Iranian Journal of Medical Education

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Introduction: Reflective thinking has been emphasized as an effective educational strategy by many researchers but there are few qualitative researches regarding the results of its application. This research was conducted to find out the mechanisms by which reflection on practice affects clinical experiences. Methods: This qualitative study was performed as grounded theory. The participants were twenty 4th year nursing students having 10 weeks experience of reflective thinking program. A guide on reflective thinking was given to students who were asked to write their thoughts about experiences obtained in clinical environment in their personal journals and give them to the researcher on a weekly base. Then, they received an appropriate feedback based on the scales of reflective thinking levels and thinking strategies in nursing. At the end of the mentioned time, students participated in focus group interviews in two groups of ten. Transcripts were analyzed through qualitative method and were coded in three stages during which the data were categorized and named. The names of categories are the themes of this study. Results: Findings demonstrated that the process of reflective thinking influencing clinical experience emerges in 5 domains of caring, thinking, theory and practice integration, self-regulatory mechanisms and motivation. Conclusion: Students’ experiences in reflective thinking show that reflective thinking leads to having holistic approach toward patients, affecting thinking, integrating theory and practice, and improving self-regulatory mechanisms and motivation. Motivation variable as a central variable influences 4 other themes and is also affected by them. The element of motivation could be added to this cycle as a central variable. Integrating reflective thinking in nursing programs is recommended.

Keywords: Reflective thinking, Thinking, Nursing, Learning, Clinical education.

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