reflective practice in nursing & cultural competency education yolanda ogbolu, phd, crnp-neonatal...

Download Reflective Practice in Nursing & Cultural Competency Education Yolanda Ogbolu, PhD, CRNP-Neonatal Assistant Professor & Deputy Director Office of Global

Post on 11-Jan-2016




0 download

Embed Size (px)


PowerPoint Presentation

Reflective Practice in Nursing & Cultural Competency EducationYolanda Ogbolu, PhD, CRNP-NeonatalAssistant Professor & Deputy Director Office of Global HealthUniversity of Maryland Baltimore, SONAPHA conference 2014

Learning ObjectiveParticipants will be able to: Describe how bias/stereotyping can be addressed in cultural competency education of health professionals using reflective practices

Cultural Competency in Nursing EducationNursing Education and Practice

Integration of cultural competence in graduate nursing education deepens the development of the leadership role in eliminating health disparities. This leadership role encompasses: Socially and empirically derived understanding of complex causes of disparities;Implementing culturally competent nursing care;Addressing social justice; Advocating for patients and policies that advance health care; Developing competency in collaboration with patients, key persons, agencies, and various stakeholders;Attitude modification and personal transformation; and Contributing to culturally competent scholarship.

Source: American Association of Colleges of Nursing


3Reflective Practice in Nursing Reflection on actionUnconsciously embedded into performanceReflection on practicePost-event reflection, examines action after the performanceAction commitment Limited use in public health, cultural competency, and unconscious bias education

Jayatilleke, N. M. (2011). Reflection as part of continuous professional development for public health professionals: a literature review. American Psychologist, 69(7), 669-684.4Reflective Practice & NursingIncreasing interest ,publications ,research & practice in public health, health professional and nursing education Evidence related to benefits and challenges Individual (internal process)Examination of ones moral consciousness, convictions, ethical dilemmas leading to a conclusionInterprofessional team (outward process)Sharing of multiple perspectives may lead to deeper reflective practice

Mann, K. G. (2009). Reflection and reflective practice in health professions. Advances in Health Science Education, 14, 595-621.Gustafsson C, A. M. (2007). Reflective practice in nursing care: Embedded assumptions in qualitative studies. International Journal of Nursing Practice, 13, 151-160.5Cultural Competency EducationCultural competency Course (Elective, online & face/face course)Reflective self-assessment exercise Reflective narratives following immersion experiencesLongitudinal reflection opportunities

Interprofessional Educational Opportunities(IPE sessions)

High Fidelity SimulationReflective debriefing following culturally based simulation6Cultural Competency CourseSelf Assessment of BiasesSelf examination of personal biases and stereotypes based on ones class, race, religion, gender, ability, and/or sexual orientationInterprofessional team & online cultural competency courseReflective responses:Empowering, eye opening, this is something that I will take to clinical practice and recommend all health professionals do; This exercise allowed me to better understand how my stereotypes and biases impact my patients The exercise opened my eyes to how I might knowingly or unknowingly discriminate against patients in the healthcare setting. 7High Fidelity Simulation in NursingMitigates the gap in theory to practice and behavior changeUses reflection, critique, correction, evaluation and open post reflection

Used at individual and team level to: Realistic clinical experience as a triggerIn a safe environment for errors without social or service responsibilities

Picture from Bridging the communication gapEvaluation of High Fidelity Simulation with ReflectionUndergraduate nurses & Interprofessional teams Case scenario grounded in the provision of culturally and linguistically appropriate servicesMultidisciplinary team and Live patients Evaluation of behavior change possible using an Objective Structured Clinical Evaluation (OSCE) ToolScenario developed by Jana Goodwin, PhDc, CRNP , University of Maryland School of Nursing, Shady Grove Department9

Reflective Learning can:Lead to a deeper of understanding of ones unconscious thoughts, attitudes, and biasesPromote self awareness, confidence, and growth Serve as a tool to elicit ongoing change and improvements in clinical effectiveness and quality service Build on a developmental process of reflective learning from everyday experiences

Key Points for Discussion

Given what is known about reflection, how we incorporate it into unconscious bias education?What strategies can be use to expand the evaluation of reflection beyond traditional qualitative assessments?Reflection is proposed to assist in the development of culturally competent care, but what are the specific processes that can be measured?What strategies can be utilized to measure and evaluate reflection in real life settings, individually or as part of an interprofessional team, to reduce unconscious bias and improve patient outcomes?What are the potential effects of promoting reflection?11