1. Development of Reflective Practice
Training in reflexive practice is integrated into most training programs as a skill to be developed and, often, as a device designed to promote the construction of the professionality of any training. However, this reflexive practice is sometimes still considered spontaneous, as it is a capacity that learners naturally have. That said, reflexive practice requires support, or even explicit training (Alexandre, Buysse, Périsset, and Renaulaud, 2019).
In this sense, several studies confirm the capacity of a reflexive practice intervention to support the development of nursing skills (Clarke, 2014; Dubé & Ducharme, 2014; Forneris & Peden-McAlpine, 2007; Goudreau et al., 2015; Levett-Jones, 2007; Nielsen, Stragnell, & Jester, 2007). However, to become a reflective practitioner, Jomas (2018) announces: “…. the student needs support. Questioning oneself about one’s practice, thinking about one’s choices and hesitations, doubting one’s achievements are not obvious to all students.”
Although there are many models of reflexive practice, Kolb’s model seems to be the most suitable for nursing education because experiential learning theory is at the root of the union of action and reflection since it is represented in a four-dimensional cyclical model: concrete experience, observation (knowledge), reflection (process) and abstract conceptualization (transformation) (Kolb, 1984). Similarly, this learning model emphasizes “the here and now of hands-on experience to validate and test abstract concepts” (Balleux, 2000).
Similarly, reflective practice can be operationalized in nursing education through a variety of devices, such as group discussions, logbooks, and portfolios, scientific approaches to practice, self-assessment, and case studies (Airasian, Gullickson, Hahn & Farland, 1995; Mansverlder-Longayroux et al., 2007; Zeichner & Liston, 1987). In other words, its development can be produced through writing and through mediation, which is presented in various forms, the most common of which are: professional memories, practical narratives (Ibert,1994; Cifali, 1996; Kelchtermans, 2001), reflexivity booklet, Donnay (2000).
According to Mercure and Rivard (2016), the concept map allows the spatial representation and organization of the field of knowledge because the student becomes better prepared to reflect, organize his knowledge, optimize his learning, and develop his creativity.
In this context, Balas Chanel (2013) explains that there are two types of collective work in Reflexive Practice are to be distinguished: the group, for a work of the type practice analysis, return from the internship, learning assistance session, preparation of files (PFE, VAE), and the team, for a work of the type debriefing of a work carried out in common (team building, feedback, formative debriefings, behavioral debriefing).
2. Impact of Reflective Practice on the Development of Autonomy
Currently, the learner's autonomy is considered one of the fundamental issues of education in general. Thus, adopting interactive approaches, tools, and teaching methods promotes the determination of the empowerment of student learning (Soussi, 2019). Despite the richness of the definitions, we note that the notion of autonomy in training is confronted at the same time with the complexity and unanimity of the definitions of this concept. In this regard, Tremblay and Eneau (2006) consider that “the concept of autonomy in training has not yet been defined by consensus among researchers” (p. 82).
Brunot and Grosjean (1999) consider the pedagogy of autonomy as being the fact of trying to make the student find his path, to have him build his path. It is a process put in place so that he can respond to a problem that is personal to him, in a situation where there is a real issue” (p. 25). Similarly, Moore (1977) explains that the independent learner is “a person who identifies a need for learning when faced with a problem, a skill to acquire, or information that he or she does not possess. She can articulate her learning need in terms of specific goals and objectives and to more or less explicitly set criteria for achievement” cited by Marcus (2010) (p.28).
In the same sense, Le Coadic(2006) states that all approaches and conceptions of autonomy emanate from the exact origin, that of the reflexivity on which it is based. Indeed, from the Kantian approach to common sense through the work of Durkheim, Elias, and Touraine, autonomy always rests on reflexivity (Le Coadic, 2006). In other words, reflective practice reinforces empowerment since the learner looks at what he or she already thinks he or she knows, perceives his or her progress, and envisages new goals to be achieved shortly (Benhattar, nd). Based on Jorro's (2012) writings, the student sees new avenues of action and thus improves his creativity by taking a step back in his posture. Through internal dialogue, self-reflection questions action by reviewing automatic beliefs, assumptions, and thinking patterns, which are so firmly anchored that they are unconsciously activated (Fronty, 2017).
Similarly, self-criticism requires time, a method, and predisposition (Bonnet and Barth, 2017; Lindh and Thorgren, 2016). This discomfort experienced during self-reflection can hinder students' recourse to reflective practice (Trehan, Rigg, 2005, in Fronty, 2017: 75). Reflexivity requires time in opposition to the continuous movement in which the practitioner is frequently involved (Bonnet and Barth 2017: 48–49). As a result, "reflexive arrest" is a condition that facilitates the construction of meaning and knowledge for the future graduate (Schaeffer, 2002).
Reflective practice is an active and deliberate process of critical examination that allows the student to enter into a reflexive spiral of personal transformation that allows him or her to acquire the autonomy to achieve a desired and effective practice (Duffy, 2007). Similarly, L'Ordre des Educateurs à Toronto (2017) indicates that engaging in reflective practice promotes autonomy and reinforces the well-being and development of student leadership. Reflective practice can also lead nursing students to develop coping strategies and problem-solving skills and increase their endurance to continue in a complex and dynamic profession. The training of nurses is now part of a new problem: constantly adapting to initiate and support the development of the skills of tomorrow while positioning itself in a much more competitive and stiller volatile environment (Guerraud, 2006).
In the face of the significant challenges faced by health care personnel and, in this case, nurses, commitment to quality, efficient approach, concern to provide responses adapted to the needs and expectations of clients is an urgent obligation. In this way, nursing students are required to develop the ability to judge their learning when faced with the multiplicity of pedagogical strategies and the complexity of the practical situations they have to face during their internships. They need to get used to self-assessing regularly to self-regulate their learning and develop their targeted skills.
