Group Reflection Research Articles

Patient and public involvement in research: Reflections and experiences of doctoral cancer nurse researchers in Europe

Background Early career researchers lack guidance about patient and public involvement (PPI). The overall aim of the study was to explore the knowledge and experiences of using PPI in research among doctoral students who are registered nurses. Methods This qualitative study included findings generated from reflective essays and focus groups involving ten registered cancer nurses who are undertaking doctoral research. The study has two stages of data collection. Participants initially wrote a reflective essay using a set of guiding questions to structure a response which was subsequently analysed. Two focus groups were then conducted to provide further insight into the themes identified in the reflective essays. Reflective thematic analysis was used to identify, name, and define the final themes. Results There were ten participants from seven countries and were at various stages of their doctoral study. Analysis of data from reflective essays (n = 10) and focus groups (n = 2) identified four themes namely, (a) evolving recognition and appreciation of PPI, (b) embracing PPI and impact on doctoral studies, (c) the influence of the research environment, and (d) the need to empower doctoral students to integrate PPI in their research journey. Conclusion Participants reported differing experiences of PPI awareness showing disparity in guidance about PPI for junior researchers across Europe. We recommend provision of early PPI training for doctoral students to support and encourage involvement of patients and the public in their research. Opportunities for sharing PPI experiences to help improve PPI culture in research environments that support doctoral students should be explored.

Reflective Practice Groups for nurses: perceptions and preferences, considerations, and cautions

Objective: Study 5, from a series of six, examines the influence of attendance rates and personal attendance preferences on the effectiveness of Reflective Practice Groups (RPGs). It also explores participant perceptions regarding benefits and barriers of RPG. This article presents the current study in context of associated research and attempts to synthesise the collective findings. Background: Nursing can be associated with burnout, secondary traumatic stress (STS) and compassion fatigue. RPGs might help mitigate these negative impacts. Study Design/Methods: This cross-sectional study surveyed a cohort of 190 nurses (88% female) using validated scales to assess professional quality of life (ProQOL), job satisfaction (JS) and psychological distress, alongside perceived effectiveness of RPG, attendance rates and preferences. Open-ended questions explored perceived barriers and benefits to attendance. Results: Nurses who attended less RPGs reported higher STS. Those who preferred to go more frequently also reported higher STS however level of attendance and personal preference did not affect each other. Nurses attending ‘as often as groups are run’ also rated the effectiveness of RPG more highly. Other outcome measures were not significant for either variable. Perceived benefits of RPG included sharing, support, cohesiveness, skills development and facilitatory alliance. Barriers included workloads, rostering, time constraints and discomfort in a group setting. Discussion: The majority of nurses reported higher STS, preferred to attend RPGs more frequently, and rated them as more effective. Nurses who attended more RPGs reported significantly lower STS, indicating a restorative benefit. The lack of significance for Compassion Satisfaction (CS) ratings contrasted with findings of earlier studies. Logistical issues and discomfort in groups were barriers to RPG attendance. Perceived benefits related to personal and workgroup development. Alongside findings from the overarching project, results indicate a positive correlation between effective RPGs, personal and job resources, and aspects of ProQOL. Conclusion: Nurses with higher STS find RPGs more useful and want to attend more often. Higher RPG attendance is associated with lower STS. Voluntary attendance, facilitatory alliance, promotion of psychological safety, and organisational support are key considerations. In context of the overarching project, RPG attendance has been positively correlated with various aspects of ProQOL, personal and job resources. Cause and effect are still not clear and further research is required. What is already known about the topic? RPGs are positively correlated with personal and job resources and CS. Barriers to reflecting in RPGs include workplace logistical issues. What this paper adds: Greater RPG attendance is associated with lower STS. Nurses with higher STS prefer to attend more often and find RPGs more useful. Discomfort in a group setting is an important consideration and should be addressed through effective facilitation and management of group process to promote psychological safety. RPGs have now been positively associated with a greater number of personal resources, job resources and aspects ProQOL.

