Student Nurse Laura

Orem – "creative effort of one human being to help another human being."

Archive for December, 2014

Nature, Format, Feedback, Consequences

Posted by Laura on December 31, 2014

Reflection Task Characteristics

Nature of the stimulus questions, directions, or probes

The nature of the stimulus to reflect will impact the quality of the reflection. Surbeck, Han, and Moyer (1991) identified three levels of reflection:

  • Reacting – commenting on feelings towards the learning experience, such as reacting with a personal concern about an event.
  • Elaborating – comparing reactions with other experiences, such as referring to a general principle, a theory, or a moral or philosophical position.
  • Contemplating – focusing on constructive personal insights or on problems or difficulties, such as focusing on education issues, training methods, future goals, attitudes, ethical matters, or moral concerns. The nature of the stimulus or directions initially provided to the learners, as well as the feedback they receive after the initial reflection, will determine the extent to which they reach the contemplation level of reflection.

Format required for reporting reflections

Yinger and Clark (1981) believe that reflection results written down are more powerful than reporting them orally. However, handwriting is slow, requires a writing surface, and revisions or extensions of what has been recorded are less likely than for products produced on a word processor. Word processing has the advantage of easy revision, but requires that equipment be readily available.

Quality of the feedback provided following reflection

Feedback takes several forms, ranging from no feedback, to acknowledging that the work was done, to commenting on how well it was done, to extending beyond or elaborating on what was submitted.

Consequences of Reflecting

Liston and Zeichner (1996) posited a five-part taxonomy of reflection, of which reflection upon completion of the action is only one type:

1.    Rapidly during an action.

2.    Thoughtfully during an action.

3.    Briefly as a review after action.

4.    Systematically over a period of time after action.

5.    Long-term as one attempts to develop formal or informal theory.

Retrieved from: The Performance Juxtaposition Site. (2011). Learning through reflection.  http://www.nwlink.com/~donclark/hrd/development/reflection.html

Surbek, E., Eunhye, P., & Moyer, J. (1991). Assessing reflective responses in journals. Education Leadership. March, 25-27.

Yinger, R., Clark, M. (1981). Reflective journal writing: Theory and practice. (Occasional Paper No. 50). East Lansing, MI: Michigan State University. Institute for Research on Teaching.

Zeichner, K., Liston, D. (eds.) (1996). Reflective Teaching: An Introduction. Mahwah, NJ: Lawrence Erlbaum Associates.

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Reflection – noticing, interpreting, and responding

Posted by Laura on December 30, 2014

There are times when I have patients admitted for their surgical procedure which may be slow, quiet, or even angry. It is part of my job to do an assessment of the patient and review their background. Most of the assessment is objective, yet in the back of my mind I am thinking on how the patient is responding to my questions or actions. Such as one patient I had who was being very slow in changing into their gown, signing documents, and explaining their medical history. This behavior can be quite normal with the older generation, but a little odd with younger ones. I find when I do my vital signs and ask about their pain, I will follow up with other questions to understand their overall wellbeing. In this case I sensed a full trust wasn’t there. Using therapeutic communication, I learned the patient had a full glass of water prior to admittance, but didn’t want to share this knowing the procedure would be cancelled.

I know from my nursing background, the patient’s health and physical, or medications didn’t suggest the patients wary behavior. I was able to “reflect-in-action” to know I had to build a level of trust to get the patient to relax and divulge the information they had. This whole process did end up canceling the procedure. It also kept the patient from possibly aspirating and getting very sick. It is the patient’s feedback, after our responding, where we get our reflection-in-action.

Flo's ReflectionIn our center, we do discuss situations where we can all learn ways to help our patients be properly prepared for surgery. We share these items stating them much like the Clinical Judgment Model shown on page 208 in the Journal of Nursing Education. According to an article by Philip Kemp in work-based learning, our staff’s reflection (or reflection-on-action) helps us learn as a group to provide the best care for our patients and support our staff.

Tanner, C. (2006). Thinking like a nurse: A research-based model of clinical judgment in nursing. Journal of Nursing Education, 45(6), 204-211.

Kemp, P., Rooks, J., & Mess, L. (2009). Work-based learning with staff in an acute care environment: a project review and evaluation. Mental Health Practice, 12(10), 31-35

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Learning, can’t seem to stop :))

Posted by Laura on December 29, 2014

I have yet again embarked a little heavy on the learning side again. I was going to open up a new site, but decided to re-open this website up. I’ll be placing new sites for information, new resources and discussions. Happy New Year to all!

New Websites I’ve been accessing for school

Healthy People 2020

The World Bank Group

World Health Organization

The Major International Health Organizations

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