Developing reflection in the curriculum

iStock [fanjianhua]
iStock [fanjianhua]
Encouraging reflection on learning is becoming increasingly central to the experience of all students within the University.  Nursing is recognised as having facilitated this approach to learning within the curriculum for a number of years. There are a variety of approaches and opportunities for reflection within the curriculum, yet students do find it challenging to move from describing accounts of their experiences; to be more critically reflective of the experience and the contribution to their future learning.

So what forms does reflection take? The student nurses are encouraged to reflect from year one of the programme through a variety of approaches.  The electronic ongoing achievement record (eOAR) is one tool used to collate reflection on learning and clinical experience throughout the four years of the students’ education.  The students reflect on aspects of each of their learning environments and how this shapes their learning and future care.  In addition a blog has been introduced as a tool for students to reflect on their learning from a clinical elective.  The students can reflect in a variety of ways using poetry, pictures, stories and critical incident techniques amongst many other approaches.

The nursing profession has experienced considerable critique for its approaches to caring and the role of University education in contributing to the care currently provided.  Through the reflective accounts of some of the student nurses currently on the undergraduate nursing programme we illustrate how reflection takes different forms for different learners and how their reflection portrays the humanity at the core of the students’ learning to nurse at the University of Edinburgh.

Kieran Burt (now a final year student) in an extract from his blog reflects on his increased understanding for the diverse and specialist skills involved in prison nursing:

‘I would describe prison nursing as the ultimate mix of nursing skills all rolled into one. It involves trauma nursing, mental health nursing, dealing with addictions, emergency situations, suicide, palliative care, a lot of medications and both minor and major injuries all in the same day. I was surprised by the amount of skills prison nurses had to have and it was clear that this placement was going to be completely different to any that I had experienced before’.

Below we share with you one of the poems developed for the eOAR. The reflective piece illustrates the caring, academic and reflective skills of the University of Edinburgh undergraduate nurses.

Ellie Jolley, when in year 2 of the nursing programme, cared for patients receiving palliative care during her long term conditions community nursing placement and wrote this poem for her reflective piece in the eOAR at the end of that spring 2017 placement.

I see tiredness and fear,

as I look into your eyes,

So I take your shaking hand,

and place it straight into mine.

Every time we speak,

you say I make your day,

I was so shy at first,

I didn’t know what to say.

My words were slow and jumbled,

What did you want to hear?

You liked hearing about my friends it seemed,

And what I’d learnt this year.

I liked washing your hair,

As you’d hum with happiness,

Because we laughed about my weekend,

and all my clumsiness!

The professional code states,

that we’re not meant to be friends,

But I’ve looked after you for weeks,

And now we’ve reached the end.

Your family couldn’t make it in time,

They live too far away,

So it’s just you and I sitting here,

It’s a bright and sunny day.

You say something so quietly,

So I listen for the words,

They’re the last thing that you spoke,

So I make sure that they’re heard.

I didn’t get to meet you,

When your body was on your side,

The view of patients’ lives,

That nurses often get denied.

You told me stories of the younger you,

And the family that you’d raised,

As I did things you once did for yourself,

You pretended you weren’t fazed.

You were the first one to leave me,

The first hand I held to the end,

And despite my student nurse badge,

I thought of you as a friend.

I’ve sat with many others now,

Given them comfort by being there,

But the room still goes cold each time,

As if it’s suddenly all bare.

Every time I wipe the tears away,

That have fallen without consent,

And I remember why I chose this path,

And what being your nurse meant.

Ellie Jolly in 2017

The blogs offer an opportunity for reflection and encourage students to engage with technology whilst enabling them to submit work for assessment from across the globe.  We plan to continue working to develop appropriate approaches to evidence reflection and enable assessment of the student nurses’ developing knowledge and skills.
Next steps:

For more ideas on curriculum development at the University of Edinburgh, see these Teaching Matters blogs:

History for the future: Update on the new pre-honours curriculum in History

Diversifying the medical curriculum using open educational resources

Fair’s Fair: embedding equality and diversity into the curriculum

Elaine Haycock-Stuart

Dr Elaine Haycock-Stuart is a Senior Lecturer in Nursing Studies, and a Principal Fellow of the Higher Education Academy, in the School of Health in Social Science.

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