"I will go if I don't have to talk": Nursing students' perceptions of reflective, debriefing discussions and intent to participate.
BACKGROUND/OBJECTIVES
The ability to be a reflective practitioner is recognized by nursing regulatory bodies as a component of professional competence and becoming a reflective practitioner is an essential part of learning to become a nurse. In this multi-site study, we explored undergraduate nursing students' beliefs, capacities and intentions to participate in reflective, debriefing discussions facilitated by clinical instructors. At the same time, we tested the effectiveness of a period of rest and an intervention designed to refresh and inspire them.


DESIGN
A randomized crossover design.


SAMPLE
Our analyzed sample consisted of 106 students; 87.7% were female and 65.1% were less than 20 years old.


METHOD
This study was guided by the Theory of Planned Behaviour and consisted of five steps: instrument development, recruitment, random assignment to intervention, data collection at two time points using four tools, and data analysis. One hundred and forty-one first year nursing students used a learning management system to sign up to one of 15 potential clinical groups; maximum 10 students per group. Eight groups were randomly assigned to an intervention during post-clinical discussions; seven groups participated in the usual post-clinical discussions for the same length of time. After six weeks, the groups 'crossed-over' (switched).


RESULTS
Students had a negative attitude towards routine discussions that occur after clinical practice experiences which did not significantly improve despite a period of rest and an intervention. Most did not feel in control and felt social pressure to participate. Additional results revealed that most students arrived at reflective post-clinical discussions with an underlying intent not to talk. Intent to remain silent (not participate) did not significantly improve despite a period of rest and intervention.


CONCLUSIONS
The context and timing of the routine discussions may dramatically influence students' decision-making regarding intent to participate. Reflective processes require time and routine reflective debriefing discussions could be delayed until later in the week after students have had a chance to absorb and assimilate their experiences.
['Andersen|Elizabeth|E|', 'Olsen|Lise|L|', 'Denison|Jacqueline|J|', 'Zerin|Ismat|I|', 'Reekie|Manuela|M|']
D000328:Adult D002983:Clinical Competence D005260:Female D006801:Humans D033182:Intention D007858:Learning D008297:Male D010465:Perception D011582:Psychological Theory D013338:Students, Nursing D011795:Surveys and Questionnaires D013850:Thinking D055815:Young Adult
Students Reflection Debriefing Discussions Intentions Participation Undergraduate Clinical