Developing and maintaining reflection in clinical journals.

There is a pressing need in today's world for nurses who are willing and able to transform health care. Teaching strategies that foster reflection are in order. The use of dialogue journals has been widely reported in the nursing literature as an effective strategy for assisting students to reflect about learning experiences in the clinical area. Despite the promise that journal writing will enhance students' ability to reflect on their clinical learning experiences, not all students respond positively to journal writing as a learning tool. The paper is a discussion of some of the common difficulties that arise in the use of clinical journals as a reflective strategy in nursing education. Common problems in the use of clinical journals include procrastination; superficial, nonreflective entries; waning enthusiasm about the activity; and unwillingness or inability to reflect. The possible etiologies for these problems will be explored. Specifically, the paper will focus on ways to prevent or minimize these concerns by maintaining and enhancing the factors required for students to reflect in clinical journals.