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At least 19 recordsLinked to original sources
PubMed2002

Reflective journal writing: how it promotes reflective thinking in clinical nursing education: a students' perspective.

According to the outcomes-based education and training system of education (OBET) in the country and the South African Nursing Council, education should focus on "creating" reflective learners and practitioners. This article seeks to determine the effectiveness of reflective journal writing in promoting the reflective thinking of learners in clinical nursing education and to validate the guidelines described in a bigger study on how to facilitate reflective thinking using reflective journal writing. A qualitative, contextual, explorative, descriptive research design was used to determine the learners' perceptions on whether reflective journal writing did promote their higher-level thinking skills during the six-month placement in a psychiatric clinical practice using the reflective diaries. From a population of seventeen fourth-year students, six volunteered to participate in a focus group interview. The data was analysed by means of the descriptive method of open coding of Tesch (in Creswell, 1994:154-156). Positive and negative results from the perceptions of the participants and a literature review served as a basis for deducing and describing guidelines for the effective use of reflective journal writing in promoting reflective thinking in clinical nursing education. The positive perception was the development of problem-solving skills attained through reflection by using analytical critical thinking, synthesis and the evaluation of situations. Self-evaluation leading to intellectual growth and self-awareness indicated a positive perception. Negative perceptions were that reflective journal writing is time consuming, content based with a lack of clear expectations from the teacher, and distrust of students about the information written. Guba's model of ensuring trustworthiness in qualitative research as described in Krefting (1991:215-222) was employed. It is concluded that reflective journal writing in clinical nursing education does promote reflective thinking and learning. The use of the developed guidelines will minimise the negative perceptions. It is recommended that the guidelines be used in basic training at all levels of training to attain the objective of nursing education and training, which is to produce a critical, analytical thinker through reflection to improve practice.

Attitude of Health Personnel↗
PubMed2002

Stages in coming to terms with reflection: student advanced nurse practitioners' perceptions of their reflective journeys.

AIM OF STUDY: To explore student Advanced Nurse Practitioners' (ANPs) experiences of reflection. BACKGROUND: The development of student ANPs' reflective abilities as part of the implementation of a Master's Course in Advanced Nursing Practice at Wolverhampton University provided the background to the study. Developing reflective abilities was seen as an essential component of ANP development. To facilitate this process a preentry degree level reflective practice module and a reflective component for the level 4 (Master's level) practice module were devised. RATIONALE: This was a new educational initiative and this study provided the opportunity to explore students' experiences of it following completion of the reflective modules. DESIGN/METHODS: A qualitative methodology was used. Fourteen ANP students were interviewed and their reflective learning contracts were analysed. Colaizzi's (1978) seven-stage model guided data analysis. FINDINGS: The findings were categorized under the headings of: (i) reflection as a transforming process, (ii) reflective journeys, (iii) worldviews. This paper presents an analysis of the second category reflective journeys. It identifies a number of stages in the development of students' reflective abilities. CONCLUSIONS: The conclusions have implications for those involved in reflective curriculum development, and for those seeking to develop reflective abilities in students.

Adaptation, Psychological↗
PubMed1995

Assessing the level of student reflection from reflective journals.

The concept of reflective learning has been widely adopted in many of the nursing curricula today. Reflective learning is of particular relevance to the education of professionals, as it encourages students to integrate theory with practice, appreciate the world on their own behalf, and turn every experience into a new potential learning experience. While nurse educators have widely accepted the educational benefits of reflection, research into reflective learning is hampered by the lack of reliable and widely accepted methods for assessing whether reflection takes place and the level of any reflection. This study attempted to develop and test coding systems for written reflective journals based on two well-known models of reflective thinking. The reflective journals submitted by the students were subjected to content analysis at two levels. The findings of this study suggest that student writing can be used as evidence for the presence or absence of reflective thinking. The process of allocating students to three categories of non-reflector, reflector and critical reflector was straightforward and reliable. Identifying textual elements within journals and allocating them to the finer levels of reflection within a more complex model of reflective thinking was, however, more problematic and considerably less reliable.

Autobiographies as Topic↗
PubMed1989

Toward absolute reflectance oximetry: I. Theoretical consideration for noninvasive tissue reflectance oximetry.

