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Developing Curricula to Encourage Students to WriteReflective JournalsDavid Kember a , Alice Jones a , Alice Loke a , Jan McKay a , Kit Sinclair a , Harrison Tse a ,Celia Webb a , Frances Wong a , Marian Wong a , Po Wa Yan a & Ella Yeung aa Hong Kong Polytechnic University , Kowloon, Hong KongPublished online: 11 Aug 2006.

To cite this article: David Kember , Alice Jones , Alice Loke , Jan McKay , Kit Sinclair , Harrison Tse , Celia Webb , FrancesWong , Marian Wong , Po Wa Yan & Ella Yeung (1996) Developing Curricula to Encourage Students to Write Reflective Journals,Educational Action Research, 4:3, 329-348, DOI: 10.1080/0965079960040304

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Educational Action Research, Volume 4, No. 3, 1996

Developing Curricula to EncourageStudents to Write Reflective Journals

DAVID KEMBER, ALICE JONES, ALICE LOKE,JAN McKAY, KIT SINCLAIR, HARRISON TSE,CELIA WEBB, FRANCES WONG, MARIAN WONG,PO WA YAN & ELLA YEUNGHong Kong Polytechnic University, Kowloon, Hong Kong

ABSTRACT How should courses be arranged if students are to be encouraged toreflect upon their practice through the writing of reflective journals? Thisresearch question was addressed in action research studies of five courses in theallied health areas. The five studies fed into one overall project which synthesisedfindings from the five subprojects through the critical discussions of theparticipants. It was discovered that students needed an introduction to andfeedback upon reflective writing as it differed from other types of writing requiredin academic courses. For reflective writing to be taken seriously, it needed to bean integral part of the course. Issues such as the disclosure of journal entriesand the assessment of reflective writing needed to be handled sensitively. Thecourses studied evolved positions on these issues which attempted to balancedichotomous concerns.

Introduction

The concepts of 'reflection-on-action' or 'reflection on reflection-in-action'have stimulated considerable interest since their formulation by Schon(1983). If the implications of the constructs are accepted they have markedramifications for professional education (Schon. 1987). Teaching technicalexpertise and systematic procedures in line with technical rationality is nolonger sufficient or even desirable. The student needs to develop the abilityto reflect on action and the confidence to reflect on his or her own practice.

The encouragement of reflection-on-action has been seen asparticularly beneficial for the periods of professional practice, which arealmost universally regarded as an essential component of any course forprofessionals. Yet, the incorporation of the practice component intoacademic courses has posed problems in many contexts and for most

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professional disciplines. In particular, there has been difficulty in meshingthe theory taught in the classroom with the practice of the professionalsetting. A potential solution to this problem is to encourage students toengage in reflection upon their professional practice and its relationship tothe theory taught in the classroom.

Journal writing is one of the most widely used strategies for promotingreflective learning among students (Boud et al. 1985; Hahnemann, 1986;Smyth, 1989; Mezirow et al, 1990; Mezirow, 1991; Nicassio, 1992). Reflectivewriting helps in explaining and clarifying complex thoughts or arguments. Inreflective writing, we externalise our thoughts, 'freezing' them there to havesecond thoughts and to experiment with new combinations of ideas (Biggs &Telfer, 1987).

Lukinsky (1990) promotes the use of journal writing as a form ofreflective withdrawal. He stresses the importance of a pause in the learningactivity to allow the individual or group to reflect upon what is being learned.It enables the journal writer to re-engage something missed, neglected, oravoided in the past so that the unfinished business can be dealt with.Journal writing is recommended as one of the specific educationalapproaches for transformative and emancipatory learning by Mezirow (1991).

Landeen et al (1992) distinguish journals from diaries. Both of themfunction as documentary records, but journals include a reflectivecomponent of one's own experiences and observations. Journal writing alsoenables students to think for themselves, to grasp a fading embryonicinsight, and to trust their fragile, emerging sense of the problem before beingsquashed by the flow of others' ideas. Personal journals can also function asa mirror of the mind for students to express astonishment and delight(Bowman & Richard, 1983). Writing about the problems or the type of stressthat students encountered can help them to cope with frustrations, andgives us a chance to comment or offer some recourses if needed(Hahnemann. 1986).

In application to nursing students, Bumard (1988) describes thefunction of journal writing as an assessment and evaluation tool. Apart fromsome other forms of assessment, journal writing is an introspective tool forpersonal growth (Lukinsky, 1990). It is a way of evaluating student progressin a non-test setting, and hence encouraging integration and application ofknowledge (Wagenaar, 1984).

In research on student teachers, Colton & Sparks-Langer (1993) foundjournal writing helped to develop the consciousness of the profession. Bean& Zulich (1989) claim that journal writing helps students to generate theirown questions in a course, explore hunches and hypotheses, and begin toperceive the multiplicity of views inherent in human experience. Journalwriting also provides a durable self-perspective on events that can then becompared with perspectives generated in other ways on the same issues(Kottkamp, 1990). Furthermore, Cameron & Mitchell (1993) recommendedthe value of peer journal work for facilitating student to student interactionand increasing knowledge of theory and practice.

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Yinger & Clark (1981) think that journal writing is not only a writtenform of experience, but also provides a means for transforming experienceinto various symbolic representations. It forces the writer to express insymbolic knowledge that which was originally represented and stored inmemory in a different form. Knowledge becomes enriched when the writershuttles back and forth between images, actions, and symbols.

