Reflective Questions Research Articles

The Clinical Judgment Debriefing Structure: Integrating the Clinical Judgement Measurement Model into debriefing

The transformation of nursing education in the United States, driven by the Next Generation NCLEX (NGN), demands a focus on clinical judgment. However, a gap exists in the literature regarding debriefing structures that center on clinical judgment and integrate the Clinical Judgment Measurement Model (CJMM). This paper introduces the Clinical Judgment Debriefing Structure (CJDS) that was designed to incorporate the CJMM into debriefing to support the development of clinical judgment and enhance NGN preparedness. The CJDS provides clinical judgment practice using reflective questions and tasks by emphasizing each element in Layer 3 of the CJMM. Implementation involves faculty inputting simulation content into the CJDS by preparing answers to the standardized reflection questions and tasks. The CJDS streamlines faculty preparation and ensures standardization of each debriefing session. Presented at the 2023 International Nursing Association for Clinical Simulation and Learning (INACSL) conference, the CJDS received positive feedback, indicating its practicality and applicability in simulation practices. Findings from initial testing of the CJDS using a qualitative/quantitative design, demonstrated increased knowledge and confidence in clinical judgment. While measuring clinical judgment remains challenging, the CJDS stands as a unique tool for centering debriefing on clinical judgment and guiding students through Layer 3 of the CJMM, ultimately contributing to safer nursing practice.

Scotland’s Student Learning Experience model: building partnership in quality in a tertiary context

Since 2003, student engagement has been a key pillar of Scotland’s higher education Quality Enhancement Framework, through which sparqs, Scotland’s pioneering student engagement agency, was founded. A key tool underpinning this has been sparqs’ Student Learning Experience (SLE) model, created in 2006 from Scotland’s quality arrangements for colleges and placed at the heart of sparqs’ course rep training. The SLE model is designed to support conversations between students and staff to identify priorities to enhance the quality of learning. In 2021, the Scottish Funding Council (SFC) announced the development of a new tertiary quality framework which would aim to put the experiences of students at the centre of the sector’s approach. sparqs identified the potential of the SLE model to fulfill this purpose and in 2021 was commissioned by the SFC to redevelop and embed the model in Scotland’s forthcoming tertiary quality arrangements. A distinct aspect of the redeveloped SLE model is that the building blocks, lenses and reflective questions are founded upon the views of students across Scotland about what makes an excellent quality learning experience. Throughout 2022 and 2023, sparqs worked with hundreds of students, alongside staff from students’ associations, institutions and sector agencies, to develop the SLE model. That it will remain at the core of course rep training, while also now rooted in quality arrangements, presents a significant opportunity for deeper synergy in understandings of the enhancement of learning and teaching. This article will introduce the SLE model, how conceptualisation of the student learning experience has evolved in policy, practice and literature, and the methodology behind the creation of the new model. It will then describe applications of the model for practice in academic development, course-level student-staff partnership, and strategies for quality enhancement. The article will conclude with next steps in the future of tertiary quality, in which students can be full, active partners in shaping their learning.

Nursing students’ perceived ability to practice interprofessional collaboration after the inclusion of virtual and immersion interprofessional education activities: A quantitative exploration

BackgroundLittle is known about the influence of interprofessional education (IPE) on interprofessional collaboration (IPC), particularly following the COVID 19 pandemic. AimTo examine nursing students’ perceived ability to practice IPC after exposure to virtual lectures and immersive clinical IPE activities founded on the competencies from the National Interprofessional Competency Framework. DesignA cross-sectional design was used. MethodsThird year nursing students (n=105) enrolled in a pediatric theory and clinical completed surveys including: Demographic items, the revised Interprofessional Collaborative Competency Attainment Survey (ICCAS) and the Interprofessional Education Collaborative Competency Self-Assessment (IPEC) (Version 3). Students completed reflective questions about their IPE experiences. Descriptive statistics, paired t-tests, confidence intervals, and point estimates were used to measure the differences from pre- to post-participation for all items of the ICCAS and IPEC. ResultsParticipants reported improved IPC competence on every item and overall, after the IPE activities. Participants from urban campuses had lower ICCAS scores (PE 0.38, 95 % CI, 0.12–0.65) than those from rural campuses (PE 0.45 95 % CI, 0.18–0.72). Students who identified as men had higher team functioning scores before participating in the IPE activities than women (PE 0.50; 95 % CI,: 0.05–0.95). The IPEC Interaction items mean score was 4.03 ±.50 and IPE values items were higher with a mean of 4.62 ± 0.46. ConclusionsThe findings can guide development and implementation of IPE experiences for nursing and allied healthcare students.

