It is an exercise for students

1. REFLECTIVE LEARNING &
CRITICAL THINKING
PIR BUX JOKHIO

2. Objectives
• Define Reflective Learning
• Discuss process of Journal writing
• Define Critical nursing
• Discuss importance of critical thinking for
Nursing education and practices

3. Reflective Learning Quotes
• Style is a reflection of your attitude and your
personality. Shawn Ashmore
• The real man smiles in trouble, gathers strength
from distress, and grows brave by reflection.
Thomas Paine
• I love those who can smile in trouble, who can
gather strength from distress, and grow brave by
reflection. 'Tis the business of little minds to shrink,
but they whose heart is firm, and whose
conscience approves their conduct, will pursue
their principles unto death.
Leonardo da Vinci
•

4. • Without reflection, we go blindly on our
way, creating more unintended
consequences, and failing to achieve
anything useful.
Margaret J. Wheatley
• By three methods we may learn wisdom:
First, by reflection, which is noblest;
Second, by imitation, which is easiest;
and third by experience, which is the
bitterest. Confucius
•

5. Introduction
• Critical thinking as “putting it all together”
through information seeking, reflecting,
assigning meaning, problem solving,
predicting, planning, and applying
information.
• critical thinking skills, which include the
capacity to evaluate and respond in novel
circumstances and to self-reflect (Brookfield,
1991; Paul,1993).

6. Reflective Learning
• Learning to learn
• Metacognition = thinking about your own learning
process
• Developing insight
• Deliberate process during which the candidate takes
time, within the course of their work, to focus on their
performance and think carefully about the thinking
that led to particular actions, what happened and what
they are learning from the experience, in order to
inform what they might do in the future.
• (King, 2002)

7. • Reflection and learning
• Reflection is a mental process of thinking and learning
often used in everyday life. It is more than just a
common sense wisdom.
• John Cowan (1998:16) gives an example of what
reflection is:
• “A student is reflecting when she notes that there is
something different about the case that she is
considering, in comparison with the examples she has
encountered in class; and when she also identifies
what the difference is, and what she should do about
it.”

8. Reflective learners continually think…
• What they are learning
• Why they are learning it
• How they are learning it
• How they are using what they are learning
• Their strengths and weaknesses in learning
• Their learning priorities
• Improve and build upon their learning process
• how well they are working towards their
short-, medium- and long-term goals.

9. Reflective learners consider:
• Their motivation
• Their attitudes and ideas, and changes
• Skills they need for different components of
their study and learning
• What (if anything) is blocking their learning
• The gaps in their knowledge and skills, and
how they might best work towards filling

10. Reflective learners engage with:
• The specialist discourse of their subject area
• -
• Discipline-specific conventions
• -
• The ways in which knowledge is constructed
and meaning is created in their particular
subject area(s).

11. DO YOU AGREE
• To be an effective reflective learner, students
must recognize that ‘failure’ is part of success.
Learning what does not work is on the same
path as learning what does work.
• There must be room for ‘failure’ in the
reflective process.
• Do you agree?

12. Reflection Involves
• Reflection involves describing, analyzing and
evaluating our thoughts, assumptions, beliefs,
theory base and actions. It includes:
• Looking forward (Prospective Reflection)
• Looking at what we are doing now (Spective
Reflection)
• Looking Backward (retrospective Reflection)
Alsop and Ryan (1996)

13. • Your writing voice is the deepest possible
reflection of who you are. The job of your voice is
not to seduce or flatter or make well-shaped
sentences. In your voice, your readers should be
able to hear the contents of your mind, your
heart, your soul. Meg Rosoff
• There are three principal means of acquiring
knowledge... observation of nature, reflection,
and experimentation. Observation collects facts;
reflection combines them; experimentation
verifies the result of that combination. Denis Diderot

14. Process of Journal Writing
• A journal is a continued series of writings made
by a person in response to their life experiences
and events.
• Diaries contain a description of daily events.
• A journal may include those descriptions, but it
also contains reflections on what took place and
expresses emotions and understandings about
them. It doesn't matter what you call your
writing, either a diary or journal, as long as you
see the distinction between these two ways of
writing.

15. Process
• Process essentially is a course of action to
achieve a given result, and
• Documentation provides information about
the operation, use, or condition of something.
As can be deduced, then,
• Process documentation is an attempt to
narrate—usually in writing—the steps you
have taken in your work.

16. Content for Process Documentation
• For your process documentation, you may want to ask
yourself the following questions:
• What were the specific steps involved in each activity—
for example, screening, building trust, understanding
development issues, forming groups, establishing bye-
laws, and conducting quality checks?
• When conducting workshops or campaigns, what were
the steps involved in proactively planning your
content? What were the stages involved in event
management?
• What processes are involved in getting information
from different stakeholders or participants—including
your field guide and people staff?