Research Issues

While the concept of reflection-on-action has excited considerable interestamong professional educators and reflective journal writing is widelypractised, there are still many unresolved issues as to how best to designand implement courses which aim to encourage reflective writing. This studyaimed to address these issues. In essence it tried to answer the question ofhow a course should be formulated if it is to promote reflection-on-actionand reflective journal writing.

In particular, this meant that the use of student journals and diariesand regular disclosures were investigated. The problematic issues ofassessment and the access of the supervisor to reflections were examined.The study looked at the major blockages to students engaging in reflectivewriting and sought ways that they could be overcome. The researcherslooked at which educational factors should be taken into account in theconstruction of a suitable curriculum and learning environment for reflectivewriting in professional education courses.

Reflective Writing

In assessing the outcomes of the various curriculum initiatives and variableswe were looking for evidence in the students' writing of reflection. In thewidest sense, Dewey's (1933) definition is a useful starting point: "active,persistent and careful consideration of any belief or supposed form ofknowledge in the light of the grounds that support it and the furtherconclusion to which it tends" (1933, p. 9). There was also an expectation thatthe courses should aim to promote higher levels of critical reflection in atleast some students. Mezirow (1991) provides a useful framework fordiscussing critical reflection. His definition of reflection shows the influenceof critical theory upon his work.

Reflection involves the critique of assumptions about the content orprocess of problem solving.... The critique of premises orpresuppositions pertains to problem posing as distinct from problemsolving. Problem posing involves making a taken-for-grantedsituation problematic, raising questions regarding its validity.(Mezirow, 1991, p. 105)

Mezirow then proceeds to divide reflection into categories of content, processand premise reflection. Premise reflection is seen as a higher or more criticallevel of reflection as it opens the possibility of transforming meaning

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frameworks. Mezirow views this more critical level of reflection as, "becomingaware of why we perceive, think, feel or act as we do" (1991, p. 108).

Development of critical reflection is important as many of our actionsare governed by a set of beliefs and values which have been almostunconsciously assimilated. Through reflective journal writing we hoped thatstudents could become aware of these value structures and assess whetherthey were valid.

Methodology

The issues were tackled through an action research approach. Cycles ofplanning, action, observation and reflection were used to test and refinecomponents of five courses designed to promote reflection and reflectivewriting. Each course was the subject of an individual action research studylooking at the teaching within the course and whether it facilitated studentreflection.

As five courses were examined simultaneously, comparison waspossible and lessons learnt from one could be applied in others. Essentiallythe research consisted of five action research spirals, one for each course. Asthe studies proceeded simultaneously and mutual reflection developed, thespirals became intertwined. On top of this tangled web of spirals was a sixthspiral, which was the cyclical processes of this overall project synthesisedfrom the five course-based projects. This might be viewed as a spiralsynthesised from and feeding back into the five course-based spirals.

The members of the research team themselves engaged in reflectionupon the outcomes of the work. Fortnightly meetings were held between thewhole of the team. This facilitated comparison between courses and servedas a means of passing conclusions for practice from one course to another.The critical discourse of these meetings was both an element of the projectmethodology and a contribution to the data. Meetings were tape-recordedand transcripts produced of useful sections of the dialogue.

The process of writing this paper itself contributed to the group'sexploration of the topic. The factors which seemed to influence reflectivewriting were noted from the group's reflective discussions of their courses. Astructure for the paper was then prepared with headings for each of theteaching aspects which appeared to influence the degree of reflection. Thoseteaching each course were then asked to write notes about their courseunder each of the headings. These notes were collected together within theframework of the paper as a 'patchwork quilt'.

The initial patchwork quilt served as a stimulus for considerablediscussion. The notes about one course often stimulated those teachingother courses to reconsider aspects of their course which they had notincluded in their own notes. The attempt to synthesise conclusions from thepatchwork was through collaborative critical reflection. The paper eventuallywent through numerous iterative drafts, each of which provided furtherstimulus for collective reflection.

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Data were also gathered from student journals and reports. Some classdiscussion sessions were tape-recorded. Interviews were held to gatherinformation about the effectiveness of the measures for promoting reflectivebehaviour, the difficulties students faced in engaging in reflective writing,and any benefits the students accrued from engaging in reflection-on-actionin their professional practice. The project used the computer programmeNUD»IST to handle the large amount of qualitative data which weregathered. Typical quotations from interviews and journals are used tosubstantiate and illuminate some of the conclusions drawn from thecomparison of courses. Only a small proportion of the collected data hasbeen used in this paper as the intention was to focus upon action researchmethodology here.

The project is still in progress. Like many action research projects it isdifficult to define distinct starting and finishing points. Most of the coursesor subprojects are towards the end of their second cycle.

Courses Examined

Each of the five courses is offered for the development of professionals forallied health service fields. All programmes contained an element ofprofessional clinical practice. The five courses examined are for the followinggroups of students:• A BSc course for post-experience nurses• A postgraduate course for clinical educators• Physiotherapy undergraduate students• Radiography undergraduate students• Occupational therapy undergraduate studentsIt should be noted that the first two of these courses are for part-timepost-registration or in-service students. The remaining three are for full-timepre-registration or pre-service students. Some differences did emerge overthe use of journal writing between these two groupings. To understandfurther the context of the study, brief details of the courses and theirteaching format are given in Table I.

