الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Reflection is a recent trend in medical and nursing education whether in teaching or treating. In 1933 the American philosopher ”John Dewey” believed that learning took place as a result of experiences, and that reflecting on experiences allowed connections to be made between thoughts, beliefs, and actions (Lousberg et al., 2020). ), Reflective practice in pediatric nursing is often seen as the cornerstone of professional identity. It is now become imperative to include as a standard reference for professional registration and practice (American Nurses Association, 2015).Nurses are able through reflection to make meaning of experience, connect theoretical knowledge to the context of clinical practice.(Reed, & Shearer, 2017).
A quasi – experimental study was done; the aim of the study was to evaluate the impact of reflective thinking intervention on improving nursing care given by nurses in pediatric critical care units. This aim was achieved through answering the following hypothesis: Reflective thinking intervention will improve nursing care given by nurses in pediatric critical care units.
The study was conducted at pediatric critical care units {surgical intensive care unit, neonatal intensive care units and emergency department} in pediatric hospital affiliated to Ain shams university hospitals.
The subjects of the present study, a Convenient sample composed of 55 nurses and all available children used at the previously mentioned setting regardless their age, sex, level of education and qualification.
Data was collected by used the following tools:
First tool: An interviewing questionnaire sheet (Appendix I):
This tool was developed by the researcher and written in simple Arabic language based on a scientific literature review (Aday & Cornelius, 2006). It divided into two parts:
Part I:
A. Demographic data for nurses such as (Age, gender, place of work / department, marital Status, occupation, level of education &years of experience (in each unit) … etc.).
B. Demographic data for children such as (age, sex, diagnosis, health status, length of hospital stay & Cause of hospital admission … etc.).
Part II:
A. Nurses’ knowledge questionnaire regarding the concept of pediatric critical care nursing : It was used to assess nurses’ knowledge regarding the concept of pediatric critical care nursing & included 6 closed ended questions (Pediatric critical care nursing is one of nursing departments that focuses on - hospitals’ department which provide pediatric critical care - in the job description of the pediatric critical care nurse - pediatric critical care must aware of the following - competencies needed for pediatric critical nurse- all working with pediatric intensive care units (PICU) toward the children’s patients).
B. Nurses’ knowledge questionnaire regarding the concept of reflective thinking: It was used to assess nurses’ knowledge regarding the concept of reflective thinking & included 8 closed ended questions ( Definition of reflective thinking - do you know a way or method for applying reflective thinking - one of the importance of using reflective thinking in medical and nursing care in general - from your point of view, the most reasons that may push you to use reflective thinking).
C. Nurses’ knowledge questionnaire regarding their role in pediatric critical care units: It was used to assess nurses’ knowledge regarding their role in pediatric critical care units& included 9 closed ended questions ( The most important critical care nursing skills in surgical pediatric intensive care unit - from the competencies needed in surgical pediatric intensive care unit - most cases admitted to in neonatal intensive care unit - the most important critical care nursing skills in neonatal intensive care unit).
Second tool. Nursing core competencies clinical evaluation tool (Appendix II):
This tool adopted from (Chisholm et al.2016) by the researcher. It was translated into simple Arabic language to assess nurses’ performance regarding reflective thinking through nursing core competencies. It consisted of 10 objectives including 24 core competencies.
Third tool: Educational Supportive material (Appendix III):
The researcher’ work handbook simple, clear, Arabic language on of reflective thinking with in illustrative and Colorful so the studied nurses can use what they like at any time or any place. This book includes the important elements of which (introduction, definition of pediatric critical care nursing, definition of reflective thinking……etc.).
A pilot study was conducted on 10% of the total number of the sample it is calculated and 6 of staff nurses were randomly selected and participated in the pilot study to examine the sequence of items, feasibility, simplicity, comprehensiveness of the tools, clarity of the language, and for estimating the time needed to fill it out. The nurse interns took 20 to 30 minutes to fill in the two tools. Those participants in the pilot study were included from the main study sample, there were no modifications done in the two tools.
The main results obtained from the present study were as follows:
• 10.9% of the studied nurses had good knowledge regarding the concept of pediatric critical care nursing at preprogram implementation compared to 85.5% at post program implementation then reduced to 81.8% at follow up implementation of the program.
• 9.1% of the studied nurses had good knowledge and performance related to NICU at preprogram implementation compared to 92.7% at post program implementation but, minimized to 85.5% at follow up implementation of the program.
• 7.3%of the studied nurses had good knowledge and performance related to SICU at preprogram implementation compared to 87.3% at post program implementation after that declined to 80% at follow up implementation of the program.
• 7.3%of the studied nurses had good knowledge and performance related to ED at preprogram implementation compared to 89.1% at post program implementation then decreased to 80% at follow up implementation of the program.
• (23.6%) had competent level of nursing core competencies through nurses′ reflection at preprogram implementation compared to more than three quarters (78.2%) at post program implementation while elevated to 94.5% at follow up implementation of the program.
• 16.4% had competent level of nursing core competencies through nurses’ comments at preprogram implementation compared to more than two thirds (69.1%) at post program implementation then elevated to 89.1% at follow up implementation of the program.
• There was highly statistically significant difference between pre, post and follow up for implementation of the program concerning nurses’ knowledge of the concept of pediatric critical Care Nursing, nurses’ knowledge of reflective thinking, nurses’ knowledge and performance related to NICU, nurses’ knowledge and performance related to SICU and nurses’ knowledge and performance related to ED respectively.
• There was highly statistically significant difference between pre, post and follow up for implementation of the program regarding nursing core competencies through nurses’ reflection and Nursing core competencies through instructor comments respectively.
• There was highly statistically significant difference between pre & post and pre & follow up regarding nurses’ knowledge regarding pediatric nursing care, Nurses’ knowledge and performance related to NICU, Nurses’ knowledge and performance related to SICU and nurses’ knowledge and performance related to ED respectively.