Becoming the right musician for the job: Versatility, connectedness, and professional identities during personalized, online music-making in hospital maternity wards

The beneficial potential for music in hospital contexts is well established, with research showing that music can promote patient well-being and support recovery. However, less attention has been paid to the ways in which musicians’ practices and professional identities are informed by working in hospital settings. As arts-and-health approaches continue to proliferate, it is essential to recognize the values, emotional labor, and skills associated with these approaches through understanding the experiences of practitioners. As part of an international collaboration led by Hanze University in the Netherlands, the ProMiMiC project explores the professional development of musicians and nurses through person-centered music-making in hospital settings. The current study focused on five conservatoire-trained musicians’ delivery of personalized music-making via Zoom in a hospital maternity setting in London during the COVID-19 pandemic. Their experiences of adapting to the new context, and the impacts on their personal and professional development, were explored using reflective journals, group discussions, and semi-structured interviews. The data were interpreted using the theoretical lens of vocational habitus to examine the skills and dispositions required to be the right musician for this job. Qualitative synthesis revealed the musicians’ developing musical values as they adapted to the online maternity setting, highlighting the centrality of communicative and musical versatility as well as the ability to connect and empathize through music. The findings offer insights into possible ways of supporting emerging music practitioners in healthcare settings and emphasize the imperative for higher music education to prepare and train musicians for this type of work.

Integrating Perspectives from Education for Sustainable Development to Foster Plant Awareness among Trainee Science Teachers: A Mixed Methods Study

This mixed-method study aimed to investigate the efficacy of an intervention unit that integrates perspectives from Education for Sustainable Development (ESD) to foster plant awareness, within the context of botanical lessons for trainee science teachers. Third-year undergraduate students (n = 91) studying to become lower secondary school (grade 7–9) science teachers from a public university in East Java, Indonesia, participated in this study. Data were collected through a self-reported questionnaire, reflective journal entries, and focus group interviews. The findings revealed a statistically significant increase in the participants’ attention and attitude towards plants, relative interest in plants, and self-efficacy in teaching plant-related topics. The triangulation of the analysis results from the reflective journals and focus group interviews demonstrated that through transformative learning, the participants’ experiences, perceptions, and learning evolved throughout the intervention unit, leading to their more comprehensive understanding of plant-related issues and their connection to broader sustainability concerns. These findings imply that the integration of ESD perspectives into botanical education positively affects plant awareness. Future research could further investigate the long-term impact of integrating ESD perspectives on teacher training programs.

Promoting the Well-Being of Supervisors for Sustainable Early Childhood Development in an Informal Settlement

Early childhood development (ECD) centres are strategically positioned to create quality early learning opportunities that prepare children for adulthood, providing the necessary holistic sustainable learning. However, many ECD facilities in the informal settlements in South Africa function under a variety of psychosocial and contextual challenges that impact directly on the well-being of supervisors and practitioners. This study explored the need to enable, and the ways to relationally promote, the well-being of supervisors. Underpinned by posthumanism, and consistent with participatory action learning and action research cycles, we recognised that the challenges facing humanity today require new understandings and responsive solutions, which include engagements and contributions with and by nonhuman relationalities for sustainable early childhood learning. In this paper, we argue that focus on the promotion of the well-being of ECD supervisors in informal settlements is crucial. Data generation was conducted with an action team of six participants, that is, three ECD supervisors and three researchers utilising reflective drawings and group meetings that provided opportunities for action and reflection. A critical thematic analysis of data concluded that innovative collaborative ways to solve own problems in own contexts utilising responsive solutions promotes social change. An adaption to the decentralisation of supervisors' power using interdisciplinary interventions makes communities feel responsible, valued, and accountable for the ECD centres-thus, relational interconnections are improved at human and nonhuman levels. This study has the potential to contribute to the well-being of supervisors, which may filter down to improved well-being for teachers and learners, resulting in sustainable ECD in informal settlements.

Reflective group supervision: psychotherapists and child health centre nurses in collaboration

ABSTRACT Postpartum depression affects every sixth mother, and emotional distress in infants is also common. The need for parent-infant consultations and psychotherapies probably greatly exceeds the number of families who in fact receive qualified help. Nurses at child health centres are the first professionals to meet distressed families. Their readiness to help them is clouded by conflicting professional attitudes, patients’ expectations, and uncertainties of how to handle patient-nurse interactions. Nurses may experience clinical impasses that need attention. Reflective group supervision can be a valuable remedy, and a method for educating nurses in daily practice. The method is illustrated by a vignette, and a review of the nursing and psychoanalytic literature. Nurses often address problems with anger, guilt, and anxiety of uncertainty, which may block their understanding of the families’ emotional entanglements. Supervision combines the supervisor’s psychodynamic competence and the nurses’ experiences, to inspire self-reflection on difficult cases. It should be provided regularly with management support, and the supervisor should preferably be a psychotherapist experienced in child and adult work. The therapist can work simultaneously as a consultant clinician at the centre, thus increasing the opportunities for families to receive adequate help.