17. Critical Thinking
• Critical thinking...the awakening of the intellect to
the study of itself.
• The intellectually disciplined process of actively
and skillfully conceptualizing, applying, analyzing,
synthesizing, and/or evaluating information
gathered from, or generated by, observation,
experience, reflection, reasoning, or
communication, as a guide to belief and action.
(Michael Scriven & Richard Paul, 1987)

18. Critical Thinking in Nursing
• a composite of attitudes, knowledge, and skills
that include “defining a problem, choosing
information fort pense the solution,
recognizing stated and unstated assumptions,
formulating and selecting relevant and
promising hypotheses, drawing conclusions,
and judging the validity of the inferences”
• (Hickman, 1993)

19. Continue
• Dewey defines critical thinking as “...active,
persistent, and careful consideration of any belief
or supposed form of knowledge in the light of the
grounds that support it and the further
conclusions to which it tends” (Fisher, 2001).
• It is purposeful, self-regulatory judgment which
results in interpretation, analysis, evaluation, and
inference, as well as the explanation of the
evidential, conceptual, methodological,
criteriological, or contextual considerations up on
which that judgment is based. (Facione, 1990)
• American Philosophical Association

20. Continue
• Ennis (1991): “Critical thinking is reasonable,
reflective thinking that is focused on deciding
what to believe or do”.
• Fisher and Scriven: “the skilled and active
interpretation and evaluation of observations
and communications, information and
argumentation”.
• Johnson (2000) indicates, “ A type of thinking
where a person must organize, analyze, or
evaluate given information”.

21. • “skilled readers do not read blindly; they read
purposely.”
• They have an agenda, goal, or objective”
• Paul and Elder (2004)
• People who think critically can analyze their own
thinking and realize they can improve their own
reasoning; a highly cultivated critical thinker
raises vital questions and problems, gathers and
assesses relevant information, thinks open-
mindedly, and communicates effectively
• (Elder, 2007; Scriven, Paul, 1987).

22. • “One’s worldview can be a major hindrance to
being fair-minded”;
• Students must be willing to negotiate previously
held positions and beliefs while considering
opposing viewpoints.
• Teaching critical thinking through direct
instruction in rhetorical analysis could improve
students’ critical thinking ability, for in order to
teach students to think critically, “we must teach
them to try to understand how one’s worldview is
likely to be embedded with prejudices, biases,
and false notions” Carroll (2007)

23. • According to Yıldırım (2011), critical thinking is
“the process of searching, obtaining,
evaluating, analyzing, synthesizing and
conceptualizing information as a guide for
developing one’s thinking with self-awareness,
and
• the ability to use this information by adding
creativity and taking risks”.

24. Rhetoric Analysis
• A form of criticism (or close reading) that
employs the principles of rhetoric to examine
the interactions between a text, an author,
and an audience.
• The point in ‘rhetoric analysis’ is merely
reading with understanding

25. • Rubenfeld (2000).
• Critical thinking in nursing is an essential component of
professional accountability and quality nursing care.
• Critical thinkers in nursing exhibit these habits of the mind:
confidence, contextual perspective, creativity, flexibility,
inquisitiveness, intellectual integrity, intuition, open-
mindedness, perseverance, and reflection.
• Critical thinkers in nursing practice the cognitive skills of
analyzing, applying standards, discriminating, information
seeking, logical reasoning, predicting, and transforming
• knowledge. (p. 357)

26. Nursing And Critical Thinking
• The ability of critical thinking increases as the
work years increase, and the critical thinking skills
can be improved during nursing education.
• Be rapid and dynamic change in the health care
system, nurses in providing optimal patient care,
problem solving, ethical decision making,
determine priorities and trends in clinical
decision making and critical thinking skills you
need to use (Yıldırım 2010b).

27. • Collucciello (1997) stated that it is “imperative
for nurses to reason critically about the
judgments they face in practice and to act on
those judgments in such a way that
management of care......exemplifies reasoned
consideration, constructive thinking, and a
particular disposition that leads to favorable
outcomes”
• .

28. Critical Thinking in N Education
• Thinking and learning are interrelated; one must
think to gain knowledge.
• Nursing Process, scientific reasoning, decision
making
• “analysis of language use, formulation of
problems, explication of assumptions, evaluation
of conclusions, weighing of evidence,
discriminating between good and bad
argumentation, and justification of facts and
values that result in credible beliefs and actions”.

29. • Sternberg (2003) reasoned that “a future of
successfully intelligent thinkers is important to
personal satisfaction and national achievement”
• Teaching students to think reflectively and
critically should be a primary goal of educational
institutions, for although students may be
knowledgeable, they may not have been taught
how to think analytically;
• ultimate goal for educators is to promote lifelong
learning by enhancing students’ problem-solving
abilities
• “Apply these steps not just in school problems,
but in problems in everyday life”.

