Reflection-Beyond-Action: A Modified Version of the Reflecting Phase of Tanner’s Clinical Judgment Model
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Eva. H. Peisachovich, Faculty of Health, School of Nursing, York University, Toronto, Canada.
This paper explores the notion of reflection-beyond-action and its implications for the teaching and learning of novice nurses. This term emerged from the data analysis of a recent study that explored internationally educated nurses’ experience and understanding of clinical judgment while engaged in High Fidelity Patient Simulation (HFPS), stimulated recall, and reflective practice. The findings and analysis of this study led to a modification of Tanner’s Model of Clinical Judgment, in which the reflecting phase was expanded to include reflection-beyond-action. This form of reflection incorporates the concepts of unlearning and unknowing in order to critically reflect upon one’s prior knowledge and beliefs and consider their impact on one’s practice. A descriptive overview of the modified model—particularly the concept of reflection-beyond-action, its significance and implications to nursing education, and potential approaches to its application—is provided. This paper explores the findings of an earlier study, which illustrated how the acts of reflection and observation are integral to understanding clinical judgment and to developing professional learning and competence. Ultimately, this integration led participants to self-awareness and critical consciousness of the meaning of patient care and overall nursing practice, providing the practitioner with the ability to reflect beyond action.
Reflection-in-Action, Reflection-on-Action, Reflection-Beyond-Action, Unlearning, Unknowing
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