Literature review

Nursing narratives and reflective practice: A theoretical review

Ana Choperena, Cristina Oroviogoicoechea, Amparo Zaragoza Salcedo, Inés Olza
Moreno, Dorothy Jones
First published: 21 January 2019

Aim

To explore the literature regarding how nursing narratives have been used to enhance reflective
practice.

Design

Theoretical review.

Data sources

A literature search from 1990 – 2017 was conducted in PubMed, CINHAL and PsycINFO
databases.

Review methods

After applying the selection criteria, 13 studies were identified. The quality of articles was
evaluated.

Results
Three themes were identified as the main components of an ongoing narrative process based
on looking back to past clinical experiences, creating spaces for dialogue and bringing the
worlds of theory and practice closer together.
Conclusions

This review provides a forum for exploring the use of narratives to enhance reflective practice,
which may lead to the acquisition of professional competences.

. Reflective practice in nursing: A concept analysis

Kiran M. Patel RN, Kateryna Metersky RN, PhD
First published: 09 October 2021

Purpose

This paper aims to clarify the concept of reflective practice in nursing by using Rodgers'
evolutionary method of concept analysis
Data sources
Literature and references on the concept of reflective practice were obtained from two
databases: Scopus and Nursing and Allied health database. Peer-reviewed articles published in
English language between 2011-2021 that included the terms ‘reflection’ and/or ‘reflective
practice’ in the title were selected. Seminal pieces of work were also considered in this analysis.
A total of 23 works were included. Most of the selected works addressed the concept of
reflective practice in nursing education or nursing practice.
Data synthesis

The data analysis integrated the stages identified in Rodgers' method of concept analysis to
analyze the concept of reflective practice. Analysis of selected works provided an understanding
of common surrogates, antecedents, attributes, and consequences of the concept of reflective
practice.

Conclusions
Reflective practice is a cognitive skill that demands conscious effort to look at a situation with an
awareness of own beliefs, values, and practice enabling nurses to learn from experiences,
incorporate that learning in improving patient care outcomes. It also leads to knowledge
development in nursing. Considering the current circumstances of the COVID-19 pandemic, this
paper identifies the need for nurses to go beyond reflection-on-action and also include
reflection-in-action and reflection-for-action as part of their practice.
Implications for nursing practice

This analysis identifies the need for future nursing researchers to develop reflective models or
strategies that promote reflection among nurses and nursing students before, during, and after
the clinical experiences.

CONFLICT OF INTEREST

No conflict

Understanding reflective practice

Abstract
The Nursing and Midwifery Council (NMC) requires that nurses and
midwives use feedback as an opportunity for reflection and learning,
to improve practice. The NMC revalidation process stipulates that
practitioners provide examples of how they have achieved this. To reflect
in a meaningful way, it is important to understand what is meant by
reflection, the skills required, and how reflection can be undertaken
successfully. Traditionally, reflection occurs after an event encountered in
practice. The authors challenge this perception, suggesting that reflection
should be undertaken before, during and after an event. This article
provides practical guidance to help practitioners use reflective models to
write reflective accounts. It also outlines how the reflective process can
be used as a valuable learning tool in preparation for revalidation.
Authors
Jacqueline Sian Nicol Lecturer, Edinburgh Napier University, Edinburgh,
Scotland.
Isabel Dosser Lecturer, Edinburgh Napier University, Edinburgh, Scotland.
Correspondence to: j.nicol@napier.ac.uk
Keywords
critical thinking, portfolio, professional development, reflection,
reflection models, reflective account, reflective practice, revalidation,
self-awareness
Review
All articles are subject to external double-blind peer review and checke
Revalidation
Prepare for revalidation: read this CPD article, answer the questionnaire
and write a reflective account. www.rcni.com/revalidation
Aims and intended learning outcomes
This article aims to increase the nurse’s
knowledge and understanding of reflective
practice and assist them to develop a portfolio
of evidence for revalidation (Nursing and
Midwifery Council (NMC) 2015a). After
reading this article and completing the time out
activities you should be able to:
 Define reflection and explain its role in
professional practice.
 Describe two different models of
reflection.
 Discuss how self-awareness is integral
to reflection.
 Discuss how reflection can be used as a
learning tool.
 Prepare several examples of reflection
to support the NMC revalidation process

