Effects of Reflective Practice on Baccalaureate Nursing Students' Stress, Anxiety and Competency: An Integrative Review

Abstract

Background: Reflective practice affects all levels of nursing, including students, as well as practicing nurses. Self-reflective practice is a widespread concept in nursing; however, few empirical studies have demonstrated the possible effects of such a practice. The purpose of this integrative literature review was to identify evidence of the effects of self-reflective practice on baccalaureate-level nursing students, especially stress.

Methods: The literature search was conducted utilizing CINAHL and PubMed databases. The inclusion criteria were studies published between 2013 and 2018, articles that were peer-reviewed, written in English, and focused on nursing education of baccalaureate programs only. A total of 15 articles were reviewed.

Results: There is limited but growing evidence to suggest self-reflective practices have positive effects on baccalaureate-level nursing students. The self-reflective practices decreased stress and anxiety and increased learning, competency, and self-awareness of nursing practice. While written reflections were most commonly used in the studies, other forms of reflection, such as verbal and photography, were effective as well.

Linking evidence to action: Nursing students can benefit from incorporating reflection into the didactic and clinical settings. Nursing faculty are encouraged to integrate reflection into the nursing curriculum. Nurses within the first year of practice could benefit from using reflective practice as well. Experienced nurses and nurse managers can encourage and mentor novice nurses on the use and benefits of reflective practice.

Keywords: baccalaureate; nursing; nursing students and education; reflective learning; self-reflection.