Schon reflective model in nursing

Schon reflective model in nursing
While in the nursing school, learning about theories and models of nursing will be a normal affair through to practicing in the hospital environment. This is something everyone planning to join or are already in the nursing institutions must embrace. Theories support the decisions taken by nurses in the real environment. They provide backbone to the experiments or the treatment methods.Schon reflective model in nursing:
Let’s talk about Donald Schons’ theory or reflective model. As a nursing student the first question that comes to your mind is who is Schon and what is the Schon reflective model? Well, Donald Schon is one of the theorist who came up with the reflective model theory referred to as the Schon reflective model in nursing.
What is the Schon reflective model in nursing?
Donald Schons (1983) reflective model emphasizes that professionals are like artist who can perfect their art in the process of delivery. He argues that practitioners meet situations that sometimes conflict their norms nut somehow apply real time solutions to get the job done.
What are the 3 models of reflection? He describes these occurrences in three major dimensions i.e.

Occurrence (the experience)
Mirroring ( the art of reflecting)
Working (taking action after the reflection process)

Schon’s reflective model main reflection was on action and inaction. Below are the principle in the model:

Reflection on action (after an experience)

Reflection on actions are done after an occurrence. An evaluative reflection is done then action taken afterwards. Schon argues that at this point professionals are supposed:

To be able to think on quick and fast
They should be able to come up with the next remedy
After an evaluation they are to implement the remedy

Reflection in action (During the situation)

Reflection in action are done while in the middle of the crisis. A quick solution is to be made and acted upon while in the situation. In action reflective, the professionals are to:

The professionals attend to experience the situations in real time
Think quickly while handling the situation
The decision of what to do next should be instant
The discoing should be implemented almost immediately

The theory base its arguments on the fact that professional need to think fast during a situation using the knowledge from the past experiences to solve the present crisis. Professionals should be able to continuously reflect during and after a situation. So, what does Schon say about reflection?
What does Schon say about reflection?

Understanding of the unspoken

This argument was based on an unknown knowledge or a random picking with no specific features to study. This was an argument by Michael Polanyi.

Ladder reflection model

Schon refers to this model as the ability to action, reflection and action the reflection. As a ladder the steps are repetitive and in sequence so is the ladder model. The significance of this is that learners are able to in the process when they are stuck. Climbing a ladder has a provision of coming down at the same time. In that concept it is easy to get the correct reflection in the process.

Learning in action

He argues that this is the kind of knowledge that is learn from how we perform our duties. The knowledge is gained as we act. This is seen in how a skill is implemented tactfully during execution.

Reflection-in-action (real time)

Schon referred to this model as acting on the present. This is the learning process during the action. Nurses are often in the learning process as they practice in the real environment. This allows them to be able to quickly adapt to any change in real time.

Reflection-on-action (after the an event)

In this reflective model, reflections or learning process is done after an event has occurred. Schon 1983 explains that the benefit of this model is because it held in recognizing the importance if in action especially when it come to the emergencies during the action.

Practical at workplace

He argues that in the world that is fast changing, the idea to keep pumping knowledge to learners expecting them to discharge in the live environment was not the best idea. However, he suggested that professionals should engage in reflective actions to ensure continuous learning process.

Effective attention

This model talks about the preparedness to implement new information. This model examines the student’s ability to use the newly acquired information and receive feedbacks from the activities based on the new learned information.
Evaluation of Schon model
Let us evaluate Shon’s model of reflection, its advantages and it relevance in the nursing practice. When considering Shon’s theory as a nurse you will get to understand in-depth why occurrences happen in a particular way and the reasons they are the way they are evaluating further on their possible outcomes.
This model when applied by nurses in practice they get to learn their strengths, weaknesses, opportunities and threats as they work towards perfecting their strengths and evaluating the other aspects.
For this they are able to apply logic in evaluations act with utmost care and base their arguments on established researches backed us with their encounters in the past. This helps them acquire more knowledge as they dispense.
What are the relevance of Schon’s theories?
Schon’s theories are one of the theories that has remained relevant to the practitioners even today. It is majorly used in teaching process and equipping the students on the importance of quick thinking in the face of emergencies. This is the relevance of Schon’s model of reflective in practice.
In the present nursing environment, the model has been used to improve treatments on the communicable diseases and the recent pandemic outbreak. It is undisputed that a number of quick thinking is done by professional nurses to save life of those the need resuscitation, those on ventilators and those that present mutated symptoms.
Schon’s reflective model advantages
The following are some of the advantages derived from Schon’s reflective model;

The model of practice can be adopted while in practice
When the model is well adopted it promotes deeper learning as the nurses get to understand some phenomenon and come up with better ways of handling emergencies.
The reflective practice helps practitioners to handle challenging situations they have never encountered before

What are Schon’s reflective model pros and cons
Well, as the saying goes there is no good thing that has no bad side. Schon’s model is one of the best reflective practice model in the nursing industry but it also has some limitations. Below are some of the pros and cons in the model;
The pros

The model offers a particular formula that can be adhered to
It gives a head start or hint to the students who are stranded in the practice
This model allows students to evaluate situations critically from all dimensions.
When a process is completely done with, a student is able to tell and gauge its success
It helps students explore more of their intuitive thinking while thinking on their fee
Promotes students for swift movement and creativity

The cons

Due to the rules that must be adhered to it becomes hard for nurses to create a diversion
When in the real environment the model might not be applied from the word go
It might not be applicable in all situations
Limits the students who are not fast learners

