Abstract
BackgroundReflection on clinical practice is the core of education for nursing students. Evaluating reflection on clinical experiences requires a tool which accurately measures reflection skills. The present study aims to develop and test the psychometric properties of a tool for measuring nursing students’ reflection on clinical practice.MethodsBased on a mix-method exploratory approach, the study was carried out in two stages: in the first stage (the qualitative phase), the concept of reflection on clinical practice was established. In the second stage (the quantitative phase), the psychometric properties of the developed scale were evaluated.ResultsBased on the results of the exploratory factor analysis and the verification process, the final version of the scale came to consist of 36 items and 6 dimensions. The dimensions were: professional competence, internal sources of motivation, challenging situational clinical setting, dynamic organizational atmosphere, reflection-based self-management, and dynamic professional growth. Overall, 6 factors accounted for 62.79% of the variances. The factor loadings of the items ranged between 0.62 and 0.94, all of which were significant. The total intraclass correlation (ICC) of the scale was found to be 0.94. Also, evaluation of the reliability of the scale as measured through internal homogeneity yielded a total Cronbach’s alpha of 0.90.ConclusionThe findings show that the developed scale for evaluation of nursing students’ reflection on clinical practice possesses satisfactory validity and reliability, and nursing professors can use this instrument to assess students’ reflection skills.
Highlights
Reflection on clinical practice is the core of education for nursing students
Developed based on the findings of the qualitative phase, the initial draft of the reflection on clinical practice scale consisted of 75 items, which, after a review of literature, increased to 85 items
Evaluation of the content validity ratio (CVR) of the items showed that 8 items had a score of less than 0.49 and were, eliminated
Summary
Reflection on clinical practice is the core of education for nursing students. Evaluating reflection on clinical experiences requires a tool which accurately measures reflection skills. According to Dewey, learning comprises of experiencing combined with reflection on experiences He believed that reflection provides for the intellectual activities required for dealing with professional challenges [5]. At the time of performing tasks or afterward, individuals should reflect on their activities and consider the related knowledge as well to reduce the gap between theory and practice and make learning through experience possible [10]. In a longitudinal study entitled “The Effect of a Self-Reflection and Insight Program on the Nursing Competence of Nursing Students,” Pai (2015) concludes that reflection on experiences in response to complexities in clinical practice reduces nursing students’ tension and improves their learning [11]. As a learning tool, reflective practice can be used in nursing educational programs to improve critical thinking skills and self-guidance, plug the gap between theory and practice, and develop professional competencies [17]. In, nursing profession reflection can, by reducing the frequency of unconscious, habitual acts, enhance the quality of patient care and increase patient safety [18]
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