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PubMed1998

How Excellent Teachers Are Made: Reflecting on Success to Improve Teaching.

The authors surveyed forty-eight distinguished teachers from clinical departments regarding the role of instructional successes in learning to teach. Using qualitative content analysis of comments, the authors identified nine common successes in clinical teaching associated with planning, teaching, and reflection. In anticipatory reflection used for planning, common successes occurred by involving learners, continuously innovating, creating a positive atmosphere for learning, considering the learners, engaging the learners, preparing adequately, and limiting content. When reflecting-in-action, the success experience most commonly mentioned was maintaining flexibility in action. Reflecting-on-action after a successful teaching event, they commented on the importance of thoughtful analysis and choosing an appropriate strategy. These teachers incorporated reflective practice into their teaching as an essential component of professional development and incrementally improved their teaching based upon successful instructional experiences.

Journal Article↗

PubMed2004

Initiation of reflective frames in counseling for Huntingtons Disease predictive testing.

Genetic professionals and clients are likely to assign different meanings to the extended format of the counseling protocols for predictive testing. In order to facilitate informed, client-centered decisions about the possibility of predictive testing, counselors routinely use the question format to initiate what we call "reflective frames" that invite clients to discuss their feelings and encourage them to adopt introspective and self-reflective stances toward their own experience--spanning the past, the present, and the hypothetical future. We suggest that such initiations of reflective frames constitute a key element of counselors' nondirective stance, although the exact nature of their formulations can be complex and varied. Examining 24 Huntington's Disease (HD) clinic sessions involving 12 families in South Wales with the tools of discourse analysis, our focus in this paper is twofold: (i) to propose a classification of six types of reflective questions (e.g. nonspecific invites, awareness and anxiety, decision about testing, impact of result, dissemination, and other) and to examine their distribution across the various clinic appointments, and (ii) to investigate the scope of these questions in terms of temporal and social axes. We link our analysis to the current debate within the genetic counseling profession about the merits of reflection- versus information-focused counseling styles and the need to abide by professionally warranted and institutionally embedded counseling protocols.

Adaptation, Psychological↗

PubMed2000

Are the discrepancies between self- and others' appraisals of competence predictive or reflective of depressive symptoms in children and adolescents: a longitudinal study, Part II.

Two cohorts of children and adolescents (who started 6th grade in 1993 and 1996), parents, teachers, and peers participated in a 4-wave, 2-year, longitudinal study of perceived competence and depressive symptoms. The authors assessed children's tendencies to underestimate their competence (discrepant self-appraisals) relative to the appraisals of significant others. We also assessed the degree to which self-appraisals reflected the evaluations of others (reflective self-appraisals). Domains of competence were academic competence, physical appearance, behavioral conduct, social acceptance, and athletic competence. Cross-sectional analyses indicated that depressive symptoms correlated with reflective and discrepant self-appraisals. Longitudinal analyses revealed that reflective and discrepant self-appraisals predicted subsequent depressive symptoms and that depressive symptoms predicted discrepant but not reflective self-appraisals. Clinical implications of the findings are discussed.

Adolescent↗

PubMed1987

Critical self-reflection and self-perceived altruism: when self-reward fails.

Social learning theory has produced a three-step model of prosocial development: In the young child, prosocial behavior is elicited by material rewards; in the older child, it is elicited also by social rewards; and in the morally mature adult, it is elicited by self-rewards based on an internalized perception of oneself as a kind, caring, altruistic individual. Self-perception theory has complicated this social learning model by demonstrating that once the third step is reached, the continued presence of material and social rewards may undermine intrinsic prosocial motivation based on self-rewards, producing moral regression. We propose a further complication. Critical self-reflection--the desire to know thyself, warts and all--may introduce a self-deprecating attributional bias that can undermine self-perceived altruism, even following helping for which one receives only intrinsic self-rewards. Two experiments are reported in which we manipulated critical self-reflection on one's reasons for helping. Results indicated that self-reflection undermined self-perceived altruism, especially when the salience of the self-rewards for helping was high. Experiment 2 also provided evidence that, as predicted, this self-reflection effect was most apparent for individuals who valued self-knowledge more highly than concern for others. Moral consequences of critical self-reflection are discussed.

