Teacher competences for supporting students' reflection. Standards, training and practice

Students in nursing education have to develop reflection skills to be prepared for continuous learning during their career. To support this development process, teachers have to expand their knowledge and pedagogical repertoire. A model of teacher learning by feedback during a training programme was developed and tentatively used as a conceptual source. Knowledge about reflection skills, asking questions, coaching and giving feedback was used to develop and validate content standards (study 1) and performance standards (study 2) for teachers and to design, develop and execute a teacher training programme (study 3). Feedback dialogues were analysed on questions, responses and prompts (study 4) and on teachers’ feedback and students’ reflection (study 5). Content standards were established in a Delphi study with 28 experts. The result of this study was a framework of six task domains including 15 tasks and 91 indicators which together formed the characteristics of what reflection education should be about. The framework was input in a standard-setting study in which six nursing teacher teams participated. Rubrics were used to developed performance descriptions of teacher competences on four achievement levels. The teams reached consensus about the second level as ‘just sufficient’ level of functioning and decided to apply a conjunctive judgmental model for each of the thirty competences which were described. The training programme was executed in five teams. Its course, the appreciation by the participating teachers, and the effects were investigated in a quasi experimental intervention study with a pre-post test control group design. The programme combined components of three different training approaches. First, components such as instruction, exercise and feedback were typical for a training-application approach. Second, discussion about current practice and reflection on alternatives fitted into a developmental-reflective approach. Third, giving information about and using relevant knowledge indicated an expertise-based knowledge development approach. Two additional specific features were the authentic feedback dialogues between the teachers and their students and the coaching of the teachers by the trainer using video interaction guidance. The time teachers devoted to the programme was on average 26 hours during 12-15 months; one third was used for attending meetings, two thirds for preparing and reflecting on conferences with students and performing other activities during periods of independent practice. Participants appreciated the quality of the training programme. According to their learner reports the participants on average increased in their focus on the content of students’ reflections and the results of their guidance, in trying things and looking for more information, and in self confidence and getting another view on guiding reflection. Participants indicated that they had developed their competences in conducting a number of specific activities during the programme. Results of analyses of the feedback dialogues indicated that the teachers learned to focus on students’ thinking activities and became accustomed to a broader repertoire of questions, especially deep reasoning questions and reasoning prompts. Moreover their dialogues contained much more different sequences of question and response categories and these sequences included more questions and prompts which potentially stimulate students to elaborate and to reflect.