Experiences of reflective practice among final year undergraduate nursing and midwifery students at two nursing universities

Abstract

Background: Nursing is a practice-profession requiring continuous reflection on actions for improving care, professional growth, and ensuring ethical practice. Despite its significance, reflective practice in nursing education in Malawi remains under-researched. This study aims to assess final-year undergraduate nursing and midwifery students' experiences of reflective practice at Mzuzu University (MZUNI) and Daeyang University. Method: The study employed a concurrent convergent triangulation mixed methods research design. The study had two settings; MZUNI and Daeyang University with a study population of 136 students. 12 students participated in focus group discussions (FGDs). One FDG was conducted at each site comprising of six participants each. The FGDs were guided by an in-depth semi-structured interview guide. A self-administered survey questionnaire was used to collect data from 101 students. Qualitative data were thematically analysed while quantitative data were analysed through descriptive statistics and multivariate linear regression by Statistical Package for the Social Sciences (SPSS) Version 25. Results: The results revealed that students have knowledge of reflective practice. Students conceded to the importance of reflective practice for improving their clinical care outcomes. The study found that more than 98% of the students engage in reflective practice. Multivariate linear regression results showed that better care outcomes negatively support the practice of reflection among the students (Coef= -0.11), (95% CI [-0.19, -0.03] P =0.009). The study identified reflective practice enablers to be either motivational or educational. Barriers to reflective practice included unsupportive Clinical Learning Environment and time constraints. Further, Daeyang University students reported significantly more support from nurses compared to Mzuzu University students (X2 = 5.32, P = 0.02). Conclusion: Findings indicate widespread knowledge and application of reflective practice, highlighting challenges such as integrating structured reflection sessions and standardized curricula. Addressing these challenges can enhance reflective practice's effectiveness in nursing education and professional development.