Reflection in Clinical Contexts: Learning, Collaboration, and Evaluation

Reflective practice is based on the fundamental principle of continuous learning through a process of self-assessment and integration of knowledge with experience. As such, it highlights the responsibility of professional nurses to adopt an open attitude and lifelong commitment to assessing and continuously improving their work. Helping professional nurses develop these qualities requires educational approaches that include open, interactive dialogue between learners and teachers. Learners need opportunities to tell their stories, especially about clinical events, in order to meld experiential learning with theoretical learning. Reflective exercises in clinical learning environments can build mental habits that carry over into professional nurse roles, whether as a clinical nurse, nurse educator, or nurse leader. Fostering a reflective philosophy of self-assessment and learning from all experiences is a habit of the mind essential to sense-making in practice and establishes lifelong learning. There is little evidence to guide nursing clinical curricula to best implement reflective learning. Reflective learning shifts from a teaching paradigm to a learning paradigm. Traditional clinical evaluative methods that rely on objective measures might not reveal the changes in attitude and behavior that derive from reflective learning. In reflective paradigms, the learner engages in self-monitoring, so there is an assessment value even within the learning experience. Educators and learners maintain openness and flexibility in the dialogue that emerges from reflective journaling and other means of feedback. This chapter will explore ways to facilitate reflection, primarily in the clinical learning context, and provide feedback to learners that is consistent with reflective learning. We will discuss how the increasing application of reflection in higher education challenges us to rethink clinical assessment and evaluation. The philosophy of learner-centered education promotes co-creating the learning environment in a partnership between learners and educators. We will explore ways to develop a reflective clinical learning environment open to inquiry and continuous learning as the foundation of self-monitoring and evaluation