Knowledge, Practices and Barriers of Reflective Practice Among Undergraduate Nursing and Midwifery Students in Malawi.

Background: Reflective practice is widely recognized as an invaluable tool for improving the provision of nursing care, promoting professional and personal development, and ensuring ethical and effective practice. However, there is paucity of research regarding reflective practice in nursing education and practice in Malawi. This study lays the groundwork for future research, offering a foundation upon which subsequent studies can build to further explore and develop the practice of reflection in nursing and midwifery education in Malawi. Therefore, this study aimed to assess undergraduate nursing and midwifery students' knowledge, practices and barriers of reflection at Mzuzu and Daeyang Universities.

Methods: This study used a quantitative descriptive cross-sectional design employing a census approach. A self-administered questionnaire was used to collect data from 101 undergraduate nursing and midwifery students. Descriptive statistics and multivariate linear regression analyses were done using Statistical Package for Social Sciences (SPSS) version 25.

Results: Overall, 101 (100%) of the students had an understanding of the meaning of reflective practice. Majority, 99 (98%) of the students engaged in reflective practice. The results showed that better care outcomes negatively influenced the practice of reflection among the students (Coef= -0.11), (95% CI [-0.19, -0.03] P =0.009). The study also revealed barriers to reflection, including unsupportive Clinical Learning Environment 53 (52.5%), unable to identify events to reflect upon 34 (33.6%), and time constraints 32 (31.7%). Further the results showed a significant difference between Mzuzu University students and Daeyang University students in terms of the support they received from nurses regarding reflective practice (Z = 12.3, P = 0.02).

Conclusion: The findings show a wide spread of knowledge and practice of reflection. More efforts are needed to put down the effects of the challenges observed such as structured reflection sessions and integration of a standardized reflection module in the curricula for nursing.