Reflective Abilities of Nursing Students: a Thematic Analysis of Reflection Journals

Abstract

Objective: Reflective writing is consistently linked to improved clinical decision-making. However, analyzing the journals to evaluate the reflective abilities of nursing students is scanty locally. This study aimed to assess the reflective skills of undergraduate nursing students. Methods: A qualitative thematic content analysis using the Lasater Clinical Judgment Evaluation Rubric was used to assess the reflective abilities of 33 undergraduate nursing students in 138 journal entries. Guided by Gibb’s reflective model, the students documented their experiences during a clinical attachment at a National Referral Hospital in Kenya between February and August 2018. Data coding and thematic linking were done using NVIVO version 11. Results: Reflective abilities differed across gender and to some extent across years of study. Most participants were more likely to notice the deviation from the norm, whether patient-related or health care environment-related. Moreover, they demonstrated the ability to respond to the situation, self-evaluate, and develop action plans for future encounters. However, the majority struggled with interpreting findings. Conclusions: Gender differences exist in the way nursing students reflect. Most nursing students focus on describing the situation rather than developing solutions. There is, however, an indication of developing reflective abilities across the year of study.