Liimatainen L, Poskiparta M, Karhila P, Sjögren A
Faculty of Sport Sciences, Department of Health Sciences, University of Jyväskylä, and Continuing Education Manager, School of Health and Social Care, Jyväskylä Polytechnic, Jyväskylä, Finland.
J Adv Nurs. 2001 Jun;34(5):648-58. doi: 10.1046/j.1365-2648.2001.01794.x.
The purpose of this follow-up study was to describe the development of reflective learning of 16 student nurses in the context of health counselling and promotion during clinical training of a 3-year nursing education programme in two Finnish polytechnics. The first aim was to analyse the levels of reflectivity in the student nurses' reflections on their videotaped counselling situations. The second aim was to explore the qualitative features of the reflective health counselling learning process in the context of health promotion. The theoretical background of the study was based on a transformative learning theory.
The data consisted of stimulated recall interviews with 16 student nurses conducted once a year between 1998 and 2000. The data were analysed using categorization and thematic analysis.
The findings of the study showed that half of the students in the research group reached the level of critical consciousness during their nursing education. The others remained at the level of consciousness. Two students who represented thoughtful action without reflection in the first study year were able to reach reflection and even critical reflection later during their education. The meaning schemas of counselling developed and were enriched when the students moved into the higher stages of reflection. There were features of an empowerment approach to health promotion only in the meaning schemas and perspectives of critical reflectors.
These results may indicate that the empowerment approach to health promotion within the modern health promoting role of nurses requires critical reflection. Therefore, effective methods and evaluation tools of reflective learning are needed to support learning from practice via critical reflection.
这项追踪研究的目的是描述在芬兰两所理工学院为期三年的护理教育项目临床培训期间，16名学生护士在健康咨询与促进背景下反思性学习的发展情况。首要目标是分析学生护士对其录像咨询情境反思中的反思水平。第二个目标是在健康促进背景下探索反思性健康咨询学习过程的质性特征。该研究的理论背景基于转化学习理论。
数据包括1998年至2000年间每年对16名学生护士进行的激发性回忆访谈。使用分类和主题分析对数据进行分析。
研究结果表明，研究组中有一半学生在护理教育期间达到了批判性意识水平。其他人则停留在意识水平。在第一年研究中表现为不假思索行动的两名学生，在后来的教育中能够达到反思甚至批判性反思水平。当学生进入更高层次的反思阶段时，咨询的意义模式得以发展并丰富。仅在批判性反思者的意义模式和观点中存在健康促进赋权方法的特征。
这些结果可能表明，在护士现代健康促进角色中，健康促进赋权方法需要批判性反思。因此，需要有效的反思性学习方法和评估工具，以支持通过批判性反思从实践中学习。
