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Hemşirelik öğrencilerinin yansıtıcı düşünme düzeyleri ile hemşirelik süreci yetkinlikleri arasındaki ilişki: kesitsel, tanımlayıcı bir çalışma

Year 2026, Volume: 9 Issue: 1, 118 - 125, 05.01.2026
https://doi.org/10.32322/jhsm.1824067

Abstract

Giriş: Hemşirelik eğitiminde yansıtıcı düşünme, klinik akıl yürütmeyi geliştirmek ve hemşirelik sürecini etkili bir şekilde uygulamak için kritik bir öneme sahiptir.
Amaç: Bu araştırma, hemşirelik öğrencilerinin yansıtıcı düşünme düzeyleri ile hemşirelik süreci yetkinlikleri arasındaki ilişkiyi incelemeyi amaçlamaktadır.
Yöntem: Kesitsel ve tanımlayıcı nitelikteki çalışma, 2025 yılında bir vakıf üniversitesinde öğrenim gören 224 hemşirelik öğrencisiyle gerçekleştirilmiştir. Veriler, öğrenci tanıtıcı formu, Yansıtıcı Düşünme Ölçeği ve Hemşirelik Süreci Yetkinlik Ölçeği ile toplanmıştır. SPSS 29.0 programı ile parametrik olmayan testler, korelasyon ve regresyon analizleri gerçekleştirilmiştir.
Bulgular: Öğrenciler, hemşirelik sürecinde orta düzeyde yansıtıcı düşünme (X̄=37,46±7,53) ve yüksek düzeyde algılanan yeterlilik (X̄=3,81±0,72) göstermiştir. Yansıtıcı düşünmenin "alışkanlık haline gelmiş eylem" alt boyutu ile hemşirelik süreci yeterliliği arasında anlamlı pozitif korelasyon (r=0,242, p<0,001) bulunurken, "yansıtma" (r=-0,385), "anlama" (r=-0,285) ve "eleştirel yansıtma" (r=-0,186) alt boyutları arasında negatif korelasyonlar gözlenmiştir. Regresyon analizi, alışkanlığa dönüşen eylemin (β=0,265) yeterliliği pozitif yönde yordadığını, yansıtmanın (β=-0,260) ise negatif bir yordayıcı olduğunu (R²=0,126, p<0,001) ortaya koymuştur.
Sonuç: Alışkanlık haline gelmiş, otomatik bilişsel kalıplar öğrencilerin algıladıkları yeterliliği desteklerken, daha derin yansıtıcı süreçler özgüvenlerini zorlayabilir. Bu bulgular, klinik yeterliliği ve eleştirel düşünmeyi geliştirmek için hemşirelik eğitimine yapılandırılmış, deneyime dayalı yansıtıcı öğrenme stratejilerinin entegre edilmesi gerektiğini göstermektedir.

Ethical Statement

Bu çalışma için etik onay Helsinki Bildirgesi'ne uygun olarak Lokman Hekim Üniversitesi Etik Kurulu'ndan (Tarih: 30.05.2025, Karar No: 202:169, Kod No: 2025140) alınmıştır. Ayrıca Hemşirelik Bölümü'nden yazılı kurumsal izin alınmıştır.

Supporting Institution

Yazarlar bu çalışmanın herhangi bir finansal destek almadığını beyan etmişlerdir.

Project Number

-

Thanks

Yazarlar bu çalışmaya değerli katkılarından dolayı tüm katılımcılara teşekkürlerini sunarlar.

