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  1. Coakley, Edward MSN, MA, MEd, RN
  2. Scoble, Kathleen B. EdD, RN


A visionary academic medical center in Colombia, South America, engaged the Institute for Nursing Healthcare Leadership in a multifaceted project for the overall goal of strengthening the model of professional practice. The authors describe a reflective model for organizational assessment that steered the in-depth assessment of the organization. The model combines the constructs of culture, theory, patterns, and phenomenon with an iterative process. The organizational reflection process is applied to assessing key nursing roles and the nursing care delivery system. Recommendations and interventions that emerged from the assessment are included.


The Institute for Nursing Healthcare Leadership (INHL) was established to increase nursing's participation in health service leadership through interprofessional collaboration, leadership development, and scholarly work. Among its goals, the INHL seeks to enhance the leadership capacity of nurses locally, nationally, and internationally. During summer 2000, nurse consultants from INHL in Boston were engaged to lead a nursing project to develop further a model for professional nursing practice in Colombia, South America. The site of the project was an academic medical center serving Colombia, Venezuela, and Central America. The hospital, operating for 85 years, is the largest private hospital in Colombia and enjoys a reputation renowned for its scientific achievements.


The project was multifaceted, composed of several objectives that were accomplished during an 18-month period. The purpose of this article is to introduce the concept and process of reflective practice, which is used in the assessment of this nursing system, into the nursing management literature. Although the description of its use is in another country, the application of reflective practice to the US healthcare system offers promise. This article describes the process used for assessing the nursing delivery system and recommended interventions. Included are selected examples that illuminate this process, recommended interventions, and outcomes.