Nurse educators often require students to write about their experiences in reflective journals or discuss them in clinical conferences, yet Sherwood and Horton-Deutsch1 note that educators rarely use a model or systematic approach to guide reflective learning experiences so that new awareness and insight occur. When reflection is used systematically to promote learning, changes in behavior and attitudes are more likely to occur, because students "make sense of the experience" and develop skills in determining better choices for their actions in the future.
In an undergraduate leadership course, we designed an assignment to use structured reflective practice to enhance student learning of 2 essential components of leadership: leadership style and assertive communication. Our assignment gave students tools with which to assess their own leadership styles and assertiveness, guided them to examine how these characteristics applied in a situation in their professional or personal lives, and steered them to reflect on possible areas for growth or change. We designed a rubric to guide students in systematic reflection in the model we used in this assignment and evaluate their achievement. The purpose of this article is to describe the reflective practice assignment and examples of student responses that demonstrate insights students gained.
Reflective Practice in Leadership Writing Assignments
Our assignment guidelines for students were based on Driscoll's Model of Structured Reflection2 and the Reflective Cycle by Gibbs3 and are consistent with Armstrong and Sherwood's4 guidance on using reflective practice to improve performance and make better choices in the future situations. Driscoll's2 Model encourages nurses and nursing students to use trigger questions to describe, analyze, and "action" new learning from experiences that occurred during clinical practice. The trigger questions encourage participants to reflect on their own and other's reactions, then move from "what happened?" to "so what?" to "now what?" Gibbs reflective cycle3 is similar to Driscoll's Model, as the nurses or nursing students describe what happened, then record what they were thinking and feeling, explain what was good and bad about the experience, analyze the "sense" they can make of the situation, conclude what else they could have done, and finally, develop an action plan of what they would do if the situation arose again. As Armstrong and Sherwood note: "the essence of learning through reflection is for practitioners to draw out contradiction between what they intend to achieve within any situation and the way they actually practice."4(p27) Because thinking about such contradictions can be uncomfortable, and there is a natural tendency to avoid that, it is essential to provide learners with structure and guidance so they can begin to identify opportunities and develop skills to bring their practice in line with their values and desired outcomes.
Discussion of the paper assignments and grading rubric at the beginning of the course was tied to the purpose, methods, and benefits of reflective practice. Content on reflective practice was also included in assigned readings from students' textbook, and the information was reinforced before students embarked on the assignments.
In the assignments, students were directed to write 2 short papers reflecting on their leadership and communication styles, assertiveness, emotional intelligence, and ethical instincts and how these characteristics influenced actual occurrences in their lives. Supplemental Digital Content 1, http://links.lww.com/NE/A305, provides the reflective practice paper assignment and grading rubric. Each paper included 3 parts: Part I was a profile of self, Part II was the application of new insights to a specific situation, and Part III was a synthesis of Parts I and II with reflections for growth. All students had previously completed a writing-intensive course and had experience writing papers for the discipline of nursing.5
For the first paper, students completed free online surveys that assessed their Myers-Briggs personality type, leadership skills and styles, emotional intelligence, and arguing, conflict management, and ethical styles. They then completed assigned readings on interpretation and use of Myers-Briggs results, leadership skills and styles, and the other topics, with particular focus on their own type and styles. The topics also were addressed in class lectures, discussions, and open-book, online examinations. The students submitted printouts of their results on these surveys with their papers. Using the survey results and information from class and assigned readings, students critically analyzed their own strengths, weaknesses, and opportunities for growth in an area of focus based on their own personal and clinical experiences.
In this first paper, students addressed whether the findings surprised them, if they disagreed with the results, the significance of the results to them, and how their styles were apparent in their personal or professional lives. After applying the findings to a concrete example from their own lives, they reflected on what they might change or develop in themselves. How would they go about making those changes? How could they use the knowledge to improve interactions with peers, patients, family, and friends? And, finally, what did they find that they do not want to change, that they could consider as one of their strengths? This first paper was evaluated and returned to students before the second paper was submitted, allowing students to incorporate faculty feedback into the second paper. Some students had individual discussions with faculty about their first papers.