References

  • Karacabay K, Savcı A, Ozturk B. Investigation of self-learning, clinical decision making and reflective thinking levels of nursing students taking surgery lessons. J Inonu University Health Services Vocational School. 2022;10(2):667-680. doi:10.33715/inonusaglik.1036039
  • Korkut S, Sahin S, Ulker T, Cidem A. Nursing students' views of the nursing process and its challenges, and their solutions: a qualitative study. Int J Caring Sci. 2021;14(2):811.
  • Kim YH, Min J, Kim SH, Kim SS, Park HR. Effects of a work-based critical reflection program for novice nurses. BMC Med Educ. 2018;18(1):30. doi: 10.1186/s12909-018-1135-0
  • Maffucci J, Vanderzwan K, Burt L. Evaluating a shared reflective practice to develop nursing student clinical judgment. Nurse Educ. 2024;49(3):147-151. doi:10.1097/NNE.0000000000001570
  • Chong MC. Is reflective practice a useful task for student nurses? Asian Nurs Res. 2009;3(3):111-120. doi:10.1016/S1976-1317(09)60022-0
  • Contreras JA, Edwards-Maddox S, Hall A, Lee MA. Effects of reflective practice on baccalaureate nursing students' stress, anxiety and competency: an integrative review. Worldviews Evid. -Based Nurs. 2020; 17(3):239-245. doi:10.1111/wvn.12438
  • Ozbudak E, Koc Z. The importance of critical thinking in nursing practices. Health and Society. 2021;31(2):38-48.
  • Taskin Yilmaz F, Sabanciogullari S, Aldemir K. The opinions of nursing students regarding the nursing process and their levels of proficiency in Turkey. J Caring Sci. 2015;4(4):265-275. doi:10.15171/jcs.2015.027
  • Bowers M, Terry D, Irwin P. The impact of reflective practice on nursing students: a scoping reviews. Nurse Education in Practice. 2025;87:104468. doi:10.1016/j.nepr.2025.104468
  • Altın M, Saracaloğlu AS. Creative, critical and reflective thinking: similarities-differences. IntJCES. 2018;4(1):1-9.
  • Kaddoura MA. Critical thinking skills of nursing students in lecture-based teaching and case-based learning. IJ-SoTL. 2011;5(2):20. doi:10. 20429/ijsotl.2011.050220
  • Basit G. Examining the Turkish validity and reliability of the Competency of Nursing Process Questionnaire: a methodological study. Turkiye Klinikleri J Nurs Sci. 2024;16(3):752-760. doi:10.5336/nurses.2024-101967
  • Yılmaz AA, Gencer E, Seckin C, Yılmaz H, Guven KT, Gozutok S. Difficulties experienced by nursing students on the data collection step of the nursing process. J Anatolia Nurs Health Sci. 2019;22(4):231-239. doi:10.17049/ataunihem.439074
  • Kember D, Leung D, Jones A, et al. Development of a questionnaire to measure the level of reflective thinking. Assessment & Evaluation in Higher Education. 2000;25:380-395. doi:10.1080/713611442
  • Cigdem H, Kurt AA. Adaptation of reflective thinking scale to Turkish. J Educ Fac. 2012;25(2):475-493.
  • Koy V, Yunibhand J, Rauth A, Bircher N, Prak M, Henker R. Development and psychometric testing of a Competency of Nursing Process Questionnaire. Int J Nurs Sci. 2023;10(2):245-50. doi:10.1016/j.ijnss.2023.03.009
  • Tanrıkulu F, Erol F, Filiz NY, Gündogdu H, Dikmen Y. An investigation into the opinions of nursing students on reflective thinking technique used in their clinical education. STED. 2018;27(3):197-204.
  • Alsalamah Y, Albagawi B, Babkair L, et al. Perspectives of nursing students on promoting reflection in the clinical setting: a qualitative study. Nurs Rep. 2022;12:545-555. doi:10.3390/nursrep12030053
  • Archer-Kuhn B, Samson P, Damianakis T, Barrett B, Matin S, Ahern C. Transformative learning in field education: students bridging the theory/practice gap. Br J Soc Work. 2021;51:2419-2438. doi:10.1093/bjsw/ bcaa082
  • Hallaran AJ, Edge DS, Almost J, Tregunno D. New nurses’ perceptions on transition to practice: a thematic analysis. CJNR. 2023;55(1):126-136. doi:10.1177/08445621221074872
  • Palesy D, Levett-Jones T. Reflection revisited: Educational interventions for advancing the professional disposition of postgraduate nursing students. In Enriching Higher Education Students’ learning through post-work placement interventions. Springer: Cham, Switzerland, 2020.
  • Basit G. Guide to care: Nursing process. Journal of General Health Sciences. 2020;2(2):77-90.
  • Berman A, Snyder SJ, Frandsen G. Kozier&Erb's Fundamentals of Nursing, Concepts, Process, and Practice (10 ed.). New Jersey: Julie Levin Alexander. 2016.
  • Akansel N, Pallos A. Difficulties experienced by nursing students in the development of nursing care plans: root cause analysis. AUHSJ. 2020;11 (2):269-275. doi:10.31067/0.2020.265
  • Aydın N, Akansel A. Determination of accuracy of nursing diagnoses used by nursing students in their nursing care plans. Int J Caring Sci. 2013;6:252-257.
  • Yont GH, Khorshid L, Eser I. Examination of nursing diagnoses used by nursing students and their opinions about nursing diagnoses. Int J Nurs Terminol. Classif. 2009;20:162-168. doi:10.1111/j.1744-618X.2009.01131.x
  • Hassanein SM, Tantawi HR, Sadek BN, Hendy A, Awad HA. Impact of structured simulation-based and on-job training program on nurses’ competency in pediatric peripheral intravenous cannulation: children’s hospital experience. Nurse Educ Today. 2021;98:104776. doi:10.1016/j.nedt.2021.104776
  • Hung CC, Kao HFS, Liu HC, Liang HF, Chu TP, Lee BO. Effects of simulation-based learning on nursing students’ perceived competence, self-efficacy, and learning satisfaction: a repeat measurement method. Nurse Educ Today. 2021;97:104725. doi:10.1016/j.nedt.2020.104725
  • Licen S, Plazar N. Identification of nursing competency assessment tools as possibility of their use in nursing education in Slovenia-a systematic literature review. Nurse Educ Today. 2015;35(4):602-608. doi:10.1016/j.nedt.2014.12.023
  • Tyndall DE, Firnhaber GC, Scott ES. The impact of new graduate nurse transition programs on competency development and patient safety: an integrative review. ANS. 2018;41(4):26-52. doi:10.1097/ANS.0000000000 000217

