Abstract:

Intentionally reflecting on action to improve practice is mandated as a method for continuing competence by nursing regulatory bodies in most Canadian provinces. Accordingly, nursing education must prepare students as reflective practitioners. Nurse educators typically use the medium of clinical post-conferences (i.e., having students engage in self-appraisal of learning and discussing their learning strategies with peers) to help students build their reflective capacity. It is widely held that such clinical post-conferences enable students to share knowledge, connect theory to practice, unload stress and confusion, examine perceptions, and deconstruct failures and successes. However, the role of clinical post-conference participation in developing student reflective capacity is not known. To help address this gap in evidence, we elicited information via a confidential online survey of students’ experiences within clinical post- conferences. Combining their quantitative responses to Likert scale questions about attitudes and beliefs with their qualitatively described clinical learning situations, we identified socio-cultural influences that inform students’ values and meaning-making processes. Our findings depict the development of reflective practice through experiences of peer support, safety, and nurse educator leadership. Peer support requires students to respect one another and establish positive group dynamics. Students’ perceptions of safety are paramount to their participation. Nurse educators who lead clinical post-conferences by modelling reflective practice promote a safe environment for students. Critical to the development of student nurse reflective capacity is confidentiality, the encouragement and timing of feedback, and seniority level of students. In this presentation, we will provide a detailed, contextually-grounded understanding of the development of reflective clinical practice and its barriers and facilitators. Following this, we suggest pedagogical strategies and resources to promote a culture of reflexivity in nursing clinical education.