Predictors of Feeling of Threat Caused by COVID-19 Pandemic, the Distinctive Effects of Automatic vs. Reflective Emotions.

The worldwide pandemic that started in December 2019 was a cause of a great rise in the feeling of threat in society. A feeling of threat and distress can be influenced by the span of emotions experienced by a person, and as it is rather clear, that the situation of pandemic evokes negative emotions, they can range from fear to depression, to even disgust. In this study, we wanted to verify the influence of the negative emotions of automatic origin, related to the well-being and homeostasis of the organism and the negative emotions of reflective origin, which are related to social constructs, on the feeling of threat caused by the pandemic outbreak. We expected automatic emotions to have a greater influence on the feeling of threat. We used an online questionnaire to measure the intensity of negative emotions and the feeling of threat among Polish participants in the time of the early outbreak of the pandemic (March-April 2020). Regression analyses were used to identify the predictors of the feeling of threat. The results show the distinctive effect of automatic and reflective groups of emotions. While automatic emotions always increased the feeling of threat, the reflective emotions suppressed the distress, especially in the group of middle-aged and elderly participants. As reflective emotions are developing in the process of socialization, the observed results could suggest, that young people do not process the situation of the pandemic in reflective categories, which leaves them more worried about the situation. We suggest, that promoting reflective thinking can be helpful in interventions in the cases of anxiety caused by the pandemic, as well as in social communication regarding the topic of the pandemic.

Staff views on reflective practice groups in an inpatient assessment and treatment unit for people with intellectual disabilities

PurposeAlthough it is recommended that reflective practice groups (RPGs) are used to support staff in inpatient intellectual disability (ID) services, there is to date no research on their effectiveness or how staff perceive RPGs in these settings. This paper aims to evaluate staff perceptions of the RPGs in an assessment and treatment unit for people with ID and to ascertain the nature of any barriers for staff in attending the group.Design/methodology/approachThirteen staff completed questionnaires ascertaining their views on the purpose, process and impact of the RPG run within the service. Questionnaires included a version of the clinical supervision evaluation questionnaire (CSEQ; Horton et al., 2008) adapted for this context and a questionnaire designed by the authors examining barriers to attending the group.FindingsStaff responses indicated that they valued the group and perceived it as improving their clinical practice and their self-awareness. Staff did not always perceive group sessions as having clear aims and did not perceive the group as enhancing their well-being or their awareness of gaps in their skills. RPGs may be most effective if they form part of a service-wide approach to staff support and development.Originality/valueTo the best of the authors’ knowledge, this is the first evaluation of RPGs in inpatient ID services. The adapted CSEQ was found to be an easily implemented method of evaluating RPGs in an inpatient ID setting.

An evaluation of the effectiveness of HCR-20v3 awareness training within a secure unit

To effectively deliver HCR-20 training to staff who work in a Forensic Mental Health Service, and to increase their knowledge and understanding of the risk assessment tool. Three separate training sessions took place with a total of 24 participants. The participants work in Forensic Mental Health Services in Leicestershire. A mixture of quantitative and qualitative data was gathered from feedback evaluation forms, and from questionnaires given to participants before and after the training session. Results from the feedback evaluation forms were mostly positive. In the first two training sessions, 100 per cent of participants felt like the training was useful and met the intended aims. The results from the questionnaires indicted that that participant’s knowledge of the HCR-20 had improved immediately after the training had been given. It can be concluded that the training delivered was able to improve self-reported knowledge of the HCR-20 and confidence in using the assessment tool. Participants suggested future improvements to training, such as delivering refresher training. Other suggestions such as incorporating formulation into reflective practice groups have been implemented.

Improving the Management of Children with Fevers by Healers in Native Rural Areas in the South of Ecuador.

Indigenous populations are represented among the poor and disadvantaged in rural areas. High rates of infectious diseases are observed in indigenous child populations, and fever as a general symptom is common. We aim to improve the skills of healers in rural indigenous areas in the South of Ecuador for managing children with fevers. We performed participatory action research (PAR) for this study with 65 healers. The PAR focused on the following four phases: (1) 'observation,' eight focus groups were used. (2) 'planning' phase was developed, and with culturally reflective peer group sessions, a culturally adapted flowchart was constructed titled "Management of children with fever." In phase (3): 'action', the healers were trained to manage children with fever. Phase (4): 'evaluation', 50% of the healers used the flowchart. Explicit recognition of the need for traditional healers and health professionals in indigenous communities to work together to improve health indicators such as infant mortality exists. Additionally, strengthening the transfer system in rural areas is based on knowledge and cooperation between the community and the biomedical system.

