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The use of a cognitive behavioural model of reflection to facilitate transformative learning in undergraduate nursing education. The quantitative results of a mixed methods study
Journal article   Open access   Peer reviewed

The use of a cognitive behavioural model of reflection to facilitate transformative learning in undergraduate nursing education. The quantitative results of a mixed methods study

Robert Batterbee, Julie Bradshaw, Andrew Frost and Susan Hunt
Nurse education in practice, Vol.87, 104444
2025
DOI: https://doi.org/10.1016/j.nepr.2025.104444
PMID: 40737862
Appears in  Open Access via Read & Publish Agreements
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CC BY V4.0,  Open Access

Abstract

Cognitive Behavioural Reflection Critical Reflection Transformative Learning Theory Undergraduate Nursing Education
Aim This study examined whether a cognitive behavioural approach to critical reflection could facilitate transformative learning in nursing students compared with a traditional reflective model. Background Critical reflection is essential in nursing practice and education. While transformative learning theory (TLT) has the potential to facilitate deeper learning, its application in nursing education remains underexplored. Cognitive behavioural approaches have successfully promoted critical reflection in other clinical professions but have yet to be used in nursing education. Design A quasi-experimental mixed methods design was employed. This paper reports the quantitative findings. Methods Two groups od second year undergraduate nursing students were compared: the experimental group received a cognitive behavioural approach, while the control group received a traditional reflective model. The Self-Reflection and Insight Scale (SRIS) measured outcomes at baseline, post-intervention and follow up. Response rates were 88.5 % (n = 139) for the experimental group and 93 % (n = 169) for the control group. Data were analysed using Linear mixed-effects models. Results Significant differences were observed in insight, engagement in reflection and perceived need to reflect. The cognitive behavioural approach led to a highly significant increase in reflective insight, with scores improving by 5.54 units from baseline to follow-up (p < 0.001). Conclusions These findings indicated that the cognitive behavioural approach facilitated critical reflection, particularly in developing insight and metacognitive skills. A separate qualitative analysis examining the utility of the approach will offer further insight into how this approach supported transformative learning.

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