A qualitative exploration of the normative and formative aspects of reflective practice groups for nursing staff in an acute care hospital setting

Abstract

Objective: This study explored nurses’ perceptions of whether and how reflective practice groups (RPGs) had influenced professional practice and skills development.

Background: A growing emphasis on technical competence has coincided with decreased focus on interpersonal aspects of nursing. Consequently, nurses can feel less prepared for the emotional requirements of their role, with potential adverse impacts on patient care. RPGs are a form of group supervision that prioritise interpersonal aspects of nursing care.

Method: Purposive sampling recruited thirty-nine nurses who attended RPGs at an Australian regional teaching hospital. Transcripts from four semi-structured focus groups underwent inductive and deductive thematic analyses.

Results: Inductive analysis revealed three prominent themes: (1) Trust: Participants who had attended fewer RPGs reported being more guarded, citing prior experiences of workplace incivility, while those who had attended more RPGs reported higher levels of trust. (2) Feedback: Differing opinions on RPGs as a space for giving and receiving feedback were also related to level of attendance, as well as sense of psychological safety and effectiveness of RPG facilitation. (3) Development of Relational Skills: RPGs were identified as a forum for exploring and enhancing interpersonal communication skills. Deductive analysis indicated that nurses used RPGs as a form of job crafting to develop interpersonal skills consistent with requisite professional standards.

Discussion: Findings suggest that whilst RPGs are already valued by nurses for their restorative benefits, they also provide normative and formative functions in regard to definition and development of relational skills. Over time, effective facilitation can promote psychological safety and trust within RPGs, helping mitigate unhealthy workplace culture and dynamics that might inhibit authenticity, reflection, and self-evaluation.

Conclusion: When effectively facilitated, RPGs can provide restorative, formative, and normative functions in relation to the interpersonal aspects of nursing, with potential positive impacts on workplace culture and patient care.

Implications for research, policy and practice: RPGs should be considered as a mechanism for providing emotional and professional support, promoting critical reflection, and developing interpersonal skills for nurses.