Reflection in the training of nurses in clinical practice

settings: a scoping review protocol
Linda Schumann Scheel1
_ Micah D.J. Peters2
_ Anna Christine Meinertz Møbjerg3
Review question/objective
This scoping review will seek to find answers for the following questions which will focus on the
use of reflection in
the education of nurses in clinical settings:
1. What tools and approaches for reflection have been reported?
2. What ‘‘levels’’ of reflection have been achieved/identified (‘‘low’’/descriptive,
‘‘middle’’/application, or ‘‘high’’/
evaluative)
3. What outcomes of reflection have been included/reported?
The review will also extract and map data regarding: i) what outcomes have been found in
relation to the use of
different tools and approaches (e.g. dialogues, diaries, case studies); ii) how approaches and
tools have been
implemented as interventions; iii) details of the topic or focus of reflection (e.g. ethical issues,
care of older adults
etc.); iv) details about the participants involved in reflection activities (e.g. first or second year
undergraduate nursing
students etc.); and v) barriers/challenges to the use of reflection approaches/tools. Additional
details may also be
extracted and mapped during the process of the scoping review and this will be explained in the
final scoping review
report.
Keywords clinical settings; nurse training; nursing practice; reflection; tools
JBI Database System Rev Implement Rep 2017; 15(12):2871–2880.
Search strategy
A three-step search strategy will be utilized. An
initial search in PubMed, ERIC, CINAHL and
Web of Science will be undertaken, followed by
analysis of the text words contained in the title
and abstract, and of the index terms used to describe
the article. The initial search strategy for use in
PubMed, ERIC, CINAHL and Web of Science is
included in Appendix I.
A second search using all identified keywords and
index terms will then be undertaken across all
included databases. Thirdly, all relevant references
selected for inclusion in the review will be subject to
a citation search in Web of Science and Scopus.
While not eligible for inclusion themselves relevant
studies from existing systematic reviews will be
examined for relevant primary studies that meet
the inclusion criteria of the present scoping review.
The reference lists of the identified reviews (introduced
above) will be inspected for relevant evidence
sources. Authors of the review are fluent in English,
Danish, Swedish and Norwegian, and studies published
in any of these languages will be sought. If
included in the review, relevant information and
data from non-English studies will be translated into
English. The databases will be examined for potentially
relevant studies published the last ten years,
since 2007 until the present. As discussed, there are a
number of similar reviews focusing on the use of
reflection in both nursing and other healthcare field
Study selection
All identified studies will be examined by reviewers
for congruity with each of the inclusion criteria
above, first at the title/abstract level, then by examining
the full-text of potentially relevant studies in
greater depth. To ensure consistency, the reviewers
will pilot the screening and selection process on a
sample of identified studies. Discussion will occur to
settle any disagreements between reviewers regarding
the inclusion of studies. Citation management
software (e.g. EndNote [Clarivate Analytics, PA,
USA]) will be used to track study selection and
inclusion process.41 Full text studies that do not
meet the inclusion criteria will be excluded and
reasons for exclusion will be provided in an appendix
in the final scoping review report. The results of
the search will be reported in full in the final report,
and presented in a Preferred Reporting Items for
Systematic Reviews and Meta-Analyses (PRISMA)
flow diagram adapted for use for a scoping review.42
Any disagreements that arise between the reviewers
will be resolved through discussion or with a third
reviewer.
Data extraction
The details of included studies as well as relevant
data pertaining to the stated review questions will be
extracted using a standardized data extraction form
adapted from the JBI scoping review methodological
guidance (see Appendix II). The tool will be piloted
by the reviewers on a selection of included studies. In
line with the JBI approach to scoping reviews, the
form may be refined and updated during the course
of the review.40 Authors will not be contacted formissing information as this will be beyond the
resource constraints of the present project.

IMPORTANCE OF REFLECTIVE PRACTICE IN NURSING EDUCATION.

 Source: West African Journal of Nursing . May2015, Vol. 26 Issue 1, p52-59. 8p.

 Author(s): Enuku, Christie Akpoigho; Evawoma-Enuku, Usiwoma

 Abstract: Reflective practice is the ability to examine ones' actions and experience with
the outcome of developing the practice and enhancing clinical knowledge. It affects all
levels of nursing from students to practising nurses. Reflective practice is an important
component of the nursing curriculum. This paper explores the concept of reflective
practice in nursing. It highlights the origin of nursing as it originates from the
apprenticeship system in the twentieth century and how it was introduced into higher
education. It examines the skills needed for reflective practice. It further states the needs
to fuse theoretical knowledge to practice. Finally, recommendations are made regarding
the step that needs to be taken to introduce reflective practice in nursing education in
Nigeria,

