The role of collaborative reflections in clinical practice: using an asynchronous online learning environment to promote reflective learning in nursing education

Nurse education has widely adopted reflective practice during clinical practicum in the form of individual reflective journals in order to enhance learning in the clinical experience. Major problems with this style of reflection have become evident through a review of the research literature, including issues with trust, difficulty choosing the experiences that might be reflected upon, the honesty of reflection, lack of feedback and a propensity to reflect at descriptive levels. These deficits have led many to question the value of reflection during the clinical placement, while others argue that a distortion of the purpose of reflection itself occurs. A limited number of studies have challenged the method of reflection during nursing practicum, most producing minor, or resource inhibitive recommendations without meaningful follow-up studies to verify their merits. A reflective asynchronous environment was incorporated into the practicum of first year nursing students in an Australian university. Peers were directed to post reflections and respond to reflections of peers. A case study approach incorporated analysis of data from the peer reflections to determine themes and quality of reflections. A questionnaire and a focus group session were undertaken to corroborate reflective data and provide insight into participant perspectives of the new environment. Findings indicated that improvement in reflective levels related to engagement with the new environment. Participants were able to validate peer experience, leading to enhanced trust, honesty of reflection and quality of reflection, addressing many issues identified in individual reflective journals. This study provides an exploration of a new reflective approach, the merits of which directly challenge the entrenched method of individual reflection.