Irish Nursing Students' Experiences And Understanding Of Reflective Practice: A Narrative Inquiry.

This thesis examines nursing students’ experiences and understanding of reflective practice in the Republic of Ireland. The aim of the study was to provide nurse educators with a deeper insight about reflection from a nursing student’s perspective, with the intention of integrating reflective practice into undergraduate nursing education more effectively. A narrative approach was employed using a convenience sample of eight newly graduated general nurses who had completed the nursing undergraduate four-year Bachelor of Science education programme in a Higher Education Institute in the West of Ireland. A narrative approach had not previously been employed to explore this phenomenon within an Irish context heretofore and therefore contributes to the body of knowledge on reflective practice in nursing. Schön’s methodological framework (1983) of reflective practice was employed for the study. Four themes emerged from the narratives: looking back at practice, seeking support, getting through, and ward reality: tensions and conflict.

The data revealed that participants had a positive view of reflective practice and understood reflection to mean looking back at an occurrence to inform future practice. Students also identified models of reflective practice as beneficial in providing guidance to students for reflection.

Schön’s reflection-on-action was apparent within the participants’ narratives. However, reflection-in-action was not as evident. Nonetheless participants may have engaged in this process in year four without acknowledging it. The findings indicate that participants positively regarded reflective practice as a method of learning within nurse education. Findings identified that support mechanisms had diverse levels of satisfaction. Clinical Placement Coordinators (CPCs) were considered by the participants as essential for reflective practice. Collegial support was also identified as effective. To a lesser extent the lecturing staff were acknowledged for the classroom teaching of reflective practice and for structured protected reflective time in year four of the programme but were not identified as helpful to the students while on clinical placement. Preceptors were not viewed as a significant source of support by the participants. The findings demonstrated significant variations concerning the facilitation of protected reflective time (PRT) during clinical placements which had previously not been explored within an Irish context. The study also found that the ward culture strongly influenced the facilitation of this time. The more experienced the participant became the less likely it was that PRT was offered. Furthermore, the narratives revealed conflict and confusion among qualified staff nurses about reflective practice which were motivated by power struggles between staff nurses and management. This was compounded by a perceived general lack of knowledge or understanding and value of reflective practice among nursing staff.