The relationship between nursing students' reflective thinking levels and competency of nursing process: a cross-sectional, descriptive study

Year 2026, Volume: 9 Issue: 1, 118 - 125, 05.01.2026
https://doi.org/10.32322/jhsm.1824067

Abstract

Aims: Reflective thinking is crucial in nursing education to foster clinical reasoning and the effective implementation of the nursing process. This study aimed to examine the relationship between nursing students’ reflective thinking levels and their competencies in the nursing process.
Methods: A cross-sectional descriptive study was conducted with 224 nursing students enrolled at a foundation university in 2025. Data were collected using the Reflective Thinking Scale and the Competency of Nursing Process Questionnaire. Non parametric statistical tests, correlation, and regression analyses were performed using SPSS 29.0.
Results: Students demonstrated moderate levels of reflective thinking (X=37.46±7.53) and high perceived competency in the nursing process (X=3.81±0.72). A significant positive correlation was found between the "habitual action" subdimension of reflective thinking and nursing process competency (r=0.242, p<0.001), while negative correlations were observed with the "reflection" (r=-0.385), "understanding" (r=-0.285), and "critical reflection" (r=-0.186) subdimensions. Regression analysis revealed that habitual action (β=0.265) positively predicted competency, while reflection (β=-0.260) was a negative predictor (R²=0.126, p<0.001).
Conclusion: While habitual, automatic cognitive patterns support students’ perceived competence, deeper reflective processes may challenge their self-confidence. These findings suggest the need to integrate structured, experience-based reflective learning strategies into nursing education to enhance clinical competence and critical thinking.

