Reflective journaling to decrease anxiety among undergraduate nursing students in the clinical setting

Abstract

Objective: Many nursing students experience anxiety in the clinical setting. Increased anxiety impairs students’ ability to learn and can negatively affect patient safety. To promote student learning and patient safety, it is imperative that nurse educators identify and implement strategies to decrease nursing students’ anxiety. The purpose of this qualitative study was to determine how undergraduate nursing students perceive the impact of writing reflective journals on their anxiety level associated with their first clinical rotation experience early in their program of study.

Methods: Participants were randomly assigned by their clinical group to either write guided reflective journals, non-guided reflective journals, or no reflective journals during their first clinical rotation where they provided patient care. Five individuals from each intervention group were randomly selected to participate in an interview. Themes related to the participants’ perceptions of the impact of writing reflective journals on their anxiety were determined through qualitative analysis.

Results and implications: Participants who wrote guided or non-guided reflective journals experienced decreased anxiety associated with their first clinical rotation. Participants in the non-journaling group expressed that they would have benefitted from having a journal assignment. Four themes were identified related to experiences with writing journals: allowed time, identified feelings, assisted with processing, and increased confidence. The findings of this study support the use of reflective journals as a pedagogical intervention to decrease nursing students’ anxiety associated with the first clinical experience. Additional benefits of the reflective journaling included taking time to identify and process feelings and increased confidence in future clinical experiences.