Altruism↗

PubMed1998

The role of attention in priming for left-right reflections of object images: evidence for a dual representation of object shape.

Three experiments investigated the role of visual attention in priming for object images and their left-right reflections. Objects to which participants attended were visually primed in both the same view and in the left-right reflected view; ignored objects were primed only in the same view. The effects of attention (attended vs. ignored) and view (same vs. reflected) were strictly additive. These results suggest that 2 separate representations mediate human object recognition (J.E. Hummel & B.J. Stankiewicz, 1996): One requires attention but is invariant with left-right reflection, whereas the other can be activated automatically but is sensitive to left-right reflection. Both representations appear to be invariant with translation across the visual field.

Analysis of Variance↗

PubMed1984

Reflectivity bias in picture-pointing grammatical comprehension tasks.

Two studies, one correlational and one experimental, supported the hypothesis that 4- and 5-year-olds' performance on a picture-pointing grammatical comprehension task administered under standard procedures is highly influenced by reflectivity style. In the first study, a substantial correlation was obtained between reflectivity and picture-pointing grammatical comprehension task performance. This correlation was significantly greater than that between reflectivity and object-manipulation grammatical comprehension task performance. In the second study, a reflectivity-promoting but grammatically irrelevant modification in the administration of the picture-pointing task resulted in significantly improved comprehension scores and a significantly lower correlation with reflectivity.

Age Factors↗

PubMed1997

Developing the reflective teacher.

The conceptual issues and research findings surrounding the meaning and use of reflection are examined in this paper and serve as a foundation for discussing significant assumptions and beliefs regarding the use of reflection in nursing education. The strengths and limitations of reflection are discussed. The paper links current knowledge about reflection to the development of reflective thinking and its use by nurse educators and suggests strategies to enhance this development.

Curriculum↗

PubMed1998

Reflection and nursing education.

The notion of reflection has become a significant concept within nursing education. What is it? How is it learned/taught? How is it implemented in practice? This paper explores reflection as both a technique and a purposeful inter-subjective process. Some of the current theoretical underpinnings of reflection, with particular attention to a Heideggerian perspective, are examined. It is suggested that the Heideggerian notion of reflection as the integration of calculative and contemplative thinking is an effective way to consider the concept of reflection.

Education, Nursing↗

PubMed1998

Reflection and patterns of knowing in nursing.

Over the last decade nursing has progressed from a reliance on empirical theory applied to practice to a recognition that experience develops knowledge that can guide the actions of practitioners. Reflection is a means of surfacing experiential knowledge, and students may begin to use reflection as their experience of nursing accumulates. As Carper was a key figure in widening that knowledge accepted as knowing in nursing beyond the empirical, it is both justified and recommended that her work should be incorporated into reflective practice. Johns has integrated Carper's work in his model of guided reflection and this paper briefly examines this combination. The main focus is on two further patterns of knowing: unknowing and sociopolitical knowing. These patterns are examined and the contribution they could make to reflective practice is discussed.

Education, Nursing, Continuing↗

PubMed2000

Barriers to learning from reflection: a study of the use of groupwork with post-registration nurses.

There are few studies which describe the use of groups to facilitate reflection and even fewer which evaluate the effectiveness of such groups. Much of the literature discussing the techniques used to facilitate reflection suggests that learners willingly engage in such processes and find them enjoyable. This paper reports on a qualitative study of the use of groups to develop learning through reflection on a part-time post-registration diploma programme for nurses. The findings suggest that there are many barriers to learning which must be overcome before practitioners can use the opportunities to reflect on and learn from their experience. It is also contended that such learning may not necessarily be an enjoyable experience. The findings suggest that previous educational experience and the current culture in which nurses and midwives work, impose tremendous barriers to reflecting on, and learning from, experience. In particular these affect the willingness of learners to expose themselves to the judgement of others and their ability to be open to taking responsibility for their own learning. Other barriers to learning in groups are the effects of other group members, their commitment or resistance to shared learning, the ways in which group members interact with each other and facilitation styles.

