Kok J, Chabeli M M
Department of Nursing Science, RAU.
Curationis. 2002 Aug;25(3):35-42. doi: 10.4102/curationis.v25i3.784.
According to the outcomes-based education and training system of education (OBET) in the country and the South African Nursing Council, education should focus on "creating" reflective learners and practitioners. This article seeks to determine the effectiveness of reflective journal writing in promoting the reflective thinking of learners in clinical nursing education and to validate the guidelines described in a bigger study on how to facilitate reflective thinking using reflective journal writing. A qualitative, contextual, explorative, descriptive research design was used to determine the learners' perceptions on whether reflective journal writing did promote their higher-level thinking skills during the six-month placement in a psychiatric clinical practice using the reflective diaries. From a population of seventeen fourth-year students, six volunteered to participate in a focus group interview. The data was analysed by means of the descriptive method of open coding of Tesch (in Creswell, 1994:154-156). Positive and negative results from the perceptions of the participants and a literature review served as a basis for deducing and describing guidelines for the effective use of reflective journal writing in promoting reflective thinking in clinical nursing education. The positive perception was the development of problem-solving skills attained through reflection by using analytical critical thinking, synthesis and the evaluation of situations. Self-evaluation leading to intellectual growth and self-awareness indicated a positive perception. Negative perceptions were that reflective journal writing is time consuming, content based with a lack of clear expectations from the teacher, and distrust of students about the information written. Guba's model of ensuring trustworthiness in qualitative research as described in Krefting (1991:215-222) was employed. It is concluded that reflective journal writing in clinical nursing education does promote reflective thinking and learning. The use of the developed guidelines will minimise the negative perceptions. It is recommended that the guidelines be used in basic training at all levels of training to attain the objective of nursing education and training, which is to produce a critical, analytical thinker through reflection to improve practice.
根据该国基于成果的教育与培训体系（OBET）以及南非护理委员会的要求，教育应专注于“培养”善于反思的学习者和从业者。本文旨在确定反思性日志写作在促进临床护理教育中学习者反思性思维方面的有效性，并验证一项更大规模研究中所描述的关于如何利用反思性日志写作促进反思性思维的指导方针。采用了定性、情境、探索性、描述性研究设计，以确定学习者对于反思性日志写作在使用反思性日记进行为期六个月的精神科临床实习期间是否促进了他们的高级思维技能的看法。在十七名四年级学生中，有六名自愿参加焦点小组访谈。数据采用特施（Tesch，见克雷斯韦尔，1994：154 - 156）的开放式编码描述性方法进行分析。参与者看法的积极和消极结果以及文献综述为推导和描述在临床护理教育中有效使用反思性日志写作以促进反思性思维的指导方针提供了依据。积极看法包括通过运用分析性批判性思维、综合和情境评估进行反思而获得的解决问题技能的发展。导致智力成长和自我意识的自我评估表明了积极看法。消极看法包括反思性日志写作耗时、基于内容且教师期望不明确，以及学生对所写信息的不信任。采用了克雷夫廷（1991：215 - 222）所描述的古巴（Guba）在定性研究中确保可信度的模型。得出的结论是，临床护理教育中的反思性日志写作确实促进了反思性思维和学习。使用所制定的指导方针将减少消极看法。建议在各级培训的基础训练中使用这些指导方针，以实现护理教育与培训的目标，即通过反思培养批判性、分析性思考者以改进实践。
