The purpose of Reflection-in-Action is to reflect upon what one has learned or how one has performed as compared with one’s expectations or goals. This assignment will provide an opportunity for students to share their experiences, thoughts, feelings and learning moments from this course.

Self understanding through reflection on life experiences, feelings, etc., is a core concept in Dr. Jean Watson’s Theory of Human Caring.

The Reflection for this course must address at least three (3) of the following topics:

Learning moments or activities from this course
Thoughts on evidence-based practice
Evidence supporting Jean Watson’s Theory of Human Caring
Ethics in research
Protecting human subjects in quality improvement or evidence-based practice projects
Understanding or comfort level with statistics in nursing research and other research reports
Perception of MSN graduates’ role in nursing research
Creating and sustaining an Evidence-Based nursing environment
Asking compelling, clinical questions
Lessons learned while conducting evidence-based literature review
Length: A minimum of two and maximum of four pages (excluding the title and reference pages). Submissions not meeting the minimum and maximum page requirements will receive a grade of zero.
Format: Formal paper, APA 7th ed format for body of paper and all citations. Reflection in Action Paper Essay

Reflection in Action Paper
Looking at my experience during this course, I would confidently say that I have achieved quite a lot taking into account the objectives that I set at the beginning. I understand that reflection is an important part of the evaluation process in order to determine whether goals have been achieved and lessons learnt. The purpose of this paper is to allow me to reflect on my experience in the course based on four of the several topics that apply to the program. These are:
i. Thoughts on evidence-based practice (EBP)
ii. Ethics in research
iii. Evidence supporting Jean Watson’s Theory of Human Caring, and
iv. Protecting human subjects in quality improvement projects.
Thoughts on Evidence-Based Practice (EBP)
My thoughts on evidence-based practice (EBP) within the context of the course are overwhelmingly positive. EBP is the way of prescribing interventions in healthcare that places emphasis on scholarly evidence supporting the use of every intervention (Melnyk & Fineout-Overholt, 2019). It is therefore the gold standard for practice for all nurses and advanced practice nurses. Throughout the course, I have seen that there is no facet of practice that is not touched by EBP. To start with, I have seen that EBP does not allow the nurse to be complacent. They are made to remain on toes all the time and to seek continuous professional development lest some new evidence renders what one knows and practices obsolete. I think this is good for practice because ultimately the person that benefits is the patient.
With the normalization of EBP in practice, I am of the opinion that a lot of lives and resources have been saved. The requirement that an intervention will not be used just because it has always been used that way means that the nurse will be hard pressed to provide evidence for efficacy of the intervention(s) they employ. This fosters accountability and greatly improves the quality of care. Nurses have as a result been actively participating in presentations and conferences in my estimation because these are the avenues for receiving disseminated information on new research evidence for interventions. The patient is thus safer with a more informed nurse. They also heal quicker and spend less on hospitalization costs.

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Ethics in Research
The other topic that I would like to reflect on is the matter of ethics in research. As a student I have been called upon already to do some projects that require using the research methodology. Earlier on in the course I was made aware that human subjects used in research and other projects such as quality improvement projects must be protected. In other words, I have been privileged to learn in this course that the bioethical principles advanced by Beauchamp and Childress apply all to these human research participants. Together with fidelity (honesty and trust), these are autonomy, beneficence, justice, and nonmaleficence (Haswell, 2019).
I now know that researchers must act ethically and take actions that are morally correct and acceptable. For instance, I now know that human research subjects must be given the leeway to decide whether to participate in a particular research project or not. This should be after thorough explanation and information has been given to them to enable the giving or otherwise of informed consent. This is autonomy; and it also involves allowing the subject to decide whether to withdraw their participation midway or not. I also now know about beneficence. In the context of research ethics, this means that the researchers should clearly explain to subjects beforehand what benefits they stand to gain (not necessarily monetary) after participating in the research. This should also include the benefits that the research will bring to humanity in general. I know the subjects have to be treated fairly and equitably to ensure justice; and also that no deliberate harm should be brought upon the research participants (nonmaleficence). Reflection in Action Paper Essay
Evidence Supporting Jean Watson’s Theory of Human Caring
Jean Watson’s theory of human caring is a grand theory that provides the conceptual framework for the practice of nursing. It is a theory that advocates for the creation of a healing environment by the nurse. This is achieved by way of applying some ten caritas or carative factors (Ozan & Okumus, 2017). I have studied very closely the metaparadigms and concepts of this theory during this course and found it to be very suitable and applicable in all nursing settings. It demands that the nurse acts and cares with selflessness, love, and compassion. It also requires the nurse to put the interests of the patient first and theirs second. To me, this is what patent advocacy is all about – and nurses are by default the leading patient advocates in any healthcare settings.

The evidence for Watson’s theory is everywhere for all to see. For instance, nurses are required to establish a therapeutic rapport with their patients the very first time they meet. What I know is that the nurse should during this time remain friendly and accommodating even if the patient is difficult and abusive. This can only mean the nurse has put the patient’s interests first. The other proof of Watson’s theory is that nurses are expected to offer holistic care and to be culturally sensitive and competent. I believe all these competencies and requirements are there to ensure that the patent’s will and needs prevail.
Protecting Human Subjects in Quality Improvement Projects
Quality improvement (QI) or EBP projects are conducted just like research and involve the use of human subjects. For this reason, the rules of ethics and morality that apply to full blown research also apply to these projects. Apart from applying and observing fidelity, autonomy, beneficence, justice, and nonmaleficence; I know that those carrying out QI and EBP projects require obtaining permission from a university committee or an organizational committee/ body verifying that the project is ethical. This is akin to researchers obtaining ethical clearance from the Institutional Review Board (IRB). In my estimation, this will help protect human subjects (OHRP, 2018).

References
Haswell, N. (2019). The four ethical principles and their application in aesthetic practice. Journal of Aesthetic Nursing, 8(4), 177-179. https://doi.org/10.12968/joan.2019.8.4.177
Melnyk, B.M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice, 4th ed. Wolters Kluwer.
Office for Human Research Protections [OHRP] (January 15, 2018). The Belmont Report: Ethical principles and guidelines for the protection of human subjects of research. https://www.hhs.gov/ohrp/regulations-and-policy/belmont-report/read-the-belmont-report/index.html
Ozan, Y.D., & Okumus, H. (2017). Effects of nursing care based on Watson’s theory of human caring on anxiety, distress, and coping when infertility treatment fails: A randomized controlled trial. Journal of Caring Sciences, 6(2), 95-109. https://doi.org/10.15171/jcs.2017.010  Reflection in Action Paper Essay