For the second paper, students completed free online surveys about their assertiveness styles and tools to identify opportunities to build those skills. As with the first paper, students next completed assigned readings, class content, and online examinations on the topics and then reflected on the survey results, applied the results to a concrete example in their lives, and reflected on new insights and what they wanted to change. For this second paper, students were also asked how a mentor might help them develop areas they identified for growth.
Rubric for Evaluating Student Papers
Rubrics have several advantages over grading guidelines that simply assign points for specific criteria of an assignment. Our experience is that student work is consistently of higher quality when students have access to a rubric rather than a grading scale for the assignment. Our grading rubric was adapted from a rubric from iRubric, a rubric sharing site. Our rubric was an integral part of the assignment because it required students to undertake structured, deep reflection, and provides descriptions of our desired outcomes for assignments (see Guidelines, Supplemental Digital Content 1, http://links.lww.com/NE/A305).
Student Achievement from Reflective Practice Exercises
This assignment can be valuable when teaching leadership and management to prelicensure students, RN-to-BSN students, and, with some modifications, graduate students in leadership and nursing administration programs. Our assignments did not require that students consult or incorporate references beyond those assigned, but for graduate students, the assignments could be easily modified to require students to explore the reliability and validity of the survey tools, critique use of the exercises with specific populations of practicing nurses, or identify professional literature that supports their desired approaches or outcomes. The student papers submitted in response to the assignment indicated that students achieved numerous insights into their own personal styles, opportunities for growth and improvement, and intentions to improve their practice on future occasions. However, reflective practice is a learned skill that takes guided practice and reinforcement to develop into a routine part of one's approach to clinical situations and to life. For students to further process this information and incorporate guided reflection into their usual practice, students would need further opportunities to practice the skills, with guidance, discussion, and debriefing-preferably in courses with clinical experiences. Because students' styles and challenges varied greatly, there was not a "typical" response to this assignment, but the student responses illustrate the types of growth and achievement of insight seen in the students.
In part 1 of the paper, where students analyzed their own test results, some students said the assessments were "right on," but others disagreed or questioned the validity of the assessments. For example, 1 student said, "When looking at my arguing style test, I agree completely that I quickly engage in an argument and yet end it quickly to the satisfaction of both parties. I see why I was good at being the president of my nursing class because I was able to argue points[horizontal ellipsis]but was fair." An RN-to-BSN student who worked on the code blue team explained that by being extroverted and controlling his emotional responses, he was able to handle crisis situations. He has now included on his resume that he works well under pressure by staying in control of his emotions and actions, and communicates clearly with others in stressful situations.
Students applied their new insights about leadership styles to a wide variety of situations. Many discussed how they had responded when in conflict with another student, peer, or family member. For example, 1 student indicated that she confronted a bully at work, and now they are friends. Another student noted that the results confirmed that at this point in her life, she would not be good in a leadership position. However, she was able to manage conflict, interact effectively with others, and use her emotional intelligence successfully. She illustrated these traits when working with the family of a patient with severe Alzheimer's disease. The family members were devastated by their mother's behaviors and frequently berated the mother. The student helped the family understand and accept that their mother's behavior was due to the disease and beyond her control. The student's ability to connect with the family's emotions and intervene calmly in the conflict helped the family interact with their mother in a more caring and supportive way.
Students also reflected on what they liked about their own leadership traits and what they would like to improve. A student commented that he needed to work on his conflict management skills: "always compromising is not the best way, as people will often feel unfilled and as though they did not get what they wanted."
In the second paper, students completed the same process concerning their assertiveness styles. An RN-to-BSN student explained that as a member of the leadership team at work, she was more willing to confront her colleagues on their "bad" behaviors. Students discussed the need to be assertive in advocating for their patients, other colleagues, and other students. A student commented on how difficult it was for prelicensure students to be assertive with nurses on the unit, and he is working on his assertiveness skills.
Conclusion
These short paper assignments give students opportunities to assess their own leadership styles, skills, and assertiveness; guide them to examine how these are reflected in their own lives; and assist them to reflect on areas for growth. The grading rubric guides students to conduct deep reflection and understand the nuances of expectations for the assignment. Structured reflection is a tool that nurse educators can use to help transform students into the effective professional leaders we want them to be.
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