Development of Interprofessional Competencies Through the Process of Collaborative Clinical Reasoning: A Qualitative Study.

Effective interprofessional (IP) collaboration is essential for managing complex patient cases. Collaborative clinical reasoning (CCR) is an approach where IP teams collectively analyze and address complex clinical cases, facilitating a shared understanding of patient management. While simulation and case-based learning are established methods for fostering IP collaboration, the process by which students develop a shared mental model for patient management after a simulated home visit and how this approach promotes the development of IP competencies is unknown. Understanding this process is critical for advancing IP competences that are fundamental to case management practice. The purpose of this study was to explore students' perceptions of the CCR processes used to develop an integrated care plan following a simulated home visit. Home care and community-based practice settings. A qualitative descriptive approach was employed to explore PT and nursing student teams' perceptions of the CCR processes used to develop an integrated care plan following a simulated home visit. Written responses to five reflection questions were analyzed using conventional content analysis among n =87 physical therapy and nursing students. There were three overarching themes: clarifying roles; developing a mutual approach; embracing shared values. Students' perceptions reflected skills needed to develop IP competencies including CCR. More research is needed to explore how student teams resolve disputes and use interdisciplinary knowledge in the process of CCR. Findings highlight the importance of IP collaboration in clinical case management, emphasizing the need for case managers to facilitate clear role clarification, mutual approaches, and shared values among IP teams to enhance integrated care planning and improve patient outcomes. These insights can inform training and development programs for case managers on IP teams, promoting the adoption of CCR in practice.

Kritiska aspekter för lärande i ekologi – en studie av biologiundervisning inom lärarutbildningen

Based on variation theory, we analyze how a teacher educator in biology enacts the objects of learning (a) how the need for energy and matter is met in different organisms and (b) flows of energy and cycles of matter in ecosystems. The teacher's enactment is then compared with the students' lived objects of learning, as expressed in their written interactions in relation to the teacher's reflection questions. The study concludes that the enacted and lived objects of learning do not always correspond and critical aspects for knowledge development in ecology for the current group of teacher students are identified. Based on the analysis, the study suggests some areas that require special focus in teacher education in ecology. Carbohydrate as a carrier of energy between trophic levels, as well as the conversion of carbohydrate to water and carbon dioxide during cellular respiration, are examples of areas that the study highlights.

Board Games and Entrepreneurial Skills Acquisition: A Mixed-Methods Study on the Efficacy of the EntreComp Framework in Higher Education