The photon diffusion theory can yield quantitative estimation of tissue hemoglobin saturation, provided that the medium is homogeneous and that one calibration data is available. The error in detection of tissue OS of the gut mucosa ranged from 5 to 10% in oxygen saturation. In application to skin, the two-layer tissue model suggests that by properly designing the optical sensor and by appropriately selecting the illumination wavelengths, it is possible to capture mainly the light returning from the specific depth in tissue. Since the skin layer thickness is roughly in the order of 1 mm, the source and detector separation distance of approximately 3 mm or larger would ensure that the measured reflectance is truly returning from the deeper layer. When such reflectances are normalized to the blood-free reflectance obtained by squeezing the blood out of the tissue, the normalized reflectance truly represents the deeper layer characteristics. In application to head, since the skin and skull thickness is considerable large, separation distance of 40 mm or greater is required to ensure the reflectance is actually returning from the brain. Closely spaced optical sensor would measure the scattering and absorption characteristics of the skin and skull of the head. As for directional changes in optical propagation due to tissue inhomogeneities, multiple light sources at the equi-distance around the detector can be placed to average out the effect. The resultant reflectance can be analyzed based on the similar mathematical treatment as presented in this study. However, since the absolute reflectance level calculated by the theory and the actual reflectance for a given transducer geometry have some deviation, again one point calibration is required to close the gap between them. This can be accomplished through arterialization of the tissue and ventilating with pure oxygen to yield reflectance from tissue containing 100% saturated blood. As for hemoglobin content, isosbestic reflectance, for example at 805 nm, can be utilized to estimate tissue hemoglobin content. Once one point calibration is accomplished, reflectance changes thereafter due to changes in HbT and OST can be fairly accurately predicted by the photon diffusion theory in combination with linear analysis. Concerning separation of arterial and venous blood in tissue, the diastolic and systolic phases of the optical plethysmographic signal can be assumed to relate to venous or DC level, and to arterial or AC component. Since the four components, arterial and venous OS and Hb, are unknowns in the system, four equations or four wavelength measurements are required to sort out each effect.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed2006

The use of reflective journals in the promotion of reflection and learning in post-registration nursing students.

The aim of this qualitative case study was to examine the use of reflective journals in promoting reflection and learning in post-registration nursing students. A purposive homogenous sample of 42 part-time post-registration students who had undertaken a module either as part of the Diploma in Professional Studies in Palliative Care or Breast Care Nursing within a UK University took part in the study. Data were collected from reflective journals and interviews. The students' journals were analysed to determine the extent and level of reflection using a model devised by Boud [Boud, D., Keogh, R., Walker, D. (Eds.), 1985. Reflection: Turning Experience into Learning. Kogan Page, London] and adapted by Wong [Wong, F.K.Y., Kember, D., Chung, L.Y.F., Yan, L., 1995. Assessing the levels of student reflection from reflective journals. Journal of Advanced Nursing 22, 48-57]. A model devised by Mezirow [Mezirow, J., 1990. How critical reflection triggers transformative learning. In: Mezirow, J. et al. (Eds.), Fostering Critical Reflection in Adulthood: A Guide to Transformative and Emancipatory Learning. Jossey-Bass, San Francisco, pp. 1-20; Mezirow, J., 1991. Transformative Dimensions of Adult Learning. Jossey-Bass, San Franscisco] was used to identify non-reflectors, reflectors and critical reflectors. The findings suggest that student writing can be used as evidence for the presence or absence of reflective thinking. Evidence also suggests that journals are a useful tool for promoting reflection and learning. However, some students appear to benefit more from their use than others.

Attitude of Health Personnel↗
PubMed2002

Transformations of sigma-pi nets: obtaining reflected functions by reflecting weight matrices.

This paper presents a methodology that reflected functions by reflecting the weight matrices of an artificial neural network. One of the major problems with the connectionist approach is that trained neural networks can only associate fixed sets of input-output mappings. We provide a methodology which allows the post-trained net to associate different input-output mappings. The different mappings are reflected in a horizontal axis, reflected in a vertical axis and scaling of the initial mapping. The methodology does not train the net on the different mappings but it transforms the weight matrix of the neural network. This paper describes a novel way of utilising sigma-pi neural networks. Our new methodology manipulates sigma-pi unit's weight matrices which transform the unit's output. The weights are cast in a matrix formulation, and then transformations can be performed on the weight matrix of the sigma-pi net. To test the new methodology, the following three steps were carried out on a neural network: (1) the network was trained to perform a mapping function, f; (2) the weights of the network were transformed; and (3) the network was tested to evaluate whether it performs the reflection in the vertical axis,f(ref-vert)(x) = a - f(x). This reflects the function in one dimension. A reflection transformation was used to manipulate the network's weight matrices to obtain a reflection in the vertical axis. Note that the network was not trained to perform the reflection in the vertical axis. The transformation of the weight matrix transformed the function the output performs. This article explains the theory which enables us to perform transformations of sigma-pi networks and obtain reflections of the output by reflecting the weight matrices. These transforms empower the network to perform related mapping tasks once one mapping task has been learnt. This article explains how each transformation is performed and it considers whether a set of 'standard' transformations can indeed be derived.

