Learning by reflection from practice situations or experiences was very evident within the narratives, so much so that no participant referred to reflecting within the classroom situation. The interaction with clinical nursing situations and environments appeared to stimulate the students to learn by or through experience. This finding resonates with Dewey (1933) who argued that students’ optimum learning is in environments where they are permitted to experience and learn from social interactions. In this study the students identified that learning that occurred from practice assisted them in preparing for future similar clinical situations that they would encounter. The lifelong learning of professional practice from reflective practice is recounted by the students who recognised the importance of learning from the practice situations that they encountered. This is supported by several theorists who recognise the significance of reflective practice for lifelong learning (Dewey, 1933; Schön, 1983; Boud et al., 1985) within the environments of professional practice.
Two participants spoke at length of ‘situations’ or ‘scenarios’ or ‘incidents’. These were viewed initially as unpleasant or frustrating by the student but did not necessarily have unpleasant outcomes. Through a process of reflection the students identified the positive learning that emerged from the scenarios and suggested a sense of student empowerment. Amy referred to helping the person feel safe and being ‘really touched by that’ while Claire talked about being in a better position to care for a palliative patient who was readmitted to the ward following self-discharge. Both of these narratives highlight the complexities of professional practice and the types of professional knowledge that inform such professional practice. Schön’s theory of technical rationality is evident within the narratives. The criticism of Schön and his lament of professionals’ attempts to apply scientific theories directly to professional practice situations are apparent. The two scenarios highlighted by the students demonstrate that technical rationality as the dominant epistemology for practice is not entirely suitable as a dominant model of professional knowledge, as additional sources of knowledge are evident within the scenarios. Schön’s concept of professional artistry could be used to describe the actions of the nurses and the student when they were engaged in caring for the palliative care patient. It reflects the professional work involved when performing in uncertain and conflicting situations at work. Tacit knowledge (Schön, 1983; 1987), the knowledge that cannot be easily articulated but is based on intuitive and skilful action for which the rules and guidelines cannot be articulated, is also present within the scenario.
The narratives further suggest that the students learned from practice by critically analysing personal practice experiences. The narratives suggest that reflection was prompted by an emotional response to a situation but that, through both students’ reflection-on-action, these reflections emerged as positive and empowering experiences. This would concur with most theories of reflection in nursing: the emotional triggering point (Boud et al., 1985) followed by an analysis of the sources of knowledge (Schön, 1983; 1987; Gibbs, 1988) with an increased level of self-awareness (Johns, 1998; Thompson and Thompson, 2008). Johns’ (1998) theories of reflective practice are also evident here. Increased self-awareness,
reflection. The scenarios chosen illustrate the practice of self-focus on an experience and elements of confronting and understanding the situation, and eventually moving towards a resolution of the conflict within the situation. This resonates with critical theorists’ views of the emancipatory effects of reflection (Bulman, 2008; Finlay, 2008).
Learning from practice is recognised within the literature related to reflective practice. Peden-McAlpine et al. (2007) identified that reflective practice transformed practice for the nurses involved in the study and they indicated that they had an increased awareness of incorporating theory with practice and also developed an increased awareness of the complexities of caring for critically ill persons. In the study the participants began to appreciate the role and identity of the family members of the critically ill person, thereby deepening their level of awareness and understanding of the context of situation. Schön (1983) refers to this as contextual knowledge and regards it as an essential element of transforming knowledge into professional practice.
Schön’s reflection-in-action was not articulated by any of the participants. One possible reason for this finding is because Schön’s theory of reflection-in-action is for the more experienced practitioners (Schön, 1983) who have a repertoire of experience and knowledge to draw from and are therefore able to, as Schön argues, ‘think on their feet’ (Schön, 1983, p. 54). Schön (1987) viewed reflection- in-action as a distinctive characteristic of expert practice involving practice experts who were able to experiment and think about their practice while they were doing it and therefore to change the outcome of the action while doing it. The participants in this study were inexperienced and therefore did not have the clinical experience or knowledge to engage in Schön’s reflection-in-action.
However, the models of reflective practice the students were encouraged to use during their undergraduate education and for their reflective assignments may have resulted in the participants not referring to reflection-in-action in spite of experiencing it. Both models (Johns, 1998; Gibbs, 1988) focussed on reflection- on-action and offered a detailed framework to assist students with such reflection.
them reflect following an experience. Therefore the focus of reflective practice may have been interpreted by the students as reflection-on-action and not