Abstract：
BACKGROUND: Self-Regulated Learning (SRL) is key in developing healthcare professionals and lifelong learner. iCARE (internalization of Critical thinking, Assessment, Reflection to Empower learning) model was designed to enhance nursing students\' SRL.
OBJECTIVE: This study investigated the effects of iCARE on nursing students\' reflective practice, SRL, self-efficacy and skill performance as compared to conventional group reflection.
METHODS: A quasi-experimental exploratory study was employed on 49 final-year nursing students in a tertiary acute hospital. The iCARE group (n = 24) received guided daily reflective journal with weekly feedback while the group reflection group (n = 25) received group reflection. Both were facilitated by clinical instructors. Participants\' SRL score, self-efficacy level and skill performance were measured pre- and post- training. End of posting reflective journal between group was compared. Their experience and perception on both facilitation methods were obtained using questionnaires. Quantitative data were summarised and analysed using Chi-Square test and t-test. Theme coding and content analysis were used to analyse the qualitative responses.
RESULTS: Compared to group reflection group, the iCARE group reported a statistically significant improvement in SRL score, reflective practice, skill performance and self-efficacy in skill performance after a four-week clinical posting. Participants from both groups perceived that reflection helped them learn from peers and experience, enhanced their performance and motivated them to learn. Three unique themes emerged only from the iCARE group: iCARE helped to developed SRL; application of assessment, planning, implementation and evaluation (APIE) improved clinical reasoning; iCARE improved the use of feedback.
CONCLUSIONS: The findings demonstrated the effect of the iCARE model in enhancing the development of nursing students\' reflective practice, SRL and clinical learning outcomes. The design of iCARE model that embeds SRL instructions, APIE framework and SRL focused feedback can promote cognitive and metacognitive development as well as skill performance.
OBJECTIVE: This study investigated the effects of iCARE on nursing students\' reflective practice, SRL, self-efficacy and skill performance as compared to conventional group reflection.
METHODS: A quasi-experimental exploratory study was employed on 49 final-year nursing students in a tertiary acute hospital. The iCARE group (n = 24) received guided daily reflective journal with weekly feedback while the group reflection group (n = 25) received group reflection. Both were facilitated by clinical instructors. Participants\' SRL score, self-efficacy level and skill performance were measured pre- and post- training. End of posting reflective journal between group was compared. Their experience and perception on both facilitation methods were obtained using questionnaires. Quantitative data were summarised and analysed using Chi-Square test and t-test. Theme coding and content analysis were used to analyse the qualitative responses.
RESULTS: Compared to group reflection group, the iCARE group reported a statistically significant improvement in SRL score, reflective practice, skill performance and self-efficacy in skill performance after a four-week clinical posting. Participants from both groups perceived that reflection helped them learn from peers and experience, enhanced their performance and motivated them to learn. Three unique themes emerged only from the iCARE group: iCARE helped to developed SRL; application of assessment, planning, implementation and evaluation (APIE) improved clinical reasoning; iCARE improved the use of feedback.
CONCLUSIONS: The findings demonstrated the effect of the iCARE model in enhancing the development of nursing students\' reflective practice, SRL and clinical learning outcomes. The design of iCARE model that embeds SRL instructions, APIE framework and SRL focused feedback can promote cognitive and metacognitive development as well as skill performance.
摘要：
背景：自我调节学习（SRL）是培养医疗保健专业人员和终身学习者的关键。iCARE(批判性思维的内化，评估,对Empower学习的反思）模型旨在提高护理专业学生的SRL。
目的：本研究调查iCARE对护生反思实践的影响，SRL,与传统的集体反思相比，自我效能感和技能表现。
方法：对某三级急症医院的49名最后一年的护理专业学生进行了一项准实验性探索性研究。iCARE组（n=24）接受每周反馈的每日引导反射日志，而小组反射组（n=25）接受小组反射。两者均由临床指导员协助。参与者SRL得分，在训练前和训练后测量自我效能水平和技能表现。组间比较了过帐反射日志的结尾。他们对这两种促进方法的经验和看法是通过问卷调查获得的。使用卡方检验和t检验对定量数据进行汇总和分析。使用主题编码和内容分析来分析定性响应。
结果：与群体反射组相比，iCARE组报告SRL评分有统计学显著改善，反思性实践,为期四周的临床发布后，技能表现和技能表现中的自我效能感。两组参与者都认为反思有助于他们从同龄人和经验中学习，提高了他们的表现，激励他们学习。仅从iCARE小组中出现了三个独特的主题：iCARE帮助开发了SRL；评估的应用，规划,实施和评估(APIE)改进了临床推理；iCARE改进了反馈的使用。
结论：研究结果表明iCARE模式在促进护生反思性实践发展方面的作用，SRL和临床学习结果。嵌入SRL指令的iCARE模型的设计，APIE框架和SRL聚焦反馈可以促进认知和元认知发展以及技能表现。
目的：本研究调查iCARE对护生反思实践的影响，SRL,与传统的集体反思相比，自我效能感和技能表现。
方法：对某三级急症医院的49名最后一年的护理专业学生进行了一项准实验性探索性研究。iCARE组（n=24）接受每周反馈的每日引导反射日志，而小组反射组（n=25）接受小组反射。两者均由临床指导员协助。参与者SRL得分，在训练前和训练后测量自我效能水平和技能表现。组间比较了过帐反射日志的结尾。他们对这两种促进方法的经验和看法是通过问卷调查获得的。使用卡方检验和t检验对定量数据进行汇总和分析。使用主题编码和内容分析来分析定性响应。
结果：与群体反射组相比，iCARE组报告SRL评分有统计学显著改善，反思性实践,为期四周的临床发布后，技能表现和技能表现中的自我效能感。两组参与者都认为反思有助于他们从同龄人和经验中学习，提高了他们的表现，激励他们学习。仅从iCARE小组中出现了三个独特的主题：iCARE帮助开发了SRL；评估的应用，规划,实施和评估(APIE)改进了临床推理；iCARE改进了反馈的使用。
结论：研究结果表明iCARE模式在促进护生反思性实践发展方面的作用，SRL和临床学习结果。嵌入SRL指令的iCARE模型的设计，APIE框架和SRL聚焦反馈可以促进认知和元认知发展以及技能表现。