From this point of view, the training of health professionals, including nursing, is now part of a new problem: constantly adapting to initiate and contribute to the development of tomorrow's skills while positioning itself in a more competitive and stiller volatile environment (Gurraud, 2006). With this in mind, the constant changes in the world are forcing practitioners to cultivate their reflection in order to be competent, that is, according to professional didactics, less deprived in the face of new professional situations (Pastré, 2011; Pastré, Mayen, & Vergnaud, 2006).
Teaching methods became more varied and associated with several learning styles (e.g., styles [Kolb, 1984], from practical experience to reflective observation for "reflective" pupils, from reflective observation to conceptualization for "theoreticians," from conceptualization to active experimentation for "pragmatists," and from experimentation to experience for "accommodators"). However, shortly after this reform, which created a real problem: students, especially in the first year, had difficulty in recognizing the objectives and were slow to commit themselves and to be operational in certain educational activities, to take responsibility for this new learning paradigm.
Engaging in reflective practice enhances your professional knowledge and experience as part of continuous professional learning. It also promotes the time needed to acquire and apply relevant and valuable new learning. It is not a "professional apprenticeship served while driving" (Curtis, Lebo, Civandes, Carter, 2013). Engaging in reflective practice takes time and can be difficult as the practitioner develops new ideas and faces tensions and challenges in your practice. Ideally, reflective practice must be integrated into daily practice and continuous professional learning activities to be successful.
On another level, several authors have revealed that reflective practice and independent learning go hand in hand. More importantly, reflective practice can be considered an independent learning activity, as it helps to make informed choices about independent learning activities.
In nursing education, the reflective practice offers students the opportunity to analyze their practice, understand their patterns of thought, and analyze their beliefs and social benchmarks about current societal and nursing-specific issues in cultural diversity. They develop independent thinking and advance their clinical judgment and practice in general (Mezirow, 1997; Pépin, Kérouac, and Ducharme, 2010).
Balas-Chanel (2014) explains that this pedagogy, which encourages the student to return to concrete situations he has experienced to build knowledge and skills, is essential for any training that combines theoretical and practical approaches. It also states that the benefit of Reflexive Practice, for nursing students, comes from the mental gestures it asks them: a) Wondering about their own practice, b) Appropriating their own experience, c) Putting at a distance what happens to them, to better understand it, d)To become aware of the way he learns, to learn how to learn, - To become aware of the way he acts, as a nurse, to become a nurse, e) To reflect on his physical, mental action, his decision-making, to understand the often implicit but powerful springs of this, f) Extend reflection in action to reflection on action and on what drives it more or less consciously, g) Analyze a situation, asking: "How did I, too, contribute to what happened?" h) Building the positive, from events (positive or not) asking yourself, "Whatever happens to me, what does it teach me?" i) Build on the past to see the future better equipped, more "educated", j) Build on this new knowledge to produce adapted behaviours in ever new situations, k)To build a thoughtful and evolutionary professional identity, l) To become a "reflexive practitioner", m) To become autonomous, and n) To build knowledge, beyond existing theories, to be a "research practitioner".
To ensure the effectiveness of reflective practice, Barriault (2016) points out that context and intentions need to be clarified so that the trainee is aware of the learning process and feels safe in this approach. In other words, the person overseeing the process must also look at his or her skills to stimulate the reflective practice and assess her or her coaching expertise.
3. Reflective Practice and Academic Achievement
Academic success or failure is closely linked to his or her relationship to knowledge, that is to say to the relationship of meaning and value he or she confers on the student (Bautier, Charlot & Rochex, 2000). Indeed, Reflexive Practice is as interested in successes as errors or difficulties. The one on success allows for understanding what works when it works and the appropriation of “good practices.” By reversing one’s mistakes, without complacency but with benevolence, it becomes possible to understand how and why one arrived at this result and thus to imagine new and more effective strategies (Balas-Chanel, 2013).
Maddage and Jonquet (2018) find, through their study, that successful students have developed a panel of postures that they adapt according to the situation. In the same sense, these authors pointed out that students mainly use the postures: of creative, academic, and reflexive in the context of successful discipline. According to the same reference, the student in check still tries to enter into a reflexive approach to better target and understand the causes of his failure.
In the same line of thinking, Lafortune (2012) states that reflexive analysis is a way to break away from one’s practice to take a critical look at one’s learning, professional practices, and judgments. This distance from his practice allows him, on the one hand, to become aware of certain aspects of his practice and, on the other hand, to adjust his actions which leads him to make different decisions.
A reflective activity promotes students’ ability to think like a “nurse” (Wheeler, Butell, Langford, Taylor, Epeneter, 2016). In this regard, Dubé (2012) evaluated a reflective practice intervention among nurses working with seniors. According to this author, introspection, openness to others, and critical analysis are skills nurses have developed through this reflective practice intervention.
In the same vein, reflexive practice stimulates the development of metacognition. It is indeed considered one of the best preachers of academic success. It rightly reflects the student’s ability to reflect on his or her knowledge and understand the reasoning he or she engages to use it to build new knowledge. Hence the importance of making students aware of their learning strategies in the face of each professional situation (Delvolvé, 2006).
In this way, it allows him to improve his pedagogical approaches, which will positively impact the student’s learning and success (Marzano, 2012). These three dimensions follow a causal relationship, as illustrated in Fig. 1.
In the same sense, it should be clarified that through reflexive practice, the teacher himself manages to build an effective model of practice in which the changes he makes lead to the transformation of his practice (Lafortune, 2008). Moreover, Barriault (2016) argues that it is essential to adopt a reflexive and critical stance towards their practice to optimize teachers' professional development and thus promote students' success.