Practicing to sing in chorus: Challenges and opportunities of collaborative inquiry-based learning in an Iranian EFL secondary school context

Not dissimilar to many other English as a foreign language (EFL) contexts, inquiry-based approaches to teaching and learning English appear to be both under-implemented and under-researched in Iranian English education settings, particularly in the public sector. In this study, the researchers explored the challenges and opportunities of teaching English based on collaborative inquiry-based learning (IBL) in an Iranian EFL secondary school context. To that end, supplementary teaching materials and classroom practices were developed for one of the national English textbooks, drawing upon inquiry phases of engagement in the topic of inquiry, exploring various sources, explaining the collected information collaboratively, and extending understanding. The participants of the study were 60 students taking English, as a compulsory school subject, in a vocational high school. The data for the study were collected through multiple sources including a semester-long class observation, teacher reflective journals, student-generated documents, and focus group interviews. The analysis of the data revealed that the students initially faced several challenges in their shift of paradigm from conventional to IBL practices, chiefly among which was their lack of tendency to sing in tune as community members. Notwithstanding the challenges, the practices also provided them with several learning opportunities like developing a searching spirit, practicing autonomy, creativity, team working, as well as voicing the self in a foreign language. We hope the research findings and classroom practices will be inspirational for curriculum designers, materials developers, and English teachers both in the Iranian context of English education and other EFL contexts worldwide.

Reflective practice and psychotherapy case experience of Specialty Doctors and Associate Specialists (SAS) working in psychiatry: UK-wide survey.

To survey nationwide opportunities for Balint-type and reflective support group participation and psychotherapy training among doctors classified as Specialty Doctors and Associate Specialists in psychiatry ('SAS psychiatrists') and the professional benefits and barriers to access. Approximately 9% of SAS psychiatrists responded, from all UK regions. A minority reported participating in a Balint-type group (27.3%) or reflective practice/support group (30.9%), and only 6.5% were not interested in participating. Although 44.8% planned to see a psychotherapy case, most reported barriers, particularly time constraints, job plans and lack of support. The 22.1% who reported already gaining psychotherapy case experience reported many benefits, including becoming a better listener (84.8%), more empathetic (81.2%), enjoying work more (78.8%) and overall becoming a better psychiatrist (90.9%). The reported interest in Balint group and psychotherapy training opportunities exceeded existing provision; psychotherapy case experience benefited professional development and self-reported clinical capabilities. Healthcare trusts and boards need to consider more actively supporting SAS psychotherapy training and reflective practice.

A reflective practice group tutorial series for medical students.

A reflective practice group tutorial series for medical students.

Practice Pointer: "My feelings are not on mute - ZOOM and Balint Practice Pointers".

Practice Pointer: "My feelings are not on mute - ZOOM and Balint Practice Pointers".

Interprofessional simulation training for perinatal mental health: A mixed methods study

AbstractObjectiveTo determine the effectiveness of high‐fidelity interprofessional simulation on improving self‐efficacy of healthcare staff caring for individuals with perinatal mental health (PNMH) problems.MethodsThis study employed a mixed methods, quasi‐experimental intervention design. Participants were 240 doctors, nurses, midwives, and other clinical and nonclinical healthcare professionals recruited to partake in the study during their time undertaking the course. The course took place in a simulation centre, re‐creating high fidelity scenarios of a woman's pathway of treatment in perinatal mental health care. The course consisted of six simulated scenarios using trained actors to portray patients with common perinatal mental health presentations. Participants each took part in and observed at least 1–2 scenarios and all subsequently engaged in reflective group debriefs.Main Outcome MeasuresThe Human Factor Skills for Healthcare Instrument (HFSHI), measuring self‐efficacy in human factors skills, and a scale developed for this study—the Course Specific Question Scale (CSQ)—to measure changes in knowledge, skills and confidence on course‐specific learning objectives were used for pre‐ and post‐data. A post‐course evaluation form was used for gathering qualitative data on learning and course experience.ResultsParticipants expressed improvements in interprofessional collaboration, emotional awareness, reflection, communication and attitudes towards perinatal mental health following the course. Improvements in self‐efficacy alongside skills, knowledge and confidence regarding perinatal mental health care were also found.ConclusionsFindings suggest potential benefits of simulation training for perinatal mental health to improve self‐efficacy, knowledge and clinical practice. More research is needed to fully assess interprofessional simulation training in PNMH and the long‐term impact of training on clinical practice.

