Exploring reflection as a process embedded in experienced nurses' practice: a qualitative study


Correspondence to M.E. Asselin: e-mail: masselin@umassd.edu



This article is a report of a study aimed at obtaining an in-depth description of how experienced acute care staff nurses perceive and use reflection in clinical practice.


Reflection is viewed as a critical component of professional practice. The basic assumption is that reflection involves a deliberate process of thinking about a clinical situation which leads to insight and a subsequent change in practice. Several prescriptive models for reflection exist to provide a guide for reflection, however, few are grounded from an empirical examination of reflection in practice. There is a dearth of empirical data on what is actually happening in practice.


Descriptive, qualitative.


In-depth interviews with 12 experienced acute care staff nurses in a community hospital in Northeastern USA was used to address the study aims. Data were collected between November 2009–May 2010.


Examples of reflection were embedded in patient situations needing immediate nursing intervention. Reflection was a process involving four phases: Framing of the Situation, Pausing, Engaging in Reflection, and Emerging Intentions.


Experienced nurses used a process of reflection-on-action in practice. They gained insight and formulated intentions for change in nursing practice. Structured facilitated reflection might assist nurses in achieving a depth of reflection necessary to move from their intentions to changes in practice.