30. Adult Learning
• Brookfield (2003) referred to the transfer of
those skills learned in the classroom and
lifelong learning as “the organizing concept for
adult education”.
• Adult learning
• is distinct to childhood and adolescent
learning in that it includes the capacity to
think dialectically, to employ practical logic, to
know how one knows what one knows, and to
think reflectively.

31. Critical Reflecting
• “The process by which adults become critically
reflective regarding the assumptions, beliefs and
values which they have assimilated during
childhood and adolescence” (Brookfield)
• It occurs over a period of time as a result of
interpersonal, work-related, and political
experiences.
• Without the capacity to think and act critically,
we would never move beyond those assumptions
we assimilated uncritically in childhood

32. Cultivate the mind
• Paul (1995b) recommended that educators
• “cultivate minds that habitually probe the
logic of the systems of the status quo as well
as the logic of the possible variations and
alternative systems”
• , and that rather than memorizing the
conclusions of others,
• “students should reason to those conclusions
on the basis of their own disciplined thought”.

33. Clinical Reasoning
• It has been likened to the process of learning
to ride a bike (Benamy, 1996)
• “A verbal description of how to ride (a bike)
would be of virtually no use to a listener
wishing to acquire the skill – it needs to be
experienced directly ... (This) accounts for the
phenomenon that expert practitioners know
more than they say.” (Benamy, 1996)
• Clinical reasoning is “the thought process that
guides practice” (Rogers, 1982)

34. Clinical Reasoning
• Ways of thinking that therapists use to
understand clients and their problems in doing
routine occupations (Reed & Sanderson 1999)
• The cognitive process whereby conclusions can
be reached on the basis of information available
(Hagedorn 1995)
• Description: A person is unable to feed
independently
• Observe (Cues), Link to knowledge base,
Hypothesis
• Implement, and Evaluate

35. • The thinking that helps therapists understand clients’ problems and
how to intervene.
• Description:
• For example; a person cannot go to the shops.
• Observe:
• What might a therapist notice?
• Link to knowledge base:
• What knowledge does the therapist need?
• Hypothesis:
• What do these cues tell us and how can we explain this?
• Implement:
• What can we do about it?
• Evaluate:
• Did it work?
• Based on Rogers and Holm (1991) in Reed and Sanderson (1999)

36. Procedural Reasoning
• This is the easiest for us to understand. There are a few
reasons for this:
• It’s the most concrete.
• It’s a big focus in our curriculum.
• As students, we see it as being the most important.
• Procedural is the “how to ” of the therapeutic process.
We see something is wrong, so we try to fix it. The
focus is on the disability itself and we draw on our
knowledge of diseases and conditions to fix it.
• Things like problem identification, goal setting, and
intervention planning all fall under this type of
reasoning (Fleming, 1991).

37. Interactive Reasoning
• client as a person. begin to understand the person
better, and can appreciate the disability or illness
experience for the client.
• “humanizes” the conditions that you identified through
your procedural reasoning.
• To engage the client in the intervention session
• To get to know the client as a person
• To understand the disability from the clients point of
view
• To match the goals and interventions to the client
• To communicate a sense of hope, trust, and acceptance
to the client
• To determine if the intervention is going well

38. • Procedural reasoning guides treatment.
• Interactive reasoning guides therapy. Fleming, 1999
• Conditional Reasoning
• Requires experience; It usually can be seen in
therapists at the expert level.
• Multidimensional process that involves complicated
forms of thinking.
• Reflects on the success/failures of the interactive and
procedural reasoning.
• The future of the client would be like, and is able to
constantly revise the therapy to suit this vision.
• The thinking moves beyond the present to a deeper
level of interpretation of the person as a whole.

39. • Have you ever struggled with what realistic
long-term goals might be for your client?
• Answering these questions comes with
experience, and with conditional reasoning.
• QUESTION
• So how do procedural, interactive,
and conditional reasoning fit
together?

40. References
• Coughlan, A (2007-08). Reflective learning:
keeping a reflective, learning journal. DCU
Student Learning Resources. (p.1-4)
https://www.dcu.ie/sites/default/files/student
s/Reflectivelearning.pdf
• Process Documentation and Journal Writing:
Guidelines for Making the Most out of Your
Field Experiences

41. References
• Özkahraman, Yildirim, B. An Overview of Critical
Thinking in Nursing and Education. American
International Journal of Contemporary Research
(September 2011) ,1 (2). P 1-7
• http://www.brainyquote.com/quotes/keywords/refle
ction.html
• Hagedorn R (1995) Occupational Therapy:
perspectives and Processes. London: Churchill
Livingstone
• Lisa Mendez and Jodene Neufeld. CLINICAL
REASONING... What is it and why should I care?
file:///C:/Users/Nursing/Downloads/Documents/Clin
ical_reasoning.pdf