The term "courses' is, of necessity, used rather loosely. The first twocourses referred to above are discrete courses within a degree programme.The remainder refer to elements within degree programmes, mainlyassociated with the clinical practice component, though not necessarilyconstituting a specific course in the handbook.

Aspects of Teaching

This section examines various aspects of courses which appeared either tohinder or promote student reflection and reflective writing. Comparison ismade between two or more of the courses in each case.

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Target group

Course level

Type of students

Mode

Number ofstudents

Number ofstaff/facilitators

Length of course

Introduction toreflection

Method of journalkeeping

Content ofreflections

Frequency ofsharing Journalentries

Assessment ofJournals

Post-experiencenurses

Undergraduate

Registered nurses

Part-time

79

3

1 year

Course outline,clear explanation,dialogue

Journalsubmission atregular intervals,four Journalentries and finalpaper submitted

Contemporarynursing Issues

Four timesduring course

No marking ofJournals, finalpaper assessed

Clinicaleducators

Postgraduatediploma

2 nurses + 4physiotherapists

Part-time

6

3

14 weeks (2 yearsfor completeprogramme)

Handout articles,explanation

Weekly entry Inlogbook

Clinical teaching,experiential

Once a week

No marks, finalassessment given

Physiotherapyundergraduate

BSC

Undergraduates

Full-time

240 (3 years)

18 full-time and2 part-time

3 years

Handout, briefintroductoryarticle,discussion

Tape record orwrite in logbookbefore, duringand after theclinicalplacement

Clientmanagement andstudent learning

Aim to have shortweekly sessionswith clinicalsupervisor

Not assessed

Occupationaltherapyundergraduate

BSc

Undergraduates

Full-time

100 (2 years)

2

3 years

Handoutdiscussion

Write on aspecific topicafter severalmeetings

Class activitiesand clinical visits

Two feedbacksessions in aterm

Not assessed,final assignmentbased on Journals

Radiographyundergraduate

BSc

Undergraduates

Full-time

59 second-yearstudents

5

3 years

Introduction andexplanation ofuse ofsemi-structuredjournal

Reflection before,during and aftereach clinicalplacement

Issues raised inJournals

During and afterclinical blocks

Not assessed

Journals handed About every 6in weeks

Other aspects

End of course End of placement

Reflective Journalincorporated alearning contract

In the middle and For copying thenthe end of the returned to keepcourse as personal

record

Table I. Summary of courses.

Introducing the Concept of Reflection

Part way through the first cycle of the nursing course it was realised that thestudents needed an introduction to the concept of reflection. The initialworkshop served as a formative model for a process for introducing studentsto the concept of reflection in the second cycle. The concept was introducedto the students using the illustration of a model of reflection (Boud et al,1985). Some of the students' reflective journals from the first cycle weregiven as examples to demonstrate the process of reflection. This nursing

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course aims to facilitate students to reflect upon contemporary nursingissues. Students were encouraged to write down their thoughts orimpressions concerning the identified issues provided by lecturers as theirreflection exercises. Feedback was given to the students each time theycompleted one of the four required journal submissions as guidance for thefuture reflective process.

The occupational therapy course had a similar introductory sessionduring one of the first tutorials. Students were introduced to the concepts ofreflective learning and given explanatory handouts. Students were requiredto reflect, analyse and critically evaluate activities they undertook during theclass in relation to their past experience, observations, and feelings.Discussion was engendered on the concepts of reflection and theirapplication in learning. Reflective journal writing was introduced andguidelines for writing journals distributed. Students were asked to keep ajournal of personal feelings and reactions to some learning activities andthen focus on an issue that they felt was of particular significance.

Difficulties and Capabilities of Altering Previous Conceptions ofWriting

In the initial cycle of the nursing course, it was assumed that studentswould be able to write in a reflective format with little guidance. This wasquickly exposed as a false assumption. The students found it hard to breakaway from previous conceptions of academic writing. Other courses they hadtaken required them to write in the third person, preferably using a passivetense. Personal observation had been discouraged in favour of citingacademic authorities.

Previous instruction in academic writing had very effectively left itsmark. With a few exceptions, the students' initial attempts at reflectivewriting most closely resembled formal reports. They were replete withevaluations of equipment and facilities and discussion of procedures inhospitals. Criticism focused towards inadequate resource provision. Most ofthe writing was in the third person and there was little evidence of personalself-reflection. A typical example from a 'reflective' journal at this early stageis given below.

During the teaching process, normal ward routine is going on, suchas doctor's round. X-ray, emergency admittance and activeresuscitation. All these will disturb the psychological preparation ofboth the learner and the mentor to perform a clinical teachingprocess. There is no lecture room in [...]. We can only holddiscussions in the duty room or at the bedside. The learnersclaimed that they found it hard to keep concentrating on theprogramme. Demonstration of skills might vary from occasion tooccasion. Since our clinical observation lies in the subjectivity of theobservational process by different nursing officers, an inherent bias

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and distortion could not be prevented. (Extractfrom reflectivejournal of nursing student)

To develop the nurses' ability to write reflectively it was necessary to haveboth the introductory session, described above, and periodic feedback onsubmitted journals. Similarly the other courses discovered that theintroductory sessions needed reinforcement throughout the course. Theextract from a journal below, which Is one from the latter stages in thecourse, clearly shows a more reflective approach has been developed.

