Development of Reflective Skills among Nurses through Portfolio: A Qualitative Study

Introduction: Use of portfolio is growing as a functional tool in promotion and development of general and specific skills such as reflection and making link from theory to practice. This study aimed to explore nurses' perceptions and experiences of using portfolio. Methods: This qualitative study was conducted during years of 2009-2010 through qualitative content analysis method in a university hospital in Bushehr. At first, portfolio was introduced to nurses and they used portfolio in their clinical performance for a year. Finally 26 nurses were selected through purposeful sampling. Three focus group discussions were run for data collection. Interviews were recorded and transcribed verbatim. Interviews were continued until data saturation and then themes were extracted. Results: Subsequent to data analysis of participating nurses’ perceptions and experiences, theme of "ladder of reflective development" was derived from interviews. This theme encompasses steps of reflection development in nurses and four steps of feeling strange, anxiety reduction and acceptance, internalization, and learning and application was introduced. Conclusion: Steps of reflective thinking skills development indicated an inadequate knowledge level among nurses about portfolios and reflection. However, portfolio left a positive impact on reflective thinking skills of nurses and use of portfolio. Therefore, use of this tool is recommended to be considered in clinical nursing.