Neural Networks, Computer↗
PubMed1995

Nurse educators' perceptions of reflection and reflective practice: a report of a descriptive study.

The concepts of reflection and reflective practice have been widely discussed in the nursing literature. Only a small amount of that literature reports research studies. This paper offers the findings of a qualitative and descriptive study in which 12 nurse educators from various teaching institutions were interviewed about reflection and reflective practice. The report identifies the findings of the study under the following headings: reflection in nurse education, reflective practice in nurse education, nursing and the use of reflection, advantages and disadvantages of reflection and teaching reflective practice. While many of the respondents reported positively and enthusiastically about reflection, a number also expressed views about its being a 'fashionable' concept and one, as yet, of unproven value. Various suggestions are made for further research in this field.

Attitude of Health Personnel↗
PubMed2000

The use of reflection in a palliative care programme: a quantitative study of the development of reflective skills over an academic year.

The use of reflection in a palliative care programme: a quantitative study of the development of reflective skills over an academic year Reflection has gained a reputation for encouraging the integration between theory and practice within professional education. However, this reputation is based on an evidence base that mostly consists of theoretical debate. The aim of this study was to test our experience that the ability to reflect is developmental and that some reflective skills are harder to achieve than others. The research was undertaken by assessing the degree to which registered nurses achieved reflective criteria within assignments submitted for a variety of palliative care undergraduate modules. A total of 160 assignments were analysed using a marking grid constructed from a literature review and the results were compared between students and across academic terms. The results suggest that students are able to describe their practice but find it harder to analyse knowledge, the context of care and to action plan. Nevertheless, reflective abilities developed over time with significant developments made between each term. However, the development of skills indicative of critical reflection was less evident and confined to the ability to raise implications for future learning. The lack of multivariate analysis limits the study. However, the findings build on previous research and prompt questions for future work, particularly with respect to the process of reflection and how this can be supported in order to encourage the development of critical reflective skills.

Education, Nursing, Graduate↗
PubMed2001

Private thoughts in public spheres: issues in reflection and reflective practices in nursing.

AIM: This paper aims to problematize the notions of reflection and reflective practice, particularly as they relate to private thoughts in public spheres and the constitution of personal and professional subjectivities. BACKGROUND/RATIONALE: Reflection and reflective practice, through the technologies of power and technologies of the self, permit the previously private thoughts of nurses to enter the public sphere where they are subject to surveillance, assessment, classification and control. Instead of raising serious concerns and debate about such practices, the plethora of literature, whilst using a bewildering array of ambiguous, diverse interpretations of reflection and reflective practice, has been united in claiming them as good for nurses and nursing. APPROACH: The paper draws on Foucauldian concepts of power-knowledge and discourse to interrogate radically the conceptualizations of reflection and reflective practice in contemporary nursing literature. CONCLUSIONS: The paper challenges the hegemonic discourse of reflection in nursing. It argues that new conceptualizations of reflection that acknowledge and value a diversity of perspectives, contexts and dimensions are needed.

Ego↗
PubMed2001

Surface acoustic wave reflection from diamond-like carbon thin film reflecting arrays on LiNbO3 substrates.

Surface acoustic wave (SAW) reflection from diamond-like carbon (DLC) strip reflecting arrays on Y-Z LiNbO3 is investigated. The reflection from DLC strips with triangular cross section has been observed. Reflection increases in alternating DLC and Al strips in 90 degrees reflecting arrays in comparison with pure Al structures. The values of reflection coefficient per period in the slanted reflecting arrays are estimated to be about 1.0% for pure DLC strips (height to wavelength ratio equal to 0.02), 2% for uniform Al coating on DLC reflecting arrays, and 3.5% for alternating DLC and Al strips. This value is higher than that for pure Al strips by about 0.7%. Reflection properties are briefly discussed, and preparation technique is presented.

Journal Article↗
PubMed1998

Analysis of wave reflections in the arterial system using wave intensity: a novel method for predicting the timing and amplitude of reflected waves.

