A Narrative Analysis of Baccalaureate Nursing Students\u27 Nurse-Patient Clinical Reflections

The purpose of this study was to identify characteristics of critical thinking in nursing students’ reflective writing assignments, which was guided by Richard Paul’s model of critical thinking. The importance of critical thinking as an outcome for students graduating from undergraduate nursing programs is well-documented by both the American Association of Colleges of Nursing (AACN) and the National League for Nursing (NLN). Graduating nurses are expected to apply critical thinking in all practice situations to improve patient health outcomes. In a previous study, Paul’s model of critical thinking was used as a basis to develop questions for reflective writing assignments. Within this study, students completed six open-ended nursing students\u27 narratives of nurse-patient clinical encounters during an eight-week clinical experience. Following completion of those assignments, improvements were seen in critical thinking scores. This is a report of the qualitative analysis of the content of student responses during the intervention. A narrative analysis approach was used. Researchers open-coded for content and three members of the research team performed repetitive readings of the narratives to enhance rigor. From these processes, narrative themes were derived. Each of the themes was defined and exemplars from the data were used to support the credibility of the findings. This study provided information as to how students critically think in and about nurse-patient clinical encounters. Identified themes provided information to nursing faculty members so that they could better understand students’ critical thinking abilities and skills