Education, Nursing↗

PubMed2001

A discussion of the strengths and weaknesses of 'reflection' in nursing practice and education.

This paper begins by exploring the principles underpinning 'reflective practice'. The impact of reflection on the nursing profession is discussed, with particular attention being paid to nursing education. The value of reflective practice in nursing has been subject to considerable debate. This paper reviews both the claimed strengths and shortcomings of 'reflection', particularly in relation to the use of reflective material in the assessment of students.

Curriculum↗

PubMed2001

Carers' reflections about their video-recorded interactions with patients suffering from severe dementia.

Stimulated recall interviews were used in connection with carers' video-recorded interactions with patients suffering from severe dementia before, during and after a 1-year intervention involving supervision for individualized nursing care. The aim was to illuminate carers' reflections on their everyday life with the patients, and to find out if any changes took place across the intervention. A phenomenological-hermeneutic approach was used in the analysis, which revealed that carers' reflections were focused on the carers themselves, on the patients, on context and on the work itself in the shared everyday life. After repeated stimulated recall interviews, together with supervision every month, an improvement in carers' ability to verbalize their reflections and an awareness and knowledge about their own influence on care quality were seen. The interdependence between carers and patients made it necessary for the carers to cope with many complicated here-and-now situations, and in their reflections the carers kept coming back to their efforts to maintain a sense of dignity for the patients as well as for themselves. Reflection through stimulated recall seems to be an important tool for carers in dementia care to facilitate understanding and to help them learn through lived experience, thus developing their skills in nursing care.

Activities of Daily Living↗

PubMed1999

Use of reflective practice in introducing change on the management of pain in a paediatric setting.

AIM: The paper describes the application of a reflective model devised by the author, in the management of paediatric pain within a district hospital. BACKGROUND: The issue of bridging the theory-practice gap in nursing has encapsulated the workings of both nurse practitioners and theorists for many years, not least in the management of paediatric pain. METHODS: The reflective model, divided into seven stages, demonstrates the way in which reflective practice and management of change can be integrated. FINDINGS: Applying this model highlighted nurses' concern themselves with a theory-practice gap, but was also evident of a theory (practice knowledge)-theory (official scientific knowledge) gap that needs to be acknowledged. CONCLUSION: It is predicted that the integration of reflective practice with management of change will be useful to nurse practitioners and theorists alike who have sought to address the issue of a theory-practice gap in nursing by embracing the concept of reflective practice.

Child↗

PubMed1999

Studies on optical properties of two commercial visible-light-cured composite resins by diffuse reflectance measurements.

Two commercial visible-light (VL)-cured composite resins were examined for their optical properties by diffuse reflectance measurements in VL spectrum and Kubelka-Munk's theory. Cured Silux Plus displayed diffuse reflectance similar to that of cured Z100, although uncured Silux Plus showed diffuse reflectance less than that of uncured Z100. By Kubelka-Munk's analyses, two optical constants of the composites at eight wavelengths such as absorption and scattering coefficients were calculated using the difference in diffuse reflectance of the composites backed between white and black standards. Upon curing, the two optical constants of the composites significantly altered especially in the shorter wavelengths. By lowering the wavelength, two optical constants of the composites tended to increase, giving rise to less light reflection and transmission. The theoretical optical transmittance of the composites was expressed in terms of hyperbolic functions of thickness of the composites at eight wavelengths in VL, dependent upon the two optical constants. The actual optical transmittance of 1 mm composites were fairly comparative with the theoretical values at 1 mm. The depth of cure of the two composites matched well with the thickness of the uncured composites which yielded the minimum theoretical optical transmittance in the wavelength region of 400-500 nm.

Composite Resins↗

PubMed2002

Effects of hydrogen peroxide on the light reflectance and morphology of bovine enamel.