The timing and amplitude of reflected arterial waves in the ascending aorta were studied by analysis of the aortic pressure waveform and were compared with those derived using wave intensity analysis. Wave intensity analysis considers aortic pressure changes to be the result of forward and backward wavelets carrying energy. Wave intensity (dI = dPdU) is calculated from changes in pressure (dP) and flow velocity (dU), and its sign indicates the direction of travel of propagating wavelets (positive for forward-traveling waves and vice versa). We measured aortic pressure and flow velocity in 14 patients, mean age 60+/-9 years, with three-vessel coronary artery disease at the time of surgical revascularization. The travel time of the reflected wave derived from analysis of the aortic pressure waveform (tp) was measured from the foot of the aortic pressure waveform to the inflection point of the aortic pressure (derived objectively from the zero of second derivative of aortic pressure). From wave intensity analysis, the travel time of the reflected wave was measured to the onset of the wave intensity of the backward-traveling wave dI_ (t(i)), and to the onset of the separated backward pressure wave (t(b)). All patients showed an aortic pressure waveform characterized by an inflection point on the rising limb of the aortic pressure, followed by a secondary rise in pressure, representing the return of reflected waves. Wave intensity analysis consistently showed a negative peak in mid systole, the timing of its onset corresponding closely to the inflection point of the aortic pressure. The travel time of the reflected wave derived from the analysis of the aortic pressure waveform (t(p)) was 121+/-21ms and showed close agreement with ti (118+/-28 ms) and t(b) (115+/-29ms), with mean differences of 4 and 6ms, and 95% confidence intervals of difference (-2 to 7 ms) and (1 to 12ms), respectively. The augmentation index, a measure of the secondary increase in aortic pressure due to reflected waves, was significantly correlated with the magnitude of dI_ (r = 0.63, P < 0.001). Wave intensity is a quantity that indicates the rate of energy flux due to wave travel and since its value is positive for forward-traveling waves and negative for backward-traveling waves, its calculation allows the timing of reflected waves to be accurately predicted. Furthermore, the magnitude of wave intensity in backward-traveling waves (dI_) is related to the augmentation index and may provide a measure of the amplitude of the reflected wave. This analysis of the arterial system is done in the time domain and therefore can be easily applied to assess temporal changes in arterial characteristics.

Aorta, Thoracic↗
PubMed2000

Extraction of diffuse reflection spectrum on reflectance spectroscopy for solid or powder surfaces.

Reflectance spectroscopy usually produces distorted spectra because it is arbitrarily composed of two different types of reflectance, specular reflectance and diffuse reflectance. That is why this has been an annoying problem for reflectance spectroscopists. In this report, we studied the extraction of only the diffuse reflectance spectra from several reflectance spectra using redundant multiple spectral information, non-negative transformation of the recorded spectra and information processing as the multi-curve resolution. As a result, we found that we could estimate just the diffuse reflectance spectral profile.

Spectroscopy, Fourier Transform Infrared↗
PubMed2002

Skin reflectance-spectra and colour-value dependency on measuring-head aperture area in ordinary reflectance spectrophotometry and tristimulus colourimetry.

BACKGROUND/AIMS: Measurement of skin colour has become increasingly popular in the study of dermatology with the increased availability of portable instruments. However, different instruments have been reported as giving different results from measurement of the same skin region. The aim of this study was to examine the effects of differences in measuring-head aperture area on skin reflectance spectra and colour values. METHODS: We measured both reflectance spectra and CIE-L*a*b* values of the skin in five different anatomical regions on 10 subjects using two MINOLTA reflectance spectrometers that were identical apart from the aperture area of the measuring heads (diameters: 5 and 11 mm). For comparison, data were also obtained from a skin-coloured tile. RESULTS: Skin reflectance values measured with the wider-aperture instrument were higher than those measured with the other, irrespective of anatomical location. The differences between the two were near zero at an incident light wavelength of 400 nm, but increased to around 10% of the reflectance value at 700 nm, increasing exponentially with incident light of increasing wavelength. Skin colour was observed to be brighter, redder and yellower, in CIE-L*a*b* expression, when measured with the wider-aperture instrument. The differences between measurements obtained from the skin-coloured tile were much smaller. CONCLUSION: Skin reflectance and colour values measured with reflectance instruments are not absolute data but depend on the aperture area of the measuring head. This is probably due to variations in the proportion of longer-wavelength light reflected from the skin and collected by the instrument.

Adult↗
PubMed2001

Reflection as a transforming process: student advanced nurse practitioners' experiences of developing reflective skills as part of an MSc programme.