Ethical Statement

Ethical approval for this study was obtained from the Lokman Hekim University Ethics Committee (Date: 30 May 2025, Decision No: 202:169, Code No: 2025140) in accordance with the Declaration of Helsinki. Written institutional permission was also obtained from the Department of Nursing.

Supporting Institution

No financial support was received.

Project Number

-

Thanks

The authors thank all the participants for their valuable contributions to this study.

References

  • Karacabay K, Savcı A, Ozturk B. Investigation of self-learning, clinical decision making and reflective thinking levels of nursing students taking surgery lessons. J Inonu University Health Services Vocational School. 2022;10(2):667-680. doi:10.33715/inonusaglik.1036039
  • Korkut S, Sahin S, Ulker T, Cidem A. Nursing students' views of the nursing process and its challenges, and their solutions: a qualitative study. Int J Caring Sci. 2021;14(2):811.
  • Kim YH, Min J, Kim SH, Kim SS, Park HR. Effects of a work-based critical reflection program for novice nurses. BMC Med Educ. 2018;18(1):30. doi: 10.1186/s12909-018-1135-0
  • Maffucci J, Vanderzwan K, Burt L. Evaluating a shared reflective practice to develop nursing student clinical judgment. Nurse Educ. 2024;49(3):147-151. doi:10.1097/NNE.0000000000001570
  • Chong MC. Is reflective practice a useful task for student nurses? Asian Nurs Res. 2009;3(3):111-120. doi:10.1016/S1976-1317(09)60022-0
  • Contreras JA, Edwards-Maddox S, Hall A, Lee MA. Effects of reflective practice on baccalaureate nursing students' stress, anxiety and competency: an integrative review. Worldviews Evid. -Based Nurs. 2020; 17(3):239-245. doi:10.1111/wvn.12438
  • Ozbudak E, Koc Z. The importance of critical thinking in nursing practices. Health and Society. 2021;31(2):38-48.
  • Taskin Yilmaz F, Sabanciogullari S, Aldemir K. The opinions of nursing students regarding the nursing process and their levels of proficiency in Turkey. J Caring Sci. 2015;4(4):265-275. doi:10.15171/jcs.2015.027
  • Bowers M, Terry D, Irwin P. The impact of reflective practice on nursing students: a scoping reviews. Nurse Education in Practice. 2025;87:104468. doi:10.1016/j.nepr.2025.104468
  • Altın M, Saracaloğlu AS. Creative, critical and reflective thinking: similarities-differences. IntJCES. 2018;4(1):1-9.
  • Kaddoura MA. Critical thinking skills of nursing students in lecture-based teaching and case-based learning. IJ-SoTL. 2011;5(2):20. doi:10. 20429/ijsotl.2011.050220
  • Basit G. Examining the Turkish validity and reliability of the Competency of Nursing Process Questionnaire: a methodological study. Turkiye Klinikleri J Nurs Sci. 2024;16(3):752-760. doi:10.5336/nurses.2024-101967
  • Yılmaz AA, Gencer E, Seckin C, Yılmaz H, Guven KT, Gozutok S. Difficulties experienced by nursing students on the data collection step of the nursing process. J Anatolia Nurs Health Sci. 2019;22(4):231-239. doi:10.17049/ataunihem.439074
  • Kember D, Leung D, Jones A, et al. Development of a questionnaire to measure the level of reflective thinking. Assessment & Evaluation in Higher Education. 2000;25:380-395. doi:10.1080/713611442
  • Cigdem H, Kurt AA. Adaptation of reflective thinking scale to Turkish. J Educ Fac. 2012;25(2):475-493.
  • Koy V, Yunibhand J, Rauth A, Bircher N, Prak M, Henker R. Development and psychometric testing of a Competency of Nursing Process Questionnaire. Int J Nurs Sci. 2023;10(2):245-50. doi:10.1016/j.ijnss.2023.03.009
  • Tanrıkulu F, Erol F, Filiz NY, Gündogdu H, Dikmen Y. An investigation into the opinions of nursing students on reflective thinking technique used in their clinical education. STED. 2018;27(3):197-204.
