Nurses Self-Reflection: A Concept Analysis

Abstract

Background: Self-reflection is widely recognized as foundational to nursing practice, education, and professional development. Despite its frequent invocation in nursing discourse, the concept of nurses' self-reflection remains ambiguously defined, with inconsistent usage across clinical, educational, and research contexts. This conceptual ambiguity impedes the development of robust educational interventions, valid measurement instruments, and coherent professional standards. Aim: The purpose of this paper is to conduct a rigorous concept analysis of nurses' self-reflection to clarify its defining attributes, antecedents, consequences, and empirical referents, and to distinguish it from related concepts such as reflective practice, critical reflection, reflexivity, and metacognition. Methods: Walker and Avant's eight-step concept analysis method was employed. A structured literature search was conducted across CINAHL, PubMed/MEDLINE, Scopus, and Web of Science, limited to peer-reviewed English-language publications from 2020 to 2025. Studies were included if they explicitly addressed self-reflection among registered nurses, nursing students, or nurse educators in clinical, educational, or leadership contexts. Results: Six defining attributes of nurses' self-reflection were identified: (1) intentional cognitive engagement, (2) inward focus on one's own thoughts, emotions, and actions, (3) critical examination of assumptions and values, (4) connection to a specific nursing experience or encounter, (5) orientation toward meaning-making and learning, and (6) iterative and developmental nature. Antecedents include psychological safety, adequate time and space, facilitative mentorship, openness to self-examination, and a triggering clinical experience. Consequences include enhanced clinical judgment, professional identity development, emotional regulation, improved patient-centered care, and lifelong learning. Empirical referents include validated self-report scales, reflective journal assessments, and structured debriefing evaluations. A model case, borderline case, and contrary case are presented to illustrate conceptual boundaries. Conclusion: This analysis offers a synthesized, operationally grounded definition of nurses' self-reflection that distinguishes it from adjacent concepts and provides a foundation for consistent use in nursing research, education, policy, and practice. Implications for curriculum design, clinical supervision structures, and future instrument development are discussed.