JMIR Publications

ABSTRACT

Background:

Social-emotional competencies (SEC) are essential for nurses to provide quality care and to maintain their own health. Historically underrepresented, nursing programs are changing their curricula to incorporate SEC-development more strongly. Although it is recommended to practice SEC during clinical placement, studies on how to support nursing students in developing these competencies are lacking.

Objective:

Our study explores second year nursing students' perceived and actual use of a reflection tool during their first 20-week clinical placement. Designed to support SEC-development, the study focuses on how students incorporate the application in their learning process for SEC-development.

Methods:

An embedded mixed method study was conducted with 15 students from a nursing program in the Netherlands. Qualitative surveys and semi-structured interviews were used to capture students' experiences with the application both during and at end of the clinical placement. Log data from the application provided insight into how the app was used. The mixed methods data was analyzed using warranted assertion analysis.

Results:

Most students remarked that the app helped them maintain awareness of their learning goals. This awareness combined with structural reflection helped students relate learning goals to clinical experiences and identify learning opportunities. The frequency and how students used the application varied. SEC-focused use was limited, with a sizeable group focusing purely on onboarding and clinical skills. Most students stopped using the application halfway through their clinical placement, as their attitude shifted from learning to working. Whether and when this shift occurred depended on how the student used the app, with similar patterns of use leading to similar outcomes.

Conclusions:

This study gives a rich description of how nursing students used a reflection application to structure their learning process during clinical placement. It reveals that smartphone-based reflection supports students in clinical placement learning. Specifically, the application lowers barriers to engage in structural reflection and decreases the mental burden of self-regulated learning. However, more guidance and a multi-modal intervention approach seem necessary for SEC-development. Further research into how to account for students' shifting attitude towards learning is needed.