CITATION AND COPYRIGHT INFORMATION:
Cite as: Teekman, E. C. (1997). Reflective thinking in nursing practice. Master’s thesis, Massey University, Palmerstown North, New Zealand. Advisors, Julie Boddy and Brenda Dervin.
© Teekman, Engelbert Cornelius (1997).
A copy of this thesis may be obtained through the Inter-Library Loan Services from Massey University, Palmerstown North, New Zealand. Alternatively, a copy may be ordered from the author for reimbursement cost of copying and mailing (approximately US $20) by contacting the author at: e.teekman@clear.net.nz

ADVISORS:
Julie Boddy
Brenda Dervin

ABSTRACT:
While it is argued in the nursing literature that reflective thinking is the approach par excellence for learning and advancing the art and practice of nursing, few empirical studies have been undertaken in this area to date to examine these claims. This thesis presents a study of reflective thinking. Sense-Making, a qualitative research method, was utilized to obtain and analyze data from interviews from ten Registered Nurses.

After exploring the seminal works of Dewey and Schon, the concept of reflective thinking was explored and clarified in order to arrive at an operational definition. Each participant was asked to share a recently experienced “non-routine” nursing situation. Time-Line interviews of the ten events resulted in a total of 59 Micro-Moments, each of which was explored in-depth in terms of how the participants engaged in reflective thinking, and furthermore, what the focus of their reflective thought was.

The study found that reflective thinking was extensively manifest in non-routine nursing situations, especially in moments of doubt and perplexity. Reflective thinking consisted of such activities as comparing and contrasting phenomena, recognizing patterns, categorizing perceptions, framing, and self-questioning as part of discourse-with-self. The latter activity was identified as a significant process within reflective thinking. Further more, by exploring and analyzing the types of questions participants were asking themselves, the study uncovered three hierarchical levels of reflective thinking. Participants most frequently engaged in thinking processes that centered on the here and now in order to act: reflective “thinking-for-action.” On the second level, reflective “thinking-for-evaluation” participants' focused on creating wholeness of the situation and their reflective thinking contributed to the realization of multiple perceptions and multiple responses. Reflective thinking-for-critical-inquiry is the highest level of the “Reflective Thinking Pyramid” even though its occurrence could not be demonstrated in the study sample. The findings of this study resulted in the development of a “Dynamic Process Model of Reflective Thinking,” and are discussed in terms of the implications for nursing practice and nursing education. Finally, Sense-Making and in particular the Micro-Moment Time-Line approach is suggested as a framework to encourage and guide reflective thinking in nursing practice.

OTHER MATERIALS BY THIS AUTHOR ON THIS WEBSITE:
See: http://communication.sbs.ohio-state.edu/sense-making/AAauthors/authorlistteekman.html