Perceptions of women as political leaders at a time of crisis: a psychosocial study

Women in political leadership have been the topic of much discussion since the start of the COVID-19 pandemic, with a number of women in executive office being praised for their empathic approach. The pandemic has raised questions about the role of women in political leadership at a time of crisis and the drivers behind the feelings they evoke. Drawing on online reflective focus groups with participants mainly from the United Kingdom during the COVID-19 national lockdowns, this article explores the feelings and affective responses evoked from seeing women in political leadership roles at a time of crisis. The focus groups highlighted the conflict that participants felt at seeing women political leaders navigating crisis situations, with expected displays of empathy at the forefront of discussions. The findings also suggest that, in order to be trusted, women political leaders must still overcome gendered expectations about their authority and warmth. The participants felt conflicted when evaluating the leadership styles of women in politics and grappled with notions of trust and authenticity. The article provides new psychosocial insights into the way we think and feel about women political leaders and highlights the complex gendered terrain that women in political leadership have to navigate.

Experiences of attending a reflective practice group in a neuro-rehabilitation setting: A mixed methods service evaluation

This service evaluation aimed to explore ward staff’s experiences of attending a reflective practice (RP) group within an inpatient neuro-rehabilitation setting. Thirteen staff members completed a bespoke questionnaire and three staff members engaged in semi-structured interviews. Findings suggested that the group was a good use of participant’s time, felt a safe space, and was a good space to discuss team dynamics. There were mixed findings regarding whether the group improved staff’s confidence or their understanding of patient’s behaviour. Thematic analysis revealed four core themes, including ‘organisational pressures’ which impacted the RP group; ‘group practicalities’; ‘benefits and improvements’; and the ‘safe space’ of the group. Future evaluations would benefit from using a validated questionnaire and measures of burnout to explore the wider impact of RP.

4.2 Launching Virtual Parenting Groups in Multiple Settings and Populations

The parent-child relationship is often the first and foundational relationship for a child that then sets up a framework of how he or she will relate to others. Much of what parents know and do is learned from the way they were parented. This presentation aims to explore the implementation challenges and opportunities of an attachment-based reflective group, the Circle of Security Parenting (COS-P), virtually within the general community and within primary care pediatrics during the COVID-19 pandemic, with a focus on the unique experience of facilitating within parents of Asian American and African American heritage.

Online peer-led group reflective practice in higher education: a seminar-based project evaluation

ABSTRACT This study explores the effects of online Peer-Led Group Reflective Practice (PLGRP) on students undertaking their master’s degree in the UK, during the Covid-19 pandemic. First, it provides an overview of the online seminar-based project called Holistic Academic and Research Reflective Practice (HARRP) which fostered the PLGRP pedagogical approach presented and evaluated here. Next, it delves into the reflective pedagogical approaches that informed the project design, before looking at its effects on students. A qualitative methodology enabled the implementation of an open-ended questionnaire which helped capture students’ thoughts on the project. Results of a thematic analysis suggest that online PLGRP provided opportunities for students to develop their academic and researcher reflexivity, researcher competence as well as their independent and interdependent learning skills. Issues around lack of time to attend seminars and lack of familiarity with working in peer-led reflective groups enabled further suggestions and improvements to the HARRP project. The contribution of this study lies in the way in which PLGRP approach is designed and operationalised with the purposes of helping students make sense of their academic and research journey individually and in groups. This study also shows how individual and peer-led group reflective practices shape one another.

Transition and Adaptation to Higher Education in Brazilian First-Year Nursing Students

ABSTRACT This study aimed to identify the main stressors in the transition and adaptation processes to higher education in nursing students. Two reflective groups were conducted with 136 students. The thematic-reflexive analysis revealed that the main stressors were the excessive workload of course activities, the need for maturation, psychological pressure, and lack of financial resources. The results demonstrated the need for monitoring students throughout the course, especially in the early years, as well as the continuity of welcoming activities. University care programs can help adapt to the course, also functioning as mental health promoters.