I still haven't any empirical experiences and deeper understandingof it I am still searching for the way out of it. From the previousdialogue, I get the idea of making it merge into our daily workrather than leave it as some high sounding theories. So I start anew way to perceive this topic by applying the nursing process tomy daily task. I do it alone and it is not so valid as there is noparticipation from the other care givers. (Extractfrom reflectivejournal of nursing student)

The clinical educators developed their abilities to write reflectively informallyrather than through structured learning activities. At first students in thecourse requested guidelines for writing and tended to want to write as if for acase management report. As this was a small, closely knit group, peerlearning was effective in the students' evolution towards a less constrainedwriting style. By a third of the way through the course the students hadapparently established their own writing approach and seemed morecomfortable with journal writing and reading. The statement made by one ofthe students demonstrates their own perception of the changes.

... at the beginning, 1 really had to think very hard, picking issuesto talk of or to enter as a reflective journal. But towards the end ofthe module, I find it more spontaneous and easier to link up theexperience to my learning. ...Not only in understanding, but as Ihave said, you wiR spontaneously pick up reflective learningyourself. (Student in clinical educator course)

Format for Reflection

The format for reflective writing and the periodicity of requiring students tocomplete journal entries was a function of the course. Clinical educatorswere provided with a small notebook for journal entries. The intention ofusing notebooks was to avoid formal, academic report-like writing andencourage the journals to be used more like personal diaries. Provision of anotebook helped to show that journal writing was different from other formsof academic writing which are word-processed and handed in on sheets of A4paper. The students were encouraged to make notes on readings and reflectat home, at work and during classes. It was reasonable not to restrict thestructure of the journal while students' intrinsic interest was encouraged.

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The other courses had more structured arrangements as a result of thediffering foci for reflection. The occupational therapy students participated insix specific class activities and four clinical visits. They were expected towrite about their own experience of these activities in their journals. Theseexperiences were also discussed in class with reference to their journalwriting. Students submitted their journals twice during the term forcomment and to receive feedback on their entries. Students were expected touse their reflective writing as a basis for an assignment for credit at the endof the course.

The physiotherapy course was interesting in that it had a quitedifferent format for reflection from the journal writing used by the othercourses. Learning contracts were the basis for reflective learning, and thetripartite involvement of lecturers, students and clinical supervisors. Alearning contract is formed by a negotiated agreement between two parties,such as, student and clinical educator or clinician regarding the type oflearning to be undertaken (Watts, 1990). It involves students in designingtheir own programmes of study, defining the criteria by which that learningwould take place and engaging them in a learning cycle of planning,monitoring and reviewing how learning is achieved under differentcircumstances in clinical settings. The learning contract is a means by whicha student can gain confidence in their own ability and in working withothers.

Students drew up learning contracts based on some of the placementobjectives. Students were asked to identify their own strengths andweaknesses of their performance in clinical placements by self-evaluation orfrom previous comments made by educators. The students were encouragedto base their reflections on previous learning experiences, particularly thoseof earlier clinical placements. Then they were required to work out their ownlearning contracts, which consisted of some realistic achievable goals,statements of how to achieve these goals, the sort of assistance they shouldseek and a target date for achieving these goals. In some groups of students,tape-recording was used in place of reflection by writing although thecontent was the same.

Even though preparation on reflective recording was given tophysiotherapy students prior to clinical placements, the majority of therecordings were more documentary in nature. The students had difficultywriting specific learning objectives. It was through discussions with theclinical supervisor and the lecturer that the objectives were formed.

Thejirst contracts that the students wrote were non-specific and ingeneral impossible to determine whether they were achieved or not.They were asked to rewrite them, to be more specific, to set targetsand goals that were identifiable in some way. The second set ofcontracts were written in such a way that there were specific goalsthat were largely observable and obtainable within the course ofthe placement. (Extract from reflective jownal of physiotherapylecturer)

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Students reflected on and discussed the contracts with the clinicaleducators. A contract would be revised if the clinical educator considered itunrealistic, and they would explain the reasons to the student. Throughoutthe placement, the three parties concerned reflected on their actions,interactions, student's progress, motivation, self-evaluation, projections andother aspects that had occurred during the time for fulfilling the learningcontract. The ongoing reflection formed part of the students' overall clinicallearning experience and the clinical educators' teaching strategies,respectively.

The learning contract served as an educational vehicle for the studentsto voice their opinions towards the clinical placement. Through theserecordings, the students expressed their frustration and fear, and at times,the outcome of purposeful inquiry and problem resolution.

I have finally corns to grasp with analysing the information by theend of the clinical placement. At first, I was only routinely carryingout all the assessment, and did not selectively choose them. Myanalytical power was very ineffective. But at the end, I realisedthat during the assessment, I should have some hypotheses builtup from the subjective assessment and then use some objectivetests to negate and support the possibilities of the patients'problem. It was really like being a detective. (Physiotherapystudent)

Physiotherapy students were expected to reflect on their patientmanagement procedures and to identify any factors that enhanced orobstructed their learning. The students were also encouraged to evaluate theeffectiveness of the communication channels between the clinical supervisorand the student and between the student and other professionals theyencountered during their placement. Their reflection, however, mainlyfocused on their approach to patient care, treatment plan and itseffectiveness rather than affective aspects of learning. Few students reflecteda lack of trust between the students and the supervisors.

