Education of reflective neonatal nurses in a South African context Carin Maree University of Pretoria

What is reflective practice? An approach to meet the demands of a specific context: Is more than just application of knowledge and skills Includes experience and personal growth Is based on reflection-in-action, reflection-on-action, reflection-before-action Puts an emphasis on ‘why’ and not ‘what’ Has positive outcomes for the clients / community

What is a reflective neonatal nurse? A professional nurse responsible for reflective practice in a neonatal nursing context, based on: Knowledge (empirical-analytical, historical-hermeneutic and critical / self-reflective) Skills (technical and cognitive) Personal attributes (values, perception of the world, self-perception, emotional status and interaction with her world)

Why do we need reflective neonatal nurses? Neonatal nursing practice is dynamic and the characteristics thereof change: Patient profile and needs are changing Explosion of knowledge Advancement of technology and pharmacology Unequal accessibility to advanced neonatal care Changes in staffing of health facilities

‘Routinised’ neonatal nurses who learned ‘recipes’ for care of infants with special needs are not able to meet the changing demands of neonatal nursing practice. Reflective neonatal nurses are able to act as ‘changing agents’ amidst the changing context.

How do we educate reflective neonatal nurses? Education of reflective neonatal nurses is: Formal post-basic practice-based course/s presented by an accredited tertiary institution Based on 4 main pillars: neonatal nursing practice, the higher education scenario, reflective education and the neonatal nurse as learner

Neonatal nursing practice Knowledge, skills and personal characteristics demanded from reflective neonatal nurses are determined by health care clients and – providers, and are related to: Basic and advanced care of neonates with special needs, including the dying infant Care of families of neonates with special needs Multi-disciplinary teamwork Utilization of medical technology and medication Managerial aspects Professional-ethical aspects of neonatal nursing

Higher Education Scenario Legislative framework is based on Higher Education Act, Act no. 101 of 1997 and makes provision for: South African Qualifications Authority (SAQA) National Qualifications Framework (NQF) National Standards Bodies (NSB) Standard Generating Bodies (SGB) Education and Training Quality Assurance Bodies (ETQA) Sectoral Education and Training Authority (SETA)

Higher Education Scenario (continue) Accredited providers (tertiary institutions) Life-long learning as aim Outcomes-based education (OBE) as philosophy

Reflective education A teaching approach that facilitates reflective learning: Curriculum is evidence- and practice-based Learning environment is conducive for personal and professional growth Education is learner-driven Educator has to be a role-model in reflective practice, reflective learning and reflective teaching, and act as a facilitator

Reflective education (continue) A variety teaching methods / techniques could be used in reflective education: Emphasis on outcomes-based education of empirical-analytical, historical-hermeneutic and critical / self-reflective knowledge, as well as technical and cognitive skills Facilitate reflection-before-action, reflection-in-action and reflection-on-action Learner plays a significant role in own assessment

Neonatal nurses as learners Adult learners: purpose-driven with significant experience Diverse backgrounds, circumstances and personalities Diverse abilities to become reflective practitioners

Achievements and Challenges! Significant personal and professional growth Change agents responsible for positive changes in practice to benefit infants and families Conflict, frustration and resignation What if a person is unable to become a reflective neonatal nurse?

“ The object of education is to prepare others to educate themselves throughout their lives” – Robert Maynard Hutchins

Thank you! cmaree@postillion.up.ac.za