The use of critical reflective inquiry among American Baccalaureate Nursing Students in a global service learning experience in Haiti: A qualitative study

Abstract

Background: Global service-learning (GSL) experiences are gaining increased recognition as essential nursing education components. Nursing students immersed in global communities contribute to society, through reciprocal partnerships, by improving health. GSL students should engage in reflection as a form of assessment, although there is limited empirical data on learning outcomes, and no universal model of reflection exists. The purpose of this study was to better understand the nature of practice events students chose to describe during a week-long GSL experience in Haiti, their reflective analysis, and ability to critique their experiences as a catalyst to change future practice. Methods: In this qualitative descriptive study, critical reflective inquiry (CRI) through guided journaling was utilized for ten nursing students who traveled to Haiti for clinical immersion. Data was analyzed using a template approach in relation to study aims and phases of the model. Results: CRI was a useful framework as students illuminated the progression of reflective thinking. Five categories in practice situations were delineated: a) ethical dilemmas, b) health promotion, c) professional role modeling and power of team, d) challenges in communicating and making a connection, and e) respect of the Haitian perspective. Students also articulated moral reckoning and ethical sensitivity skills not previously reported in relation to GSL experiences. Conclusions: CRI could be considered a universal model of reflection for GSL experiences among nursing students. Use of focus groups in future studies may improve recall of student experiences as they often described same practice situations. It is difficult to determine if reflection can be maintained to transform practice, but long term impacts of GSL could be studied longitudinally. In contrast to current literature, students' description of moral reckoning and ethical sensitivity skills pose a challenge to nurse educators about how to further develop these essential skills post GSL immersion.