This exercise [learning contract] is quite a good tool in finding outone's strength and weakness. However, mostly, only the weaknessis observed rather than the strength. I guess not many studentsdare to say out their strength because it may in fact be theweakness in other people's point of view. (Physiotherapy student)

Content of Reflection

Reflection was used in the clinical educators' course as a method forstudying aspects of teaching and learning for students on clinicalplacements. Initially the students were given short lectures, exercises andreading materials for discussion. Journal writing focused on issues related tothe reading and exercise. Students were expected to use one journal entrywritten through the week between classes, as a basis for comment at the

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beginning of the next class session. As the classes developed, the studentsbecame heavily involved in their reflective discussions, which took over onehour of the 3-hour class session. As long as the class reflective discussionsfocused on aspects of clinical education and teaching and learning,discussions were encouraged to be open and student directed.

During the second cycle of the nursing course, the students were giventhe freedom to choose their own theme for reflective learning. However, thisarrangement did not prove effective. In their initial journal writing, studentswere asked to write about an incident which yielded a sense of interest orinner discomfort. However, they were not able to recognise a single themefrom the incident. Students' groups of about 12 were not able to agree on acommon theme for discussion in reflective dialogue sessions, and theysought specific guidelines on reflection. Lecturers shared the sameobservation that students travelled through the initial reflective journey withmore difficulties as compared to those who participated in the first cycle ofthis action research study, when themes were specified. Learning from thisexperience, in the third cycle of this research, the lecturers decided toprovide a list of major themes about prevalent professional issues forreflective activity.

In the pre-registration courses reflection was used to encourage the useof theoretical learning in the clinical field so as to achieve close integration ofclinical experience into the course structure. The aim was also to developstudents' abilities to reflect upon their practice in a clinical setting. Theexercises in reflective writing were, therefore, centred upon the clinicalexperience sessions. For example, occupational therapy students were askedto write on issues like interviewing techniques, occupational profile, workingwith age groups, teaching and learning processes.

This is one aspect of the teaching for which synthesised conclusionsare generally inappropriate. The subject for reflection will largely be governedby the curriculum and course content. What does seem to emerge overall isthat reflective learning can be applied widely and in a variety of forms.

Structure of Journal

No structure to the journals was provided in the two post-registrationcourses. Students were free to express their views however they liked. Thenursing students' discussion could be based on library sources andreferences. However, it was emphasised that their interpretations of theideas and the integration of nursing practice were of the ultimateimportance. The clinical educators were simply asked to write something intheir journal ready for each of the weekly classes.

Occupational therapy Journals were semi-structured. Brief guidelinesabout journal writings were provided to the students although they were notasked to follow them strictly. Students were recommended to start withdescribing their experience of learning during a particular learning activitysuch as an interview situation or visits. Then they could focus on some

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aspects that impressed them most and explain their feelings in relation totheir strengths, capacities, fears, weaknesses, biases, etc.

An early attempt at structuring journals in the radiography courseshowed that provided structure should be kept to a minimum. Studentswere initially provided with a list of objectives for each placement and askedto reflect on their progress towards achieving them during the clinical period.Rather than stimulating reflection, the provision of objectives reduced mostof the students to ticking objectives met and making brief comments onothers. A typical journal entry follows.

Objectives not yet achieved:1. arrangement of patient for changing of clothing2. management of children when crying3. setting of exposure factor4. decision of examination according to information onrequestform.(Extractfrom reflective journal of radiography student]

The revised reflective journal for the radiography students was divided intosections. Firstly students were asked to review their previous experience inlight of the clinical objectives, then to state what progress they would like toachieve over the course of the clinical block. They then set specific objectivesand reviewed progress for each individual placement, and finally made anassessment of overall progress at the completion of the block. The followingquotation is typical of those produced with this arrangement, and clearlyshows an advance on that above.

Another problem which is annoying me is exposure factors, I amstill not able to grasp the setting of the exposure accurately. Isometimes feel confused about the effect of[...] and [...] onphotographic qualities. The unique means to solve the problem is toclear the concept of I...] and [...] on film quality. This can be attainedby getting more experience. Lastly, as the criteria for a passablefilm is very subjective, I am not clear whether a film is correctlyexposed sometimes. (Extractfrom reflective journal of radiographystudent)

The students were also expected to complete written exercises during theperiods of clinical experience that were designed to encourage them toinvestigate and reflect upon clinical settings using their theoreticalbackground. The level of reflection was expected to increase as the courseprogressed. At the first stage they were required to note and discuss themanner and degree to which certain examination types were used in aparticular clinical setting. The second stage required them to producecase-studies of examinations from a series of placements offering differentexperience. The students reported on cases that differed, for some reason,from the normal department procedure. At the third stage the students madea comprehensive analysis of two clinical settings they attended, includingtheir own strengths and weaknesses within the team. At each stage the

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clinical assignments were incorporated into tutorial classes at thecompletion of the clinical period.

The experience in the radiography course of providing students with anover-structured journal format suggests that the provision of extensivestructuring in journals is likely to stifle individual reflection and lead tostereotyped responses. However, the provision of one or two headings, incourses which desired students to reflect on specified topics, did seem toserve a useful purpose.

