Cooke Marie, Matarasso Beth
School of Nursing, Nathan Campus, Griffith University, Nathan, Queensland, Australia.
Int J Ment Health Nurs. 2005 Dec;14(4):243-8. doi: 10.1111/j.1440-0979.2005.00388.x.
Reflective practice in nursing has been shown to improve both client care and nurses role satisfaction. Students require regular and guided opportunities to learn the necessary reflective skills that underpin best practice. Problem-based learning (PBL) processes based on comprehensive learning packages developed from actual clinical cases provide a contextualized and realistic means for students to develop and hone their reflective skills for use as mental health practitioners. This paper uses a case illustration to demonstrate the usefulness of PBL as a mechanism for developing reflective practice in the mental health context. Students analysed five cases drawn from actual documented clinical materials that included nursing, medical and allied health professionals' assessments, treatment regimes, and progress notes. One student's written analysis of the five cases and an interview with the student is presented as a case illustration. The case illustrates the student's reflections on the theme of 'hope' for the clients and identified three obstacles. These were: (i) a lack of acknowledgement by health professionals of traumatic life events; (ii) overlooking less tangible losses; and (iii) a central focus on drug treatment. Reflective learning strategies can be incorporated in on- and off-campus learning environments and used to assist the learner to practise critical reflective skills in a controlled and safe manner. Reflective processes are more meaningful if the PBL package that students encounter represents real clinical scenarios with comprehensive resource materials.
护理中的反思性实践已被证明既能改善患者护理，又能提高护士的角色满意度。学生需要有规律且有指导的机会来学习支撑最佳实践的必要反思技能。基于从实际临床病例开发的综合学习包的问题式学习（PBL）过程，为学生提供了一种情境化且现实的方式，来培养和磨练他们作为心理健康从业者所使用的反思技能。本文通过一个案例说明来展示PBL作为在心理健康背景下培养反思性实践的一种机制的有用性。学生分析了五个来自实际记录临床资料的案例，这些资料包括护理、医学和相关健康专业人员的评估、治疗方案和病程记录。作为一个案例说明，展示了一名学生对这五个案例的书面分析以及对该学生的访谈。该案例说明了学生对患者“希望”主题的反思，并确定了三个障碍。这些障碍是：（i）健康专业人员对创伤性生活事件缺乏认知；（ii）忽视不太明显的损失；（iii）集中关注药物治疗。反思性学习策略可以纳入校内和校外学习环境中，并用于帮助学习者以可控且安全的方式实践批判性反思技能。如果学生遇到的PBL包代表具有综合资源材料的真实临床场景，反思过程会更有意义。
