Journaling as a Metacognitive tool: A Reflective Exercise in Nursing Education

Introduction

First year nursing students were asked to complete reflective journaling assignments over the course of the semester. Reflective journaling has been identified as an effective method for cultivating higher-order thinking in nursing education settings. The application of metacognition, or higher-order thinking, can enhance nursing students’ self-awareness of cultural humility, thereby promoting empathy, reducing implicit bias, and increasing their propensity to deliver patient-centered, culturally appropriate care. In this context, nursing students were assigned to community organizations, which serve diverse populations, to deliver health education tailored to community needs. 

Goals and Methods

A deductive qualitative approach with interrater reliability was utilized to investigate the enhancement of awareness and metacognition by analyzing the depth of student reflections. Each student completed three reflections based on provided journal prompts over five weeks while engaged in a community setting. Utilizing an evidence based  rubric the reflections were assessed for depth and further categorized into levels of depth by evaluating them for descriptive, emphatic, analytic, and metacognitive elements, which corresponded to low to high levels of depth, respectively.

Results

A total of 63 reflective responses were coded and analyzed  using Dedoose Software. Key words, phrases and idea development contributed to assessing the excerpts as aligning with one of the four  levels of depth. Examination of the excerpts  suggest  overall student growth from predominantly a descriptive level (level one) to an analytic level (level three). 

Conclusion 

The study results led to two main conclusions. One, guided reflections promote metacognitive processes within a community based student practicum course. Two, inclusion of guided reflections has potential as a valuable pedagogical tool to be integrated across the nursing curricula.