implementing reflective practice in the curriculum. The results are limited by a response rate of 50% and by the geographic setting. Further research is needed to substantiate the findings of the study. However, there results do suggest that there is a need to clarify curricular content in relation to reflective practice and prepare nurse tutors for their role in teaching this subject more effectively.

Attitude of Health Personnel↗
PubMed2004

Reflective practice and daily ward reality: a covert power game.

BACKGROUND: The concept of reflection is propounded in the literature as an epistemology for practice that enables practitioners to solve their daily problematic situations through conscious thought processes which eventually leads to practice-based knowledge. Hence, reflection became a central tenet of both theory development and educational provision in nursing. Furthermore, this centrality of reflection was reinforced by statutory nursing bodies and service providers by adopting it as the means for carrying out adequate professional practice. Although this may be the case, issues of implementation of reflection within the daily reality of practitioners are frequently overlooked within the literature. Moreover, little consideration appears to be given on the impact that the organizational culture and the politics of power may exert on the implementation of reflective practices within daily ward reality. AIMS: This paper explores how reflection is viewed by nurses within their daily reality in the medical wards, examines the relationships between the organizational culture of these wards and the practitioners and investigates whether reflective methods of practice were being implemented when the study was conducted. METHODS: An interpretative ethnographical methodology was implemented and the data collecting methods used were observation, interviews and qualitative content analysis with a group of 16 practising nurses from four medical wards of one NHS Trust in England. Two interviews were conducted with each nurse within 3-week intervals. The content of these interviews evolved from the analysis of episodes of practice observed when the nurses were giving nursing care. These data were supplemented by narratives from the nurses' in the form of written reflective accounts that were analysed via qualitative content analysis techniques. FINDINGS: Four themes were generated: (i) relationships between nurses and doctors; (ii) relationships between nurses and managers; (iii) nursing practice; and (iv) nurses' input in the outcome of a clinical situation. CONCLUSIONS: The concept of reflection appears to be invalidated by the organizational hierarchy of the wards on the basis of a power struggle game. The ward structure portrays reflection as an abnormal method of practice and knowledge development. This belittlement of reflection does not mirror the practitioners' reality. Instead, it is an intelligent and intentional act on behalf of the dominant professional groups in the wards to create an illusionary picture of ward reality to allow them to survey and define nursing practice and thus maintain and remain in power. This is explicated by using Foucault's analysis and critical social theory framework. Hence, reflective processes are constrained by this covert power game; reflection, where used, is confined to nurses' personal time and space. RELEVANCE TO CLINICAL PRACTICE: The realization of this covert power game by individual clinical nurses can become the incipient point for formally using reflective methods in the practice setting.

Anthropology, Cultural↗