AIM OF THE STUDY: The aim of this study was to explore student advanced nurse practitioners' (ANPs) experiences of reflection. BACKGROUND: The implementation of a National Health Service (NHS) Executive initiative to develop a Master's Course in advanced nursing practice at Wolverhampton University provided the background to the study. The course was designed to enable experienced nurses to take on activities previously considered the province of physicians. The aim was to extend practice within a holistic nursing framework. Reflection was perceived as central to this process. A pre-entry degree level reflective practice module and a reflective component for the level 4 (Master's level) Practice Module were devised to enhance practitioners' reflective skills. RATIONALE: The rationale for the study was that it should explore student ANPs' perceptions of reflection following completion of these modules, to evaluate their experiences and inform curriculum development. DESIGN/METHODS: A qualitative methodology was used. The sample comprised 14 ANP students. Interviews and reflective learning contracts were used to collect the data. Colaizzi's (1978) seven-stage model guided data analysis. FINDINGS: The findings indicated that all but one of the students described the development of their reflective skills positively. Changes are described in students' thinking and behaviour. CONCLUSIONS: The conclusions have implications for ANPs, for patient care, and for others seeking to develop the ANP role.

Attitude of Health Personnel↗
PubMed1995

Reflecting on reflection: a personal encounter.

This paper reports a retrospective study of a Senior Lecturer in Nursing Studies experience of supervising a student teacher who, as part of her teaching placement experience, utilised 'Critically Reflective Analysis of an Educational Event' as a means to assess her teaching in the practice setting. The Senior Lecturer and student nurse teacher used an external 'advisor' to facilitate their meta-reflection on the theoretical perspectives that informed the process in which they were engaged. The paper raises the following questions for consideration--What is the link between ability to reflect and quality of practice? Is it possible to utilise reflective tutorials as a means of assessing professional competence whilst at the same time encouraging personal and professional development? Is the ability to reflect on practice dependent on the context? Should we assume that all practitioners have the necessary skills to supervise students in practice and what preparation and support is needed? The paper demonstrates that by introducing 'Critically Reflective Analysis of an Education Event' into the student teachers' curriculum the role of both supervisor and student teacher was challenged and changed. The paper also demonstrates that reflective tutorials are not wholly a retrospective business. They are creative, or recreative of a teaching experience, as well as to some extent representing it. Finally, even if one cannot speak in Kuhnian parlance, of a conceptual revolution, it would seem legitimate to say, in Schon's terms, that the contextual frame in which professional problems are addressed has undergone significant change.

Education, Nursing, Baccalaureate↗
PubMed1995

[The reciprocal reflecting team. A further modification of the reflecting team in inpatient child psychiatry].

The purpose of reflecting teams is to instigate change in systems that have become bogged down, including helper systems. The modifications that have been made in the Andersen reflecting team since it was first described (1987) are summarized. The reflecting team technique derives from family therapy and is epistemologically based on the radical constructivism of Bateson (1981), von Förster (1985), von Glaserfeld (1985) and others. Making use of the information resources of the key workers on our child psychiatry unit, we developed another variation, a "reciprocal reflecting team". This model is suitable for use in a clinical setting because it involves all of the key individuals working with a given child. The fundamental difference between our model and Andersen's is that initially we have no reflecting phase for psychotherapists. Rather, we start with a reflecting sequence in which the multidisciplinary clinical team discusses observations, information and hypotheses about the index patient and his or her family. Our impression is that our results are compatible with those of Höger et al. (1994) that family therapy using a reflecting team effects positive change in two of three cases. Because we have no follow-up data and our sample is still very small we base this on spontaneous positive feedback from the family members regarding their satisfaction with treatment. Further evidence is provided by clinical observations on the children's behavior and on changes in family interaction.

Child↗
PubMed1998

On reflection in action: unaddressed issues in refocusing the debate on reflective practice.

Reflective practice is now widely debated as a means of improving nursing practice. However, assumptions about reflective practice are rarely clarified and seldom subjected to critique. Therefore, the purpose of this paper is to take up Clarke, James & Kelly's suggestion that limits to the scope and depth of reflection be considered. This is achieved by reflecting on what these authors claim it means to reflect in action. Four arguments are presented: (i) that nurses cannot be conscious of all aspects of nursing practice because there are aspects of practice that cannot be represented in consiousness, (ii) that those aspects of practice that can be represented in consciousness can be so only imperfectly, (iii) that all such representations are not reflexive, and (iv) that any representation in the form of an internal dialogue that could be regarded as reflection is overdetermined. Implications for reflexivity are then considered.

Consciousness↗
PubMed1998

Caring through a reflective lens: giving meaning to being a reflective practitioner.

Who is a reflective practitioner? It is assumed that a reflective practitioner is someone who views and responds to practice through an appropriate reflective lens. The present paper is a reflective account that gives meaning to being a reflective practitioner within everyday practice whereby the reflective lens is structured through the Burford Nursing Development Unit (NDU) Model: Caring in Practice.

Activities of Daily Living↗