The purpose of this study was to examine the effects of a bleaching agent (30% hydrogen peroxide) on the surface of bovine enamel using a scanning electron microscope and a UV-VIS-NIR spectrophotometer. Five non-carious bovine incisors were bleached for 0, 1, 2 and 3 days using 30% hydrogen peroxide. The light reflectance spectrum was measured using a spectrophotometer with diffuse reflectance mode. Colour values and colour differences in the teeth were evaluated from the reflectance measurements with the CIE L*a*b* colour coordinate system. Surface alterations in the bleached and unbleached teeth were studied using a scanning electron microscope. The change of reflectance in the teeth was related to the change of colour. Most reflectance change occurred within a 1-day bleaching, and this result was confirmed by a CIE L*a*b* colour coordinate system. The colour differences in the bleached teeth were significant enough to be perceived by the observer's eye. The comparison of bleached to unbleached bovine enamel revealed that the bleached surface showed non-uniform slight morphological alterations, and it developed varying degrees of surface porosity. This study indicates that the bleached bovine teeth showed apparent colour differences as well as slight morphological alterations after bleaching.

Animals↗

PubMed1999

Reflection as empowerment?

Reflective practice, as an ideal model, is generally espoused as a developmental process to empower practitioners to achieve and sustain effective practice. Yet when reflective practice is accommodated into the real world of everyday practice can this ideal itself be realised? Or will reflective practice be accommodated within existing norms whereby it becomes another technology of surveillance? The paper draws on dialogue taken from a guided reflection session to consider whether reflection can be empowering and to consider those factors which limit this potential.

Female↗

PubMed2002

Reflective practise in clinical teaching.

The present paper describes the process of reflective practise in clinical teaching through a workshop entitled 'Effective Clinical Teaching'. The clinical teachers were invited to analyze the content of a videotape in which various clinical teaching scenarios were presented. Following this, they discussed a series of questions designed to promote reflective activities and evaluated the interaction among the student, the client and the clinical teachers in each scenario. The teachers also identified the positive and negative aspects of the teaching approaches portrayed on the tape. Finally, the participants made recommendations that would improve the interaction and suggested alternate teaching strategies to enhance the learning outcome. In addition, there was sharing of clinical teaching experiences among the clinical teachers. Through this process of reflection on action, the clinical teachers were able to understand various teaching approaches as perceived by students, and to address the issues that might hinder student learning in clinical settings. Different reflective activities have also been proposed to enhance student's reflective learning skills.

Clinical Medicine↗

PubMed2001

Fluorescence, reflectance, and light-scattering spectroscopy for evaluating dysplasia in patients with Barrett's esophagus.

BACKGROUND & AIMS: The aim of this study was to assess the potential of 3 spectroscopic techniques (fluorescence, reflectance, and light-scattering spectroscopy) individually and in combination, for evaluating low- and high-grade dysplasia in patients with Barrett's esophagus (BE). METHODS: Fluorescence spectra at 11 excitation wavelengths and a reflectance spectrum were acquired in approximately 1 second from each site before biopsy using an optical fiber probe. The measured fluorescence spectra were combined with the reflectance spectra to extract the intrinsic tissue fluorescence. The reflectance spectra provided morphologic information about the bulk tissue, whereas light-scattering spectroscopy was used to determine cell nuclear crowding and enlargement in Barrett's epithelium. RESULTS: Significant differences were observed between dysplastic and nondysplastic BE in terms of intrinsic fluorescence, bulk scattering properties, and levels of epithelial cell nuclear crowding and enlargement. The combination of all 3 techniques resulted in superior sensitivity and specificity for separating high-grade from non-high-grade and dysplastic from nondysplastic epithelium. CONCLUSIONS: Intrinsic fluorescence, reflectance, and light-scattering spectroscopies provide complementary information about biochemical and morphologic changes that occur during the development of dysplasia. The combination of these techniques (Tri-Modal Spectroscopy) can serve as an excellent tool for the evaluation of dysplasia in BE.

Barrett Esophagus↗