  • Alsalamah Y, Albagawi B, Babkair L, et al. Perspectives of nursing students on promoting reflection in the clinical setting: a qualitative study. Nurs Rep. 2022;12:545-555. doi:10.3390/nursrep12030053
  • Archer-Kuhn B, Samson P, Damianakis T, Barrett B, Matin S, Ahern C. Transformative learning in field education: students bridging the theory/practice gap. Br J Soc Work. 2021;51:2419-2438. doi:10.1093/bjsw/ bcaa082
  • Hallaran AJ, Edge DS, Almost J, Tregunno D. New nurses’ perceptions on transition to practice: a thematic analysis. CJNR. 2023;55(1):126-136. doi:10.1177/08445621221074872
  • Palesy D, Levett-Jones T. Reflection revisited: Educational interventions for advancing the professional disposition of postgraduate nursing students. In Enriching Higher Education Students’ learning through post-work placement interventions. Springer: Cham, Switzerland, 2020.
  • Basit G. Guide to care: Nursing process. Journal of General Health Sciences. 2020;2(2):77-90.
  • Berman A, Snyder SJ, Frandsen G. Kozier&Erb's Fundamentals of Nursing, Concepts, Process, and Practice (10 ed.). New Jersey: Julie Levin Alexander. 2016.
  • Akansel N, Pallos A. Difficulties experienced by nursing students in the development of nursing care plans: root cause analysis. AUHSJ. 2020;11 (2):269-275. doi:10.31067/0.2020.265
  • Aydın N, Akansel A. Determination of accuracy of nursing diagnoses used by nursing students in their nursing care plans. Int J Caring Sci. 2013;6:252-257.
  • Yont GH, Khorshid L, Eser I. Examination of nursing diagnoses used by nursing students and their opinions about nursing diagnoses. Int J Nurs Terminol. Classif. 2009;20:162-168. doi:10.1111/j.1744-618X.2009.01131.x
  • Hassanein SM, Tantawi HR, Sadek BN, Hendy A, Awad HA. Impact of structured simulation-based and on-job training program on nurses’ competency in pediatric peripheral intravenous cannulation: children’s hospital experience. Nurse Educ Today. 2021;98:104776. doi:10.1016/j.nedt.2021.104776
  • Hung CC, Kao HFS, Liu HC, Liang HF, Chu TP, Lee BO. Effects of simulation-based learning on nursing students’ perceived competence, self-efficacy, and learning satisfaction: a repeat measurement method. Nurse Educ Today. 2021;97:104725. doi:10.1016/j.nedt.2020.104725
  • Licen S, Plazar N. Identification of nursing competency assessment tools as possibility of their use in nursing education in Slovenia-a systematic literature review. Nurse Educ Today. 2015;35(4):602-608. doi:10.1016/j.nedt.2014.12.023
  • Tyndall DE, Firnhaber GC, Scott ES. The impact of new graduate nurse transition programs on competency development and patient safety: an integrative review. ANS. 2018;41(4):26-52. doi:10.1097/ANS.0000000000 000217
There are 30 citations in total.

Details

Primary Language English
Subjects Fundamentals of Nursing
Journal Section Research Article
Authors

Beratiye Öner 0000-0002-8004-4657

İlknur Maraşlı 0000-0002-5804-2532

Kardelen Ayyıldız This is me 0009-0004-7777-903X

Neşe Yıldız 0009-0008-5086-8816

Project Number -
Submission Date November 15, 2025
Acceptance Date December 1, 2025
Publication Date January 5, 2026
Published in Issue Year 2026 Volume: 9 Issue: 1

Cite

AMA 1.Öner B, Maraşlı İ, Ayyıldız K, Yıldız N. The relationship between nursing students’ reflective thinking levels and competency of nursing process: a cross-sectional, descriptive study. J Health Sci Med / JHSM. 2026;9(1):118-125. doi:10.32322/jhsm.1824067

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