The landscape of higher education has witnessed a paradigmatic shift towards methodologies that are more interactive and engaging. The integration of gamification and board games as active learning methodologies in higher education, as well as the instruction in entrepreneurial competencies, has garnered significant interest for its potential to engage and motivate students, thereby enhancing learning outcomes. Gamification, characterized by the incorporation of game design elements into non-game contexts, offers a captivating and novel learning experience that fosters intrinsic motivation and active participation among students. One of the main ways of applying gamification is through board games, providing hands-on opportunities for students to apply theoretical knowledge in practical scenarios. A critical aspect of this educational innovation is its contribution to the instruction of entrepreneurial competencies, a domain gaining traction within higher educational settings. The European Entrepreneurship Competence Framework (EntreComp) stands at the forefront of this educational endeavor, offering a comprehensive blueprint for cultivating entrepreneurial skills and mindsets. This study is anchored in the context described above, with a focused aim to delineate which entrepreneurial competencies, as outlined by the EntreComp framework, are most effectively developed through these novel educational interventions. To facilitate this investigation, the "Game It Away!" project was initiated, encompassing three pilot studies. These pilots innovatively employed board games as the medium through which participants could acquire and hone their entrepreneurial skills. A key component of the learning process within these pilots was the maintenance of a learning journal by the students. This journal, filled with various reflective questions, provided a structured mechanism for participants to document and reflect upon their learning journey throughout the project. In this way, by using qualitative and quantitative methodologies, it is possible to verify the evolution of certain competences. The integration of gamification and board games within educational settings, particularly through the lens of the "Game It Away!" project, represents a pioneering approach to fostering entrepreneurial competencies among students. This study, leveraging both qualitative and quantitative methodologies, has illuminated the substantial potential of these innovative pedagogical strategies to revolutionize the teaching and acquisition of entrepreneurial skills as outlined by the EntreComp framework.

Affordance-based lesson planning in pre-service teacher education

Abstract This article reports on an exploratory study investigating the extent to which affordance-based lesson planning is feasible and useful in pre-service teacher education. After using both affordance-based and outcomes-based lesson plans, trainee teachers in North Macedonia participated in both a survey and interviews. Respondents found both types of lesson plan useful, but in different ways and for different reasons, with some disagreement among the sample in a number of areas. While their considerations of affordance often helped them to prepare and reflect on lessons effectively, they also expressed concern about the time and cognitive challenge required to do so, with many indicating that they would appreciate more agency, both to develop their own pro formas and to explore affordance in alternative ways, such as through discussions. We conclude our article with a number of reflective questions that may be useful to other teacher educators and practicum supervisors.

Reflective Groupwork For Introductory Proof-Writing Courses

We discuss two proof evaluation activities meant to promote the acquisition of learning behaviors of professional mathematics within an introductory undergraduate proof-writing course. These learning behaviors include the ability to read and discuss mathematics critically, reach a consensus on correctness and clarity as a group, and verbalize what qualities “good” proofs possess. The first of these two activities involves peer review and the second focuses on evaluating the quality of internet resources. All of the activities involve groupwork and reflective discussion questions to develop students' experience with these practices of professional mathematics.

Adult recollections of childhood memories in individuals convicted of sexual offences: implications for narrative therapy

ABSTRACT This study examines the autobiographical memories of 84 individuals convicted of sexual offences. Our results indicate that despite their adverse childhoods, chaotic families, and compromised social competence, justice-involved clients can engage meaningfully in longform narrative interviews that contain probing personal and reflective questions about their early lives. In fact, many participants expressed gratitude that they were invited to engage and share their experiences in this way. This pioneering interdisciplinary study has important practical implications for providers of psychotherapeutic treatment who work with custodial and community samples of people convicted of sexual offences. We conclude by emphasising the value of narrative therapy and present directions for future research. PRACTICE IMPACT STATEMENT Most therapeutic approaches offered in correctional settings emphasise a cognitive behavioural approach intended to dismantle cognitive distortions. Our results suggest that the willingness and ability of justice-involved individuals to participate in narrative therapy has been likely underestimated. Accordingly, this study will help clients and clinicians alike to make the treatment experience more personalised and meaningful.

