Accompagner les infirmières et les étudiantes dans la réflexion sur des situations de soins : un modèle pour les formateurs en soins infirmiers

Abstract

The reform of nursing education programs and their gradual shift to a competency-based approach lays the groundwork for the introduction of active teaching strategies. These strategies focus on exposing learners to situations similar to those they will encounter in their professional practice, while encouraging them to reflect on their learning processes. This approach is akin to the process by which clinical judgment develops, which would build on reflection on past clinical experiences (Tanner, 2006). This article defines a model to support the development of clinical judgment among nurses and student nurses by having them reflect on various care scenarios. The proposed model draws on Dewey’s theory of experiential learning and reflective thinking (1909/2007, 1938/1997) and includes elements of Tanner’s model of clinical judgment in nursing (2006). An educator helps learners through the reflective process by asking open-ended questions. For learners, the reflection includes communicating their impressions of a difficult care situation, arriving at and expanding on one or more hypotheses to explain the situation, and testing relevant responses to a given situation. Throughout the process, learners are asked to reflect on how their beliefs about their nursing role, previous nursing and personal experiences, emotions and formal knowledge is impacting their response to the situation in question. This article illustrates how the model under consideration can be incorporated into different active teaching strategies, including the debriefing process associated with clinical simulations or within the context of ongoing clinical training. Research evidence shows that the model’s implementation is feasible, acceptable and beneficial and as such, an aid to learning. The strategy may also prove useful in other active learning environments, one of these being clinical placements.