Nursing

REFLECTION CAN BE SCIENTIFIC, as in light bending and folding back on itself; or personal, as in introspection. In psychiatric mental health nursing, reflection refers to the expression of one's thoughts, feelings, and beliefs, and careful consideration of his or her clinical experience. One avenue that encourages reflection is through a guided journal and an expression of an art form. Journaling allows reflection simultaneously with processing an experience so that reflection becomes a natural part of analysis and synthesis.¹ From experience, as journaling becomes a daily practice, it enhances self-awareness and awareness of others while personalizing the learning experience. A model of reflective journaling practice developed by Christopher Johns is widely used in nursing education for both student evaluation and supervision.² Applying this model of reflective journaling lets nursing faculty guide students toward being caring, holistic nursing practitioners. This model discovers and identifies students' understanding and knowledge, describing current views and allowing for growth while providing the foundation for their future practice.¹

As psychiatric mental health faculty members in the College of Nursing at the University of Texas at Tyler, we strive to emulate holistic practitioners and recognize the importance of caring for the whole person, body, mind, and spirit. A thread in our curriculum is holism—a state of positive well-being that includes physical, spiritual, intellectual, emotional, and social aspects. One definition of holistic care includes time and attention to the mind, body, and spirit.³ Individuals are more than just their diagnoses, their symptoms, and their disease process; they are searching for life meaning and comfort, and wanting to feel love and a degree of fulfillment.³ The nurse educator's goal is to demonstrate a holistic, caring attitude toward the students, one that expresses genuine and empathetic understanding. Collaboration and information exchange between educator and student sustain a positive learning environment. A quality educator aims to empower the student to formulate, assimilate, and apply nursing knowledge. Instructors encourage the student to use critical thinking, develop insights, recognize patterns, and find meaning in human experiences. However, students are ultimately responsible for their own learning, becoming autonomous learners and active participants in their education, and in this stance, their mental health clinical.

EVIDENCE-BASED PRACTICE Reflection allows the practitioner to methodically discover meaning and apply these insights in new and different situations.² Furthermore, in current theory, reflection is a "way of being," such that one should reflect within the moment. This type of reflection pays close attention to how one thinks, feels, and responds with each unfolding moment.⁴ Reflective practitioners take nothing for granted; they are in a constant state of reflection because the art of reflecting is in essence a way of being. Another study reports that intuitive knowledge is gained through the practice of reflective journaling.⁵ To round out critical thinking, studies show that reflective journaling practice develops a deeper understanding of multiple issues, provides a framework to summarize what has been learned, identifies what appears subtle or abstract, and promotes understanding to the nature and theories of teaching.⁶

Observing the intersection between psychiatric patients and students identifies student needs and personality styles. in combination with objective data, subjective information from observation can lead to a teaching moment. all too often, instructors focus on quantitative measures and miss the essence of interaction.