Nursing Education: “The Making of a Butterfly”

The article being summarized is titled “The Making of a Butterfly: Reflective Practice in Nursing Education,” written by Jessalyn F. Barbour and published in the International Journal of Human Caring in 2013. The article elaborates on the necessity of reflective practices in nursing and sustains for them to be included in the education and preparation of future healthcare workers. The first part of the article elaborates on what reflection is and how does it connect to the purposes and concepts of nursing. Barbour identifies reflections as a cyclical form of self assessment to critically examine and explore the issue of concern. Typically, such reflections are triggered by various experiences, which present themselves as issues, and help the nurse clarify the meanings of self, knowledge, and experience concerning the issue as well as their conceptual perceptions of practice.

The cyclical nature of the reflective practice is connected to Gibb’s reflective framework, which contains the following steps: identifying the issue at hand, determining one’s feelings about the event, evaluating the positive and negative results of the action, analysis of one’s perceptions about the situation, identifying other steps that could have been made during the event, and coming up with a plan of action for the future. This framework is currently used within the majority of nurse educational facilities due to its ubiquitousness and ease of understanding.

The literature review section of the article analyzes the positive and negative sides of reflective practices. Among the positives, Barbour mentions an increase in learning opportunities, cultivation of critical thinking skills, improved chances of self-discovery, and the chance to bridge the theory-practice gap, which often occurs in novice medical students with little to no prior working experience. Among the negatives, time and general unwillingness to expose one’s thoughts and feelings to others were deemed the most critical barriers to engaging in reflection. These findings are congruent with the findings of Sikora, who stated that reflective practices require significant amounts of undisturbed time, when not performed on the fly. In addition, nurse students are often concerned with having “wrong reflections,” and trying to guess what is expected of them, instead of writing down their thoughts.

The second part of the article offers a descriptive phenomenological study performed by students in a private university of Baltimore, Maryland. The participants were asked to answer two questions, which included revealing their own stories about facilitating reflective practices, and then presenting their opinions about what would be the main barriers to doing so. The research involved 18 participants. The researchers used a thematic analysis to highlight major themes in the answers and group the results accordingly. The results largely mirrored previous findings on the subjects, such as those by Fontaine as well as the findings already cited in the literature review. Namely, that the majority of the nurses engaged in reflective practices on the go, as a means of circumventing the lack of time. Reflection after the event was also present, especially as a means of dealing with ethical and moral issues. Overall, the nurses found it to be a helpful practice that improved their quality of care and prevented burnout. In terms of barriers, fear of emotion and self-exploration, a lack of time, and a lack of operational autonomy were cited as the major barriers to operation. These are supported by Sherwood et al., who claim that the uniformity and strict regulation of practices prevent nurses from improving their performance beyond the established norms. The article concludes on a note that reflective practices should be maintained as a part of the nursing curriculum, and states that critical thinking is among the most universal qualities for a nurse to have, that will transcend space and time.

References

Arumugam B, Narayanan V, Kathiravan V, Nagalingam S. Reflective writing–how a medical student can reflect? Journal of Education Technology in Health Sciences 2017; 4(2): 47-53.

Barbour JF. The making of a butterfly: Reflective practice in nursing education. International Journal of Human Caring 2013; 17(3): 7-12.

Fontaine SJ. The role of reflective practice in professional development. The Veterinary Nurse 2018; 9(7): 340-347.

Husebø SE, O’Regan S, Nestel D. Reflective practice, and its role in simulation. Clinical Simulation in Nursing 2015; 11(8): 368-375.

Sherwood G, Cherian UK, Horton-Deutsch S, Kitzmiller R, Smith-Miller C. Reflective practices: meaningful recognition for healthy work environments. Nursing Management 2020; 27(2): 30-34.

Sicora A. Reflective practice. New York: Policy Press; 2017.