新人看護職に対する複数回の臨床体験のリフレクション支援の効果

The Effects of Multiple Reflections on Clinical Experience for New Nurses

要旨

目的：新人看護職が支援者とともに臨床体験のリフレクションを複数回経験したことによる新たな学びや発見したことと新人看護職が認識した効果的なリフレクション支援を明らかにする．

方法：複数回の臨床体験のリフレクションを実施している2施設で，新人看護職の時にリフレクション支援を受けた7名に面接を実施し，質的記述的分析を行った．

結果：複数回のリフレクション支援による新人看護職の新たな学びや発見は，【見えなかった自己の弱みへの気づき】【自分が大切にしていることへの気づき】【対話によって具体的な行動に気づける】などの5つであった．新人看護職が認知するリフレクション支援は，【新人看護職個々を尊重した対応】【新人看護職の行動の承認】などの効果的な支援と【一方的な助言】【新人看護職の状況を理解しない断定的な指導】などの非効果的な支援であった．

結論：複数回のリフレクションを支援者と行うことによって，新人看護職と支援者のお互いの理解が深まることによって，新人看護職個々を尊重した支援が得られたことが示された．その結果，単回のリフレクションよりもより気づきが促進され，新人看護職の自己理解や実践につながる思考が促進されることが明らかになった．

Purpose: The purpose of this study was to reveal what new nurses had recently learned and discovered through multiple reflections about their clinical experiences with their mentors as well as to reveal ways for them to recognize effective reflective support.

Method: A total of seven nurses, having experienced reflective support when they were new nurses, were interviewed at two facilities that practiced multiple reflections on clinical experience. The data was content analyzed qualitatively.

Results: These new nurses gained “awareness of their own previously unrecognized weaknesses,” “awareness of what they value most,” and “recognition of concrete actions through dialogue,” etc. Effective reflections that participants recognized included “respecting the uniqueness of new nurses” and “supporting new nurses' actions.” On the other hand, ineffective reflections included giving “unilateral suggestions” and “authoritative guidance with a lack of understanding concerning the situations of new nurses.”

Conclusion: The results of this study revealed that the new nurses did receive effective support, such as being respected for their uniqueness, through a deepening understanding between them and their mentors. As a result, more than a single reflection method, a multiple reflection method facilitated within them a greater awareness of self-understanding and practices.