Nursing studies

From personal story to group experience: how reflecting via Schwartz rounds helps students

Sessions give students a safe space to share and learn from the emotional aspects of training

Sessions give students a safe space to share and learn from the emotional aspects of training

Sharing personal stories about the emotional and social aspects of training helps nursing students become more accomplished professionals, says senior teaching fellow Ali Smith, of the University of Surrey.

About two and a half years ago, the university began running Schwartz rounds , starting with a trial involving academic staff before extending the option to nursing students.

Knowing yourself and your responses really well helps you to be a better clinician it informs anyones role, but its really good for nursing, says Ms Smith.

Schwartz rounds have been used in clinical settings across the UK for more than ten years, moving into

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Sessions give students a safe space to share and learn from the emotional aspects of training

Picture: iStock

Sharing personal stories about the emotional and social aspects of training helps nursing students become more accomplished professionals, says senior teaching fellow Ali Smith, of the University of Surrey.

About two and a half years ago, the university began running Schwartz rounds, starting with a trial involving academic staff before extending the option to nursing students.

‘Knowing yourself and your responses really well helps you to be a better clinician – it informs anyone’s role, but it’s really good for nursing,’ says Ms Smith.

Schwartz rounds have been used in clinical settings across the UK for more than ten years, moving into universities in 2015 when they were first used with students on a medical course run by University College London.

Following growing interest from universities, they are now increasingly being offered to pre-registration healthcare students to help them cope with the demands of their courses and prepare them for their careers.

An emotionally safe space to reflect on training

At the University of Surrey, the rounds have moved online since the pandemic began, attracting up to 70 students each time, with staff sessions held separately. Ms Smith has led the implementation of the initiative and facilitates monthly rounds.

‘What’s really striking is the kindness. It reminds us why these are the people we want to be our student healthcare professionals’

Ali Smith, senior teaching fellow, University of Surrey

‘It’s an emotionally safe and confidential space for reflection and thinking about things that might be difficult, or positive, in either students’ academic experience or their clinical practice,’ she says.

‘It’s not a place for questioning or problem-solving, but very much for sitting, thinking and possibly commenting.’

Feedback collected after each session is overwhelmingly positive. ‘People share very personal stories, with a depth of disclosure and honesty,’ says Ms Smith, whose work has been nationally recognised with a prestigious Shining Star in the 2021 Schwartz Awards.

‘But what’s really striking is the kindness. It reminds us why these are the people we want to be our student healthcare professionals. It’s exactly what you want from someone entering healthcare.’

What are Schwartz rounds?

Introduced to the UK in 2009 from the United States, Schwartz rounds are named after patient Ken Schwartz, who was diagnosed with terminal cancer.

During his treatment, he found simple acts of kindness from his caregivers mattered more to him than anything else. His legacy established the Schwartz Centre in Boston to foster compassion in healthcare.

Usually held once a month, Schwartz rounds focus on understanding staff experiences from a social and emotional perspective. Three or four stories are told at the outset, as a basis for a facilitated wider discussion that should remain reflective, rather than trying to resolve issues. Rounds are confidential, with identities protected.

Although they began in larger organisations providing acute care, the rounds are now taking place in a range of UK clinical settings, including community and mental health trusts, hospices and primary care, as well as educational settings.

Source: Point of Care Foundation

Students share experiences they may not have discussed before

The university’s hour-long rounds begin with two or three student panellists volunteering to share their own stories, lasting around five minutes, about an experience they have had based on a specific theme, such as ‘the day I made a difference’ or ‘a colleague or patient I will always remember’.

‘The themes are quite loose, allowing each person to elaborate in whichever way they choose,’ says Ms Smith.

Ali Smith: ‘Students can be surprised by the feelings they have after telling a story’ Picture: University of Surrey

Two facilitators, trained by the Point of Care Foundation – which supports organisations in the UK to introduce Schwartz rounds – then open up the discussion for others’ contributions, while monitoring and observing what is happening.

‘We are very attentive, and with those who may have told a difficult story or been impacted by what someone else has said, we check in with them to make sure they are okay,’ says Ms Smith. ‘They can be surprised by the feelings they have as a result of telling a story they have not told out loud before.’

The topics that regularly feature

There can be laughter and lightness too. ‘There is silliness and students sharing things they have done in placement that are a bit embarrassing. There’s some really nice collegiate stuff – it’s certainly not all doom and gloom,’ says Ms Smith.

Regularly occurring topics include the impact of COVID-19 on placements, working remotely and feeling isolated, experiences in acute settings, and the balance between academic and clinical work.

‘There can be a feeling that they have to get everything right and they worry if they get things wrong,’ says Ms Smith. ‘There’s lots of working out how they can look after themselves.’

In one particularly memorable recent round, first-year students shared their anxieties and worries about going on their first placements, with post-registration students able to offer reassurance. ‘There was an incredibly supportive and reflective environment created in a really short time,’ says Ms Smith. ‘It felt very powerful.’

Valuing students – and teaching them to value themselves

She hopes that taking part in the initiative as a student will encourage individuals to practise continuous reflection once qualified. ‘In healthcare, we are geared up to solve problems quickly,’ says Ms Smith. ‘But having the capacity and willingness to reflect is really important. I hope it travels with them.

‘It will also help them to seek out Schwartz rounds once they are in practice settings, and make the time to do them,’ she adds.

‘When we are giving of ourselves, it’s important to have permission to think and reflect. It’s about making sure the students see themselves as a resource to be looked after. It reinforces that they need to value themselves – and that we value them.’


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