Guided reflection as a tool to deal with the theory– practice gap in critical care nursing students

Abstract

Critical care nursing students experience inconsistencies between the theoretical content they have learnt and what is expected from them in practice, which retards the learning process. This has been described as the theory–practice gap. There seems to be no single solution to address the integration of theory and practice. In an attempt to bridge this gap, a study was done to establish the influence of guided reflection on critical care nursing students in dealing with their theoretical and practical experiences. A qualitative, explorative, descriptive and contextual design was followed. An instrument for guided reflection was designed which was used during semi-structured interviews during the data collection process. Field notes and narrative descriptions were also used as means to collect data. Themes that emerged from the data included a description of incidents experienced, critical analysis of knowledge, critical analysis of feelings and changed perspective experienced. Theory–practice integration occurred to an extent in some of the categories; conversely, the inability to apply theory to practice evoked responses such as feelings of guilt and incompetence. Guided reflection appeared to have assisted the participants in clarifying theoretical and practical experiences, and in reaching a changed perspective by understanding the link between theory and practice. Guided reflection ought to be incorporated in the education of nurses from their basic training in theory and practice so that student nurses will be aware of their own competencies in order to provide optimal patient care.

Opsomming

Kritiekesorgverpleegstudente ervaar teenstrydighede ten opsigte van dit wat hul geleer word en wat van hul in die praktyk verwag word wat weer die leerproses vertraag. Dit word as die teorie–praktykgaping beskryf. Daar blyk geen enkelvoudige oplossing te wees vir die integrasie van teorie en praktyk nie. In ’n poging om die gaping te oorbrug, is ’n studie oor die invloed van begeleide refleksie op kritiekesorgverpleegkundige studente se teoretiese en praktiese ervaringe gedoen. ’n Kwalitatiewe, verkennende, beskrywende en kontekstuele navorsingsontwerp is gevolg. ‘n Instrument vir begeleide refleksie is ontwerp wat gebruik is tydens semi-gestruktureerde onderhoude in die data-insamelingsproses. Veldnotas en narratiewe beskrywings was ook middele ten einde data in te samel. Tema’s wat uit die data na vore gekom het was ‘n beskrywing van ervaringe, kritiese analise van data, kritiese analise van gevoelens en ‘n veranderde perspektief met betrekking tot ervaringe. Teorie–praktyk integrasie het tot ‘n mate in sommige kategorieë plaasgevind het. Daarinteen het die onvermoë om die teorie in die praktyk toe te pas response tot gevolg gehad, soos skuldgevoelens en gevoelens van onbevoegdheid. Dit wil voorkom asof begeleide refleksie die deelnemers gehelp het om duidelikheid en ’n veranderde perspektief ten opsigte van hul teoretiese en praktiese ervaringe te verkry. Begeleide refleksie behoort reeds vanaf basiese opleiding in verpleegkundiges se teoretiese en praktiese opleiding geïnkorporeer te word sodat verpleegkundiges bewus sal wees van hulle eie vaardighede om sodoende optimale pasiëntsorg te kan lewer.