Improving Critical Thinking in New Graduate Nurses Through the Use of Reflective Journaling: A Quality Improvement Project

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BackgroundCritical thinking is an important skill for newly graduated nurses to develop to learn how to best recognize and manage deterioration in their patients. New nurses may be too focused on nursing tasks and may not have adequate time to pause and reflect on their patient experiences that foster critical thinking. An exercise like reflective journaling may help new graduate nurses engage in active reflection with the goal of learning from their experiences, which may enhance the development of critical thinking. PurposeThe purpose of this paper is to explore whether the use of a once weekly reflective journaling exercise influences the development of critical thinking in new graduate nurses during their 6-week nursing orientation. MethodsA quality improvement (QI), pre- and post-test design was used to improve the current process of nursing orientation for newly graduated nurses in a single hospital setting. Six participants participated in a once weekly reflective journaling intervention, utilizing Kim's Critical Reflective Inquiry, over a 6-week orientation period. Participants completed the Health Sciences Reasoning Test (HSRT) before reflective journaling was implemented and at the end of their 6-week hospital orientation. Preliminary ResultsPreliminary results found that there were no significant mean differences in the total HSRT scores after the reflective journaling was implemented (t = 1.085, p = .328). However, there was a strong, positive, and significant correlation between participants’ baseline and post reflective journaling critical thinking scores in the deduction domain (r =.810, p = 0.051). Clinically significant differences in the pre- and post-test domain scores of the HSRT were evident in the interpretation, inference, explanation, induction, and numeracy domains. ConclusionNew graduated nurses may benefit from using reflective journaling into their hospital orientation, but more research is needed to determine efficacy.