The need for structuring arose in the three courses which were forpre-registration or pre-service students. Initially the students have noreservoir of experience upon which to draw and, entering their early periodsof professional practice, are often uncertain what they should be looking outfor. Providing journals with a few focus questions seemed to help ingenerating an enquiring or critical approach to these new experiences.

The other two courses were for part-time post-registration or in-servicestudents who have a reservoir of past and current experience on which todraw. They also possess developed frameworks for interpreting material. Anunstructured format seemed essential for their journals, especially since thecourses both took advantage of the students' experience by being more openas to the topic of reflection and the course content.

Assessment of Journal Writing

The issue of assessment for grading purposes poses a dichotomy for coursesintending to incorporate journal writing. Assessing journal entries candiscourage the process of private reflection. There is also the obviousproblem of what might have been written for the student alone becomingtransformed into something quite different in an attempt to gain bettermarks. Assessing journal entries tends to discourage criticism and leads topolishing of work and a more academic style rather than spontaneousreflection.

However, if the written entries are not assessed students tend to takejournal writing less seriously or even not do it at all. Students are highlyassessment driven and course marking schemes are usually treated asguidelines for the relative importance of components of courses.

The quotation below shows this dilemma from the perspective of aradiography student:

If marks are given, we will be more serious and morehard-working. Probably we will do more. If marks are not given, itis not saying we do it roughly, I think we wiR not be sohard-working. But if marks are given, it seems to be that it is not sogood.

Why is it not so good?

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It is because you dare not write something unusual. For example,something which is commonly seen and something which isdefinitely right, you can ensure you are not going to get wrong.Also, I think it is not so good.

I think if marks are given, the things which can be learnt will beless ... The scope is not so wide. (Radiography student)

The nursing and radiography courses recognised this problem of studentsfailing to take reflective writing seriously if it was not assessed. Both evolvedarrangements which retained an element of freedom and privacy in journalwriting while integrating it within the course and incorporating elementsfrom the journal writing in the assessment.

For the nursing course the students were required to submit fourjournals and a final reflective paper at regular intervals throughout thecourse. The journals were unstructured and not marked. They were handedin so that feedback could be given to students as guidelines for their futurereflective activities. A final reflective paper, which was assessed, was to besubmitted after the experience of all the dialogue sessions. The final paperwas meant to be distilled from the four journals submitted previously.Students themselves also regarded marking as an effective and essentialfeedback to their assignments. In an interview at the end of the course, oneof the students in the nursing course stated:

In fact marking is a good thing. Without it, I would not be able toknow the quality of my journals. After they had read ourjournals,they told us whether the content was relevant to the topic duringgroup discussion. But I think it was not enough for every one of us.I would be able to know my performance better if the papers aremarked. (Nursing student)

In the radiography course the reflective process was initially encouraged asan exercise separate from the clinical assignments that were already inplace. The students were asked to keep journal notes on each placementthey atended. They were asked to review the placement in terms of theobjectives to be achieved, and to analyse their own success in fulfilling them.

After two cycles of clinical experience with students writing separatereflective analyses, it was felt that the separation of the reflective exercisefrom the more formal clinical assignments reduced the students'concentration on the reflection exercise. Rather than make the reflectionexercise additional to the clinical assignments it was agreed to reformulatethe assignments to include more clearly the reflective process. At the firstlevel, for example, the assignments now require the students to discuss theirown ability to perform and assess the outcomes for the examinations andprocedures they are analysing. Similar adjustments have been made at thesecond and third levels of clinical experience.

If the type of journal writing is loosely structured, the importance ofexamination and feedback is particularly high. For example, a radiography

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student stressed the motivational effect of feedback when he talked aboutassessment of journals. The importance of the writing making a significantcontribution to the assessment is also apparent.

Is it better to give marks or not?

As I said before, even if marks are given, it gives some sort ofmotivation to do it. The motivational effect, however, is not great.For example, if it carries 5 marks, I would be willing to hand it in. IfI hand it in, at least, I might have 3 marks. The most seriousproblem is having no feedback. They have to show respect to thework of other people. They need to go through, correct and talk withus when it is given back to us. This would be the most importantquestion. For instance, even if they tell me I get full marks, I won'tcare much as I don't know where my paper is right now and theywon't give it back to you. (Radiography student)

Journal writing was introduced in the physiotherapy course as a voluntaryelement but the majority of students felt they had enough to cope withwithout having to keep a journal as well! However, a handful were agreeableto trying it out. The plan for keeping reflective diaries on an ongoing basisduring the clinical placement raised little interest, not only among studentsbut, as discovered later, also with staff. However, despite this, most of thestudents tended to agree that reflection would assist with betterunderstanding of, for example, a problem or interaction and hence, couldpave the way for improvement. The main reason given for why the students(and some clinical educators) were unwilling to write journals on an ongoingbasis was because it would consume too much of their time, which theydesperately needed for looking up relevant medical and other information inorder that they can treat patients properly, which will affect their chances ofpassing the placement!

There is no easy answer to this dichotomy. The courses we studiedprovided examples of the influence of assessing or not assessing journalentries. We also evolved some intermediate positions in which the bulk of thejournal entries remained private but work derived from them was assessedso that students had some incentive to participate in journal writing. Indeciding if assessing reflective writings is appropriate or not, one shouldconsider the format and the nature of the writings.