Introduction to Interactive Video-Based E-Learning to Improve Critical Thinking Skills in Vocational High School Students

This Community Service (PKM) activity aims to introduce interactive video-based e-learning to improve critical thinking skills in Vocational High School (SMK) students. Critical thinking skills are essential in facing the challenges of the world of work, especially for vocational school graduates. This activity was conducted online through the Zoom application, involving vocational school teachers as the main participants. The training focuses on using interactive videos as a learning medium that integrates interactive elements such as reflective questions, simulations, and problem-solving tasks to stimulate active student engagement. The evaluation was carried out through pre-test and post-test tests that showed a significant improvement in students' critical thinking skills, with an average post-test score of 80, an increase from 65 in the pre-test. In addition, a survey of teachers showed that 85% of participants benefited from using interactive videos to make learning more engaging and effective. However, some challenges related to internet infrastructure and students' technical ability to access video were identified. As a solution, materials are also provided offline. The results of this activity show that interactive video-based e-learning effectively improves the critical thinking skills of vocational school students. Hopefully, this method can be adapted more widely in the context of vocational education and contribute to developing the quality of education in Indonesia.

Inquiry for Social Transformation: Black Mother Scholars Redefining Scholarly Inquiry Through Black Artistic Expression

Writing, dancing, drawing, spittin’ rhymes, and other artistic expressions have long offered us, Black mother scholars, opportunities to reaffirm our humanity amid oppression (Fearon, 2023). Art offers Black mother scholars space to reconceptualise inquiry in ways that engage our families, challenge injustices, and usher social change within the educational milieu and beyond. The centring of Black artistic expression in educational research invites Black mother scholars to affirm the parts of ourselves, our families, and our communities that dominant forms of inquiry and anti-Blackness have sought to discredit. Educational research grounded in Black artistic expression compels us all to reimagine scholarly inquiry for social transformation. In this paper, I critically reflect on an arts-informed research study I led with a group of Black Canadian mothers who are adult literacy learners. In this reflexive piece, I explore how grounding research practices in Black art allows opportunities for storytelling, story listening, and Black refusal. Specifically, this paper explores the ways Black art supports researchers in addressing power differentials inherent in inquiry processes. The paper concludes with a series of reflective questions challenging scholars, especially Black mother scholars, to redefine traditional academic boundaries and recommit to social transformation through the arts.

AI-Powered Curricula: Unpacking the Potential and Progress of Generative Technologies in Education

The aim of this narrative review is to understand how Artificial Intelligence (AI), specifically generative AI (e.g. ChatGPT) is thought to be used to support teachers in content authoring and curriculum production. Our findings indicate that Generative AI is envisioned as a co-design partner in enhancing educational content such as rubrics, lesson plans, interactive exercises, analogies, reflective questions, and case studies tailored to learning goals and instructional needs. The literature suggests that the key issues with the use of ChatGPT in education can be summarised mainly around its accuracy, and reliability, and its potential to lead to plagiarism. The analysis of empirical studies on the use of generative AI in higher education revealed first insights into themes such as ChatGPT's role in administrative tasks, varied perceptions of AI, generational differences in attitudes, multifunctional roles of ChatGPT, concerns about academic integrity and need for AI literacy, and the call for teaching philosophy reform, around assessment.

First-year health professions students’ interprofessional identity development following participation in a brief introductory interprofessional activity: a qualitative study

ABSTRACT Healthcare providers need to simultaneously identify with their own profession and the broader interprofessional group to improve interprofessional team functioning and collaboration. The purpose of this study was to explore firstyear healthcare students’ interprofessional identity development following a brief introductory interprofessional activity. The Extended Professional Identity Theory (EPIT) served as the framework for this qualitative study. The sample included 1,047 students from 19 different health professions at one institution in the first semester of their professional program. Deductive content analysis was used to analyze students’ reflections from two reflective questions in a mandatory course evaluation survey. The 24-item version of the Extended Professional Identity Scale was used as a structured categorization matrix for deductive coding of student reflections to the three EPIT constructs: interprofessional belonging, commitment, and beliefs. Participant responses, spanning all three EPIT constructs, support the ability of early health professions learners to demonstrate the development of an emerging interprofessional identity. Future research is needed to assess IPI at various points across the curriculum and to explore between profession differences and the implications for foundational IPE design and learning along the continuum into practice.

