Reflective writing: Factors that influence the successful transition of nursing students entering into their second semester of a RN-ABSN program

Abstract

Objective: Identify factors influencing the successful transition of nursing students entering into their second semester of a RN-ABSN program.

Background: Newly graduate registered nurses (RNs) are able to enter practice within weeks of graduation as fully licensed RNs. An inadvertent effect of this transition is placing new graduates into an environment that demands safe, effective and quality care. Identifying factors that influence the successful transition of nursing students entering into the second semester of an ABSN (Accelerated Bachelor of Science Nursing) program sets off ones actions, increases awareness and understanding, and promotes the development of personal experiences by means of reflective journaling. Reflective journal rubrics (personal narrative of storytelling) help to fortify the successful transformation to practice by allowing self-reflection and encourage the reconceptualization of the problem situations. Reflective journals illuminate performance expectancies and can diminish misperceptions around role. The reflective journal rubric for assessing RN performance, focused on reflective writing. The tool was developed using the modified version of written exercises by Freshwater, Taylor and Sherwood for active learning concepts used in the classroom. Reflective journaling incorporates the application of concepts and leads to increase mastery and retention of content. Additionally, it identifies important themes and offers opportunities for students to discuss essential topics for a smooth transition into their first and second semester.

Methodology: A group of seventeen ABSN students in the second semester medical surgical clinical were required to participate in the reflective journaling at the beginning and end of their experiences in training as a part of their preparation for a clinical rotation. Nurse educators, read the reflective journals to gain insight into the participants’ experience and then coded to highlighted themes. The journals were evaluated with the reflective practices of Freshwater, Taylor and Sherwood who have proposed the use of the term “art” pertinent in the context of reflective journaling in nursing. Qualitative content analysis was deemed complete when agreement was reached regarding major themes. Dependability was achieved by the researchers using the participants’ own words to support the themes and conclusions.

Data Collection: IRB approval was obtained. 17 students participated in the study and identifying themes from approximately 17 students over the past 2 years. The self-reflection rubric contained open-ended, short write-in items. Responses were anonymous. No names, email addresses, nor computer IP addresses were collected.

Results: Seventeen journals were analyzed. Students are using critical reflection to improve practice, especially with respect to Freshwaters statement ‘thinking about thinking’. The key outcomes indicated that reflective journals assist students to focus on their clinical learning during the coaching point. These following themes emerged: my preceptor was knowledgeable about nursing practice, therapeutic touch, confidence level, prioritization of patient care, caring, communication, six rights of medication administration, holistic approach and skills.

Conclusions: This study heightens most discussions on the use of reflective journals validating previous information defined in the literature with the advantages of utilizing journals in terms of fostering and stimulating reflection type to enhance first-hand learning in the nursing student’s clinical practice.