Frequency with which Journal Entries are Examined

A further aspect of the dichotomy over the privacy of journal writing iswhether, and if so how often, the lecturer looks at what is written in thejournal. The issue of the frequency with which journal entries are examinedis bound up with the purpose for which they are examined. The courses inthis study formed a spectrum in terms of how often the lecturers examinedthe students' journals. For the clinical educators' course the journals formed

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the basis of weekly discussion and of a final assignment but were notrequired to be handed in.

Occupational therapy students discussed their journal entries informal discussion sessions in class about halfway through the course. In aninterview at the end of the course, students generally showed the need formore discussions about the content of their journal. The quotations belowwere examples of some of their statements.

Maybe the lecturer can arrange more discussions on the journalwriting. Discussions can help students to know they have learnt inthe visit or in thejoumal writing. The lecturer canfurther elaborateour information. (Occupational therapy student)

Ideally, the discussion should be before and after thejoumalwriting, but I know that there is not enough time for discussion. So.I think the discussion should take place after journal writing.(Occupational therapy student)

Similarly, in the radiography course journals were normally used as thefocus for discussion between an individual student and clinical instructorduring clinical placements, and apart from this they were reviewed at thecompletion of a block of clinical experience. A higher frequency of journalreviewing by lecturers would be impractical.

The nursing course required the students to submit four journals at6-week intervals. The journals were not marked for assessment but studentswere given feedback on their journal writing. The arrangement wasintroduced so the lecturers could monitor both understanding of nursingissues and the students' development as reflective writers.

The various arrangements show different compromise positions wereadopted. Excessive intrusion into journals would inhibit personal reflectionand change the writing to a more publicly acceptable form. Yet noexamination means that the lecturers gain no feedback on understanding ofthe course material and no opportunity to monitor and shape the students'development as reflective writers.

Overall our conclusion was that examination of journal entries neededto be reasonably frequent if students were new to reflective writing. Withoutfrequent disclosure there was no opportunity to provide feedback on thestudents' development as reflective writers and no chance to assist thestudents to evolve away from ingrained conceptions of academic writingtowards a more open, reflective style. The type of feedback can vary,including written feedback and tutorial discussions.

Conclusion

Of the elements of teaching arrangements and course format discussedabove, some are worth bringing together, refining and restating within thisoverall conclusion.

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Formative Development of Reflective Writing

We came to see reflective writing as an ability which took time to develop andfor some was quite hard to achieve. Formal education normally requires astyle of writing which is virtually the antithesis of reflective writing. Manystudents find it hard to unlearn their conception of impersonal academicwriting and to record their personal reflections. In this paper, however, wehave demonstrated the students' capability of achieving this through carefulinstructional planning and frequent feedback.

Formality is one of the major defects of traditional academic writing.Health care professionals need a more flexible style of writing becauseproblems in professional practices are sometimes so complicated that thereare no formal rules to follow. The quotation below may demonstrate thecontradiction of professional practices and traditional writing style.

In our placement, we have made modification to our knowledgeand become more informal. A third person might regard it as doingsomething wrong, but you have actually used and applied theknowledge in practice without being noticed. If you write this in the

journal others might feel uneasy when they read about thetechniques being employed. We have to write formal techniques inour writing. The best thing is to have some background supportfrom academic journals. (Radiography student)

Journal writing, therefore, needs to be treated as an ability to be developedover time. Courses must allow space and time for this development to takeplace. There needs to be provision for frequent feedback on what is written.In providing feedback lecturers/tutors, clinical supervisors and fellowstudents have a role to play.

Integrating Reflective Writing with the Course

The clinical educators' course was seen as successful in promoting reflectionby both students and lecturers. By the end of the course studentsparticipated very enthusiastically in reflective writing. An important reasonwas that journal keeping was a central and intrinsically important feature ofthe course.

The course which had the greatest difficulty in persuading students toparticipate in journal writing was physiotherapy. Students were encouragedto think that the learning contracts and journal writing would not be acompletely new exercise for them as they had at the end of the previousplacement already reflected on objectives that they had and had notachieved. They had also reflected on which objectives they would particularlylike to fulfil during the following placement and how they would achievethose learning objectives. However, because journal writing was treated as avoluntary exercise students saw it as an additional burden and there wasnot full participation by the whole class.

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Our conclusion was that courses needed to adapt their formats so thatstudents perceived reflective writing as an intrinsic component. The processof adapting the course format needed both sensitivity and experimentation,though. The course elements which signify centrality are assessing journals,examining the writing in them and requiring students to disclose at leastsome journal entries in tutorial discussion. Yet, if handled insensitively, eachof these measures can inhibit private journal writing. The courses in thisstudy attempted to evolve a format which signified the importance of journalwriting while still retaining some element of the sanctity of personalreflections.

Configuring Teaching

In this paper we have discussed a range of elements within the teaching andlearning environment. In each case we have tried to show how variablesimpinge upon reflective learning. The paper provides some suggestions as towhich factors are important and discusses how they might be configured.

There are few aspects of teaching which have a clear unidirectionalimpact on reflective writing: rather a course often has to evolve towards anintelligent position between dichotomies. The curriculum and teachingformat needs to achieve a balance between factors which act in combinationand are to some extent sensitive to each other.

Courses can differ markedly in terms of variables such as theircontent, the background of the students, the institutional climate and thetime and resources available. Each of these contextual variables should betaken into account in configuring a curriculum to promote reflective writing.Curriculum planning should draw upon established wisdom, but interpret itin a way which is sensitive to these contextual variables.