Schon’s reflective model summary
Donald Schon’s reflective model emphasizes on professionals learning more and getting exposed while on the real environment that is during the action and after a situation. He argues further that with this model practitioners are able to make concrete decisions by leaning from the tried and tested research backed with their past experiences.
His major concerns that he addressed are on the ‘reflection on action (real time experience) and ‘reflective on action (after a situation). In action entails: quick thinking and acting while in the process while on action emphasizes on afterward experience and employing an action.
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NR 439 PICOT Question Guide

NR 439 PICOT Question Guide
 NR 439 PICOT Question Guide
 
The following contains PICOT question guides/templates to use to help write questions using all of the PICOT elements.  Each template contains a guide that you can use to write a complete PICOT question, examples of PICOT elements, and illustrations[1].  Review some tips and hints below to think about for each of the PICOT elements that can help create a sound clinical nursing PICOT question:
 
P=Population of patients:     Think about a group of patients you are interested in studying—identify the group by age ranges, diagnosis/disease of interest, history or length of time with the diagnosis/disease of interest, location, unit, or setting, gender type (if applicable), race (if applicable), or other identifiable characteristics such as Medicare, Medicaid, immobile, ventilated, inpatient, outpatient, etc NR 439 PICOT Question Guide.
I=Intervention:                     Consider the nursing action or intervention you are thinking that would make a difference?  From your search for evidence, what is the evidence indicating that nurses can do to help improve the problem or issue you have chosen?
C=Comparison:                     Think about comparing to the intervention of interest or the alternative such as routine/standard care.  If no comparison, state not implementing the intervention or no comparison group.
O=Outcome:                          Reflect upon what would be the measurable, relatable indicator that would demonstrate the intervention is making a difference or not?  What would be the needed outcome that you could observe/check/measure? For example, “the pain is okay” would not be a measurable outcome.  Rates pain level less than 3 on pain scale would be measurable.
T=Timeframe:                       For this element, reflect on how long it would take to implement your study by collecting data or the time needed to observe to see if any changes occurred or will occur. Think about 1 month, 3 months, 6 months etc… Use a timeframe that is realistic.
 
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Template A
 
Among/In _________________________ (P), does______________________ (I) (**decrease/increase/impact/influence/affect/reduce/improve**) _____________________ (O) compared to ______________________________ (C) over ______________________________(T)?
(**choose one term**)
Example:
Among 65+ and older diabetic immobile adults in long-term care (P), does a bedside oral care kit and checklist protocol (I) compared to routine oral care without a bedside oral care kit (C) affect the number of times oral care is completed (O) over 3 months (T)? NR 439 PICOT Question Guide
P=Population of patients:  65+ and older diabetic immobile adults in long-term care
I=Intervention:   bedside oral care kit and a checklist protocol
C=Comparison:  routine oral care without a bedside oral care kit
O=Outcome:  number of times (frequency) oral care is completed
T=Timeframe:  3 months
Template B
Among/In _________________________ (P), would______________________(I) (**decrease/increase/impact/influence /affect/reduce/improve **)_____________________ (O) compared to ______________________________ (C) over ______________________________(T)?
(**choose one term**)
Example:
 
In male ICU patients who are 65+ and older diagnosed with COPD (P), would the confusion assessment screening tool (CAST) (I) impact the number of early identification of delirium (O) compared to no screening tool (C) over 6 months (T)?
P=Population of patients:  Inpatient male ICU patients 65+ and older diagnosed with COPD
I=Intervention:   confusion assessment screening tool (CAST)
C=Comparison:  routine care/no screening tool
O=Outcome:  number of early identification of delirium
T=Timeframe:  6 months
 
Template C
 Among/In _________________________ (P), will ______________________ (I) (**decrease/increase/impact/influence/affect/reduce/improve **)_____________________ (O) compared to ______________________________ (C) over ______________________________ (T)?
(**choose one term**)
 
Example:
Among Hispanic pregnant women between 36-40 weeks (P), will completing a lactation course (I) increase the number of breastfeeding initiations by or within 6 hours of delivery (O) compared to no lactation course (C) over 6 months?
P=Population of patients:  Hispanic pregnant women between 36-40 weeks
I=Intervention:   lactation course completed
C=Comparison:  no lactation course
O=Outcome:  number of breastfeeding initiations within 6 hours of delivery
T=Timeframe:  6 months
 
 
Template D
 
Among/In _________________________ (P), what is the effect of ______________________ (I) on ____________________ (O) compared to ___________________________ (C) over ______________ (T)?
Example:
In pediatric non-Hispanic Black males ages 8-18 years old with a 5 year history of type 1 diabetes (P), what is the effect of the Glucose Buddy Diabetes Tracker app (I) on maintaining HbA1C levels <7% (O) compared to the mySugar Diabetes Tracker Log app (C) over 6 months (T)? NR 439 PICOT Question Guide   P=Population of patients:  pediatric non-Hispanic Black males ages 8-18 years old with 5 year history of type 1 diabetes I=Intervention:   Glucose Buddy Diabetes Tracker app C=Comparison:  mySugar Diabetes Tracker Log app O=Outcome:  HbA1C levels <7% T=Timeframe:  6 months [1] Adapted from Houser (2018) and the American Academy of Ambulatory Care Nursing (AAACN). (2018). AAACN research toolkit:  Template for asking PICOT questions. NR 439 PICOT Question Guide


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