Extensive Writing in Tertiary Education

The current study seeks to find out whether Extensive Writing (EW) practices has an effect on attitudes of students towards writing and if their attitudes towards writing differ by gender. The study was conducted with two groups of intermediate level English language preparatory class students at a state university in Turkey. In the study, explanatory sequential design of mixed methods research was used for data collection and analysis procedures. In order to collect data, a four-week research lesson cycle was planned. Together with learners’ written works, a questionnaire and learning reflection questions were used. The findings of the study revealed a notable improvement of writing performance in the experimental group. As for gender differences in attitudes and writing scores, there appeared significant differences in test scores of the control group, with males outperforming females. In the experimental group, however, there was no indication of gender-based difference neither in test scores nor in their attitudes regarding writing. By analyzing learning reflection questions, it was concluded that the participants were mostly positive about this new practice. These findings collectively suggest that while observable gains in writing skills are evident, the treatment did not have an effect on gender-related differences in writing.

Implementation of the optometry Aboriginal and Torres Strait Islander health curriculum framework.

There is now an Optometry Council of Australia and New Zealand (OCANZ) accreditation requirement for Australian and Aotearoa New Zealand optometry programs to ensure students can provide culturally safe care for First Nations Peoples. To assist programs, OCANZ developed the Optometry Aboriginal and Torres Strait Islander Health Curriculum Framework (Optometry Framework). The objective of this study was to evaluate early progress towards the implementation. All seven Australian optometry programs were invited to complete a modified version of the OCANZ curriculum mapping tool. Where available, online unit outlines were reviewed to verify and supplement the data. Curriculum maps were synthesised using qualitative content analysis. None of the five participating programs had a standalone Aboriginal and Torres Strait Islander health unit; instead, programs were integrating content into core units. Only 25% of the units with relevant content had a directly related learning outcome. All programs had at least some content that was either directly or indirectly related to each of the Optometry Framework themes, and included some content related to novice and intermediate levels of learning. Four programs had content related to entry to practice levels of learning. The average total duration of directly related content in programs (excluding clinical placements) was 18 hours. Not all programs offered an Aboriginal and Torres Strait Islander health setting clinical placement opportunity. Directly related assessment was minimal in most programs, where the format was predominantly reflective journals or questions within written examinations. Progress has been made in implementing the Optometry Framework; however, further efforts are required. Programs need to integrate additional directly related learning outcomes, content (particularly entry to practice level learning), and assessment. Further curriculum enhancements will improve the likelihood of optometry students acquiring the necessary capabilities for providing culturally safe care.

Locating TPACK XK between theory and practice: Reflective practice, applied ethics, and technoskeptical dispositions

The problem of context, contextualization, and XK has stalked TPACK since its inception. We suggest that efforts in education technology to deepen the theory and scholarship around this domain of knowing have run up against the field's tendency toward discrete interpretations of TPACK, its continued reluctance to explore socio-cultural influences on education and technology, and the inherent tensions between abstracted theoretical models and the realities of practice they represent. Additionally, context raises important ethical considerations that are deeply embedded in educational technology selection and use. In an attempt to reject the binary of theory and practice and also extend the relationships between contextual and ethical knowledge in TPACK, we propose ways the field can extend both research and practice related to XK through reflective practice, professional ethics, and technoskeptical dispositions. Using examples from classroom practices, we have developed reflective and critical questions to elicit connections between TPACK, XK, and ethics which include hyper-local and narrow contexts as well as broader socio-cultural contexts. Intersecting ethics with TPACK helps educators situate the profession of education within society; consider the broad social implications of technology, pedagogy, and content separately and as TPACK; and work toward commitments for learning and social justice through the actions of the good enough.