Action Research Approach

Putting such a curriculum into practice in a situation will undoubtedlyrequire further fine tuning to achieve a balanced arrangement which suits aparticular course and learning environment. There are suggestions in thispaper which should help the initial curriculum design and we also feel thatthe action research approach we have described is appropriate for dealingwith implementation and adaptation to a particular context.

An important element of our approach has been its participative andcollaborative nature. An aspect of this which has perhaps been understatedso far in the article has been the involvement of the students. Our writinghas focused at the meta-project level at which we synthesised findings fromfive course-level action research projects. Student involvement has beenmuch more apparent at the course level, where they have been contributorsto each of the individual course projects.

Indeed, it has been essential to have the involvement of and input fromthe many students enrolled on these courses. Students' reflection on thecourse experience has directly or indirectly influenced all of the strategies

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described. An example of the value of this input is given by the followingsuggestions on how to introduce the concept of reflection which will beincorporated into future cycles.

I think it would be good if the lecturer lets the students in year 2 oryear 3 or some graduated students tell the year 1 students what isthe importance or the significance of reflective journal writing. Ithink it will be more exciting than an introduction by the lecturer....It may arise their interest and they will become more active...(Occupational therapy student)

I think that the lecturer has to explain the main aim of reflectivejournals at the beginning of the year. And the lecturer may usesome guideline to the student and use journals of the past studentsfor samples. And the lecturer may help the students to discuss inclass in group or some topics that related to the lecture. Then, afterdiscussion, we can jot down some notes and write the reflectivejournal to the lecturer. I think this is the best way. (Occupationaltherapy student)

At the meta-project level, the collaborative and inter-departmental nature ofthe project has been important. Collaboration complicated the logistics of theproject as even arranging a meeting time when all were free was quitedifficult. However, the logistical difficulties were outweighed by the benefitsfrom the cross-fertilisation of ideas and experiences between courses andteachers.

Acknowledgements

This research was supported by grants from the Action Learning Project, theEducational Development Fund of the Hong Kong Polytechnic University, theHong Kong Polytechnic University Research Committee and the UniversityGrants Committee of Hong Kong.

Correspondence

David Kember, Hong Kong Polytechnic University, Hung Horn, Kowloon,Hong Kong.

References

Bean, T. W. & Zulich, J. (1989) Using dialogue journals to foster reflective practice withpreservice, content-area teachers, Teacher Education Quarterly, 16, pp. 33-40.

Biggs, J. B. & Teller. R. (1987) The Process of Learning. Sydney: Prentice Hall.

Boud, D., Keogh, R. & Walker, D. (Eds) (1985) Reflection: turning experience intolearning. London: Kogan Page.

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Bowman.R. F. Jr & Richard, F. (1983) The personal student journal: mirror of themind. Contemporary Education, 55, pp. 25-27.

Burnard, P. (1988) The journal as an assessment and evaluation tool in nurseeducation. Nurse Education Today, 8, pp. 105-107.

Cameron, B. L. & Mitchell, A .M. (1993) Reflective peer journals: developing authenticnurses. Journal of Advanced Nursing, 18, pp. 290-297.

Colton, A. B. & Sparks-Langer, G. M. (1993) A conceptual framework to guide thedevelopment of teacher reflection and decision making. Journal of TeacherEducation, 44, pp. 45-53.

Dewey, J. (1993). How We Think: a restatement of the relation of reflective thinking to theeducative process. Boston: D. C. Heath.

Hahnemann, B. K. (1986) Journal writing: a key to promoting critical thinking innursing students, Journal of Nursing Education, 25(5). pp. 213-215.

Kottkamp, R. B. (1990) Means of facilitating reflection. Education and Urban Society,22. pp. 182-203.

Landeen, J., Byrne, C. & Brown, B. (1992) Journal keeping as an educational strategyin teaching psychiatric nursing. Journal of Advanced Nursing, 17, pp. 347-355.

Lukinsky, J. (1990) Reflective withdrawal through journal writing, in J. Mezirow (Ed.) etal Fostering Critical Reflection in Adulthood: a guide to transformative andemancipatory learning. San Francisco: Jossey-Bass.

Mezirow, J. (1991) Transformative Dimensions of Adult Learning. San Francisco:Jossey-Bass.

Mezirow, J. and Associates (1990) Fostering Critical Reflection in Adulthood. A guide totransformative and emancipatory learning. San Francisco: Jossey-Bass.

Nicassio, F. (1992). SwampLog: a structured journal for reflection-in-action. WritingNotebook: creative word processing in the classroom, 9(3), pp. 13-18.

Schön, D.A. (1983) The Reflective Practitioner: how professionals think in action. NewYork: Basic Books.

Schön, D. A. (1987) Educating the reflective practitioner: San Francisco: Jossey-Bass.Smyth, J. (1989) Developing and sustaining critical reflection in teacher education.

Journal of Teacher Education, 40(2), pp. 2-9.Yinger, R. J. & Clark, C. M. (1981) Reflective journal writing: theory and practice,

Occasional Paper, No. 50, Michigan State University, Institute for Research onTeaching.

Watts, N. T. (1990) Handbook of Clinical Teaching. Edinburgh: Churchill Livingstone.Wagenaar, T. C. (1984) Using student journals in sociology courses, Teaching Sociology.

11, pp. 419-437.

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