Developing reflective competence between simulation and clinical practice through a learning transference model: A qualitative study

Objective: This study sought to understand the effects of a pedagogical resource combining a multi-moment debriefing model with reflective journaling that is designed to develop reflective competence. Design: A qualitative educational study was used with an instrumental case study design. Participating in the study were 32 nursing students who wrote 96 individual reflective journals in accordance with each moment (M1, M2, M3) of the proposed reflective practice resource. The journaling was conducted during both the clinical simulation activity and the period of clinical practice. Methods: The reflective journals resulting from the high-fidelity clinical simulation process were used to explore three moments of learning: debriefing immediately after simulation, post-scenario debriefing, and clinical practice. The typology of content analysis used was classical content analysis, which followed a deductive logic, since to assess reflection levels the 5Rs Reflective Writing Scale was used. Results: In the post simulation moment (M1), students produced a greater number of meaningful units associated with a level of strategic narrative reflection. During clinical practice however reflection was more analytical, with the highest level of reflection. Conclusion: Nursing students developed reflective competence through an iterative process of reflective practice establishing a continuum between simulation experience and clinical.