Design thinking mindset: a user-centred approach toward innovation in the Welsh creative industries

ABSTRACT The Design Thinking (DT) mindset, a fundamental aspect of User-Centred Design (UCD), is often presented as a powerful and accessible trigger for innovation. There is much discussion in the extant literature on the communication of the DT concept to non-design practitioners to encourage broader use of design-led innovation. The present study expands this discussion by exploring which DT mindset attributes are considered meaningful for non-design professionals in small and medium-sized enterprises (SMEs). It presents a UCD intervention that embeds the DT mindset attributes to introduce design-led innovation to SMEs of the Welsh creative industries. Semi-structured interviews, non-participatory observation, and reflective open-ended questioning are utilised to analyse the impact of the intervention in supporting creative industry practitioners’ understanding of the DT mindset and design-led innovation approaches. Our findings demonstrate that the intervention has prompted participants to (i) challenge the idea of ‘ideas,’ (ii) frame failure as an option, (iii) learn to trust the process, (iv) acquire innovation self-efficacy, (v) view collaboration = learning, and (vi) change their perception of innovation. We discuss how these identified ‘mindset shifts’ are valuable toward building individual innovation capacities in non-design industries.

Patient and Caregiver Engagement in an Era of COVID-19: What Did We Learn and How Do We Move Forward?

Patient and caregiver engagement is a core component of high-quality healthcare systems. The COVID-19 pandemic revealed to us the fragility of patient and family engagement that was not as firmly rooted in the health system as expected. In this paper, we reflect on case examples from healthcare organizations across Canada where pivots and adaptations were made to patient engagement activities. We share core enablers of engagement in times of high system stress, drawing on illustrative examples. We then synthesize key learnings in relation to existing literature and conclude with reflective questions as we orient the work of engagement into the future.

Pharmacy students' process of learning of real patients in a simple first-person perspective patient simulation exercise — A qualitative analysis

IntroductionPharmacists need more insight into patients' perspectives on medicine to target their counseling and improve patient outcomes. Patient simulation exercises, where pharmacy students are asked to consume medicine-like products, have been shown to foster such understandings, although the specifics of how this occurs, in particularly, how students turn their first-person perspectives toward generalizations about real patients' lives with medicines, are not well documented.The aim was to identify central aspects of the learning process by introducing reflection questions about real patients and follow students' development during a study period. MethodsThe study was conducted with students in their 4th semester in the second year of Pharmacy Education at the University of Copenhagen who were asked to respond to free text questions in a survey instrument about their daily experiences of taking a licorice product for one week as well as answering patient reflection questions. Qualitative deductive analysis was performed by coding students' experiences according to concepts of ‘experiential learning’. Pattern identification within each concept was then inferred, as were their interrelationships. ResultsPatient reflection questions enabled students to turn their first-person perspectives toward relevant generalizations about real patients' lives with medicines, including involved psychological mechanisms and how real patient groups differ in their ability to take medicine regularly. Students who during the week faced challenges with following the required dosing scheme came to more nuanced realizations that medicine adherence requires special efforts and restricts one's daily life; hence, negative emotions were involved in the learning process. ConclusionsThe design of the simple patient simulation exercise gave rise to new types of insights into real patients' lives with medicines. Negative emotions due to interference between the requirements of the exercise and students' normal social lives, as well as commitment to the exercise, were important aspects of this process.

Designing an Effective Governance Model for Data Collaboratives

Overview: Data Collaboratives have gained traction as interorganizational partnerships centered on data exchange. They enhance the collective capacity of responding to contemporary societal challenges using data, while also providing participating organizations with innovation capabilities and reputational benefits. Unfortunately, data collaboratives often fail to advance beyond the pilot stage and are therefore limited in their capacity to deliver systemic change. The governance setting adopted by a data collaborative affects how it acts over the short and long term. We present a governance design model to develop context-dependent data collaboratives. Practitioners can use the proposed model and list of key reflective questions to evaluate the critical aspects of designing a governance model for their data collaboratives. Practitioner Takeaways: Practitioners can develop a detailed understanding of the governance factors that influence the successful creation of data collaboratives. The governance design process model offers practitioners a tangible roadmap and concrete activities to help them revamp an existing data collaborative or create a new one. The list of reflective questions can guide practitioners’ initial design efforts and help them assess the robustness of their data collaboratives’ current governance models.