POSITION PAPER The Role of Reflective Practice in Pharmacy

MARCUS DROEGE University of Minnesota, Department of
Pharmaceutical Care & Health Systems, College of Pharmacy,
Minneapolis, MN 55455, USA
 ABSTRACT Context: There has been a considerable paradigm shift from a
productcentred focus towards a patient-centered focus in pharmacy. Pharmaceutical care
practice (Cipolle et al., 1998) can be seen as the latest proposal to transform the profession as
mandated by most major professional associations in pharmacy. Pharmaceutical care is an
innovative way of practicing pharmacy that has the potential to make drug-therapy safer, more
effective, and more convenient for the patient. Even though pharmacists’ time spent on
customer communication has increased over time (Savage, 1999), this alone will not be
sufficient to bring about a paradigm shift in view of what the pharmacist actually does to provide
quality patient care. It appears equally important to reflect on how pharmacists practice
pharmacy. Methods/Objectives: It is the aim of this discussion paper to argue for the importance
of linking education and practice as a core part of the teaching of pharmaceutical care.
Conclusions: In order for pharmacists to partake in truly interdisciplinary health care teams and
the profession of pharmacy to demonstrate its unique and indispensable contribution to quality
health care, pharmacy curricula would teach toward reflective practice, be problem-based, be
positioned in collaborative teams, and have an outside (authentic) focus. KEYWORDS Practice,
reflectivity, problem-based learning, pharmacy, pharmaceuti

Action and reflection: practice and theory in nursing

Margaret Clarke SRN RNT BSc MPhil
First published: January 1986

Abstract

There are three isssues related to theory and practice in nursing which are continually
problematic. These are: the separation of theory from practice; reality vs the ideal; and nursing
adherence to a scientific paradigm versus nursing adherence to an arts paradigm. It is
suggested that Shotter's ‘theory of personal action’ (1974, 1975) may form the basis for a
resolution of these three issues. Applying Shotter's work, a nursing action may be defined as an
action which is deliberately thought out and which has as its goal the benefit of the patient and
client. The ‘deliberate thought and goal’ of the action which is an integral component of it then
forms the basis of nursing theory which is concerned with reasons for and reflections on action.
This immediately unites theory and practice as two components of nursing action. The use
which could be made of the theory of personal action in nursing practice, research and theory
building and nurse education is explored.

The role of reflective practices in enabling final year nursing students

to respond to the distressing emotional challenges of nursing work
Nurse Education in Practice
Volume 13, Issue 1, January 2013, Pages 48-52

Abstract

Drawing on the findings of a phenomenological study which sought to understand something

more about the lived experience of final year nursing students of learning through reflective
processes; this paper seeks to consider how engagement with reflective practices enabled the
participants to manage the distressing emotional challenges and labour of nursing work.
Choosing to pay attention to the affective domain appeared to enable the participants to better
understand the complex nature of the emotional challenges of nursing work and what it meant
to them personally to be a nurse. Some of the participants were proud to describe how reflective
activity had enabled them to develop and justify a ‘traditional’ emotional detachment from their
care, whilst others used the ‘own knowing’ developed through reflective activity to reject the
notion of professional detachment and come to value a more embodied sense of care which
inevitably led them to become entangled in the distress and suffering of their patients. This type
of personal reflective learning may emphasise and value more humanising characteristics of
care.

Methods

The study was structured with the framework for undertaking empirical – phenomenological
research suggested by Todres and Holloway (2004) which enabled an explication of how the
phenomenon came to be interesting and how the descriptions of experienced happenings were
sought and gathered. Giorgi's framework for descriptive phenomenological analysis (1985,
2009) was utilised to intuit and test the meanings of the participants' experiences which led to
the presentation of a ‘digested’

Findings

Uncomfortable feelings such as anger, guilt, frustration and sadness are often acknowledged as
the primary triggers for reflective activity (Boud et al., 1985; Gibbs, 1998; Atkins and Murphy,
1993; Johns, 2006, 2009). Reflective consideration of the experiences that caused disquiet or
distress helped the participants to understand their personal affective response, to disperse
some of the emotional load, and to consider what they had learnt about themselves and their
practice. The participants

Reflective practice in nursing care: Embedded assumptions in

qualitative studies
Christine Gustafsson RNT MSc, Margareta Asp RNT BSc PhD, Ingegerd Fagerberg RNT
First published: 18 May 2007

Abstract

Qualitative nursing researchers have long recognized that reflective practice (RP) seems to be a
valuable tool in nursing care. The aim of the present meta-study was to analyse current
qualitative research on RP in nursing care, in order to create and synthesize the knowledge and
the understanding of registered nurses' RP. Using a meta-study synthesis approach, embedded
assumptions were identified in qualitative studies that have influenced the way researchers
have interpreted and made sense of RP in nursing care. Despite empirical focus in research on
RP in nursing care, it was found that assumptions about RP were predominantly based on
theory. The reflective movement within the practice of nursing care has mainly a constructivist
epistemology, based on learning from experience. The individual nurse's RP capability is
essential in providing and improving ethical and holistic nursing care.