Clinical Reasoning in Nursing Students
Advances in Nursing & Midwifery,
Vol. 29 No. 4 (2020),
15 October 2020
,
Page 24-30
Abstract
Abstract Introduction: Diagnosis and understanding of patient conditions require nurses 'clinical reasoning skills, as in the absence of this skill; the nurses will not be able to diagnose the patients' condition and will impose harmful consequences on the patient. The purpose of this study is to evaluate and compare the clinical reasoning skills of the nursing students at Shahid Beheshti University of Medical Sciences at the end of theoretical courses in medical-surgical nursing in 2018. Methods: In this descriptive-comparative study, 150 nursing students from freshmen, sophomores, and juniors studying at the Faculty of Nursing and Midwifery of Shahid Beheshti University of Medical Sciences were selected by stratified sampling method. Students in each year comprised one category and the total number of was 3, also the number of students per category was 50, and the total number of categories will be equal to 9. Data were collected using a researcher-made questionnaire employing Key Feature Problem (KFP) method and analyzed using descriptive statistics by SPSS V.20 software. Results: The results showed that there is a significant difference between the grades of third-year students and those in their first and second years of study (P <0.001). Based on the results, the clinical reasoning skill in the first year was poor (51.59 ± 0.06%), in the second year was very weak (48.41 ± 0.09%) and in third-year students was very weak (37.62 ± 0.88). Also, the average skill of clinical reasoning of all students was very weak with a mean percentage of 46.01%. Conclusions: The findings indicate that the level of students' clinical reasoning skills has been declined comparatively from freshmen to juniors. In general, the level of clinical skills in nursing students of Shahid Beheshti University of Medical Sciences is disappointingly low.
- Nursing Students
- Clinical Reasoning
- Clinical Educators
How to Cite
References
van Graan AC, Williams MJ, Koen MP. Professional nurses' understanding of clinical judgement: A contextual inquiry. Health sa Gesondheid. 2016:280-93. doi: 10.4102/hsag.v21i0.967
Van Graan AC, Williams MJS. A conceptual framework to facilitate clinical judgement in nursing: A methodological perspective. Health sa Gesondheid. 2017;22(1):275-90. doi: 10.4102/hsag.v22i0.1015
Connor DM, Durning SJ, Rencic JJ. Clinical Reasoning as a Core Competency. Acad Med. 2020;95(8):1166-71. doi: 10.1097/ACM.0000000000003027 pmid: 31577583
Monajemi A. Clinical Reasoning: Concepts, education and assessment. Isfahan: Isfahan university of medical sciences publication.2011.
Harmon MM, Thompson C. Clinical reasoning in pre-licensure nursing students. Teach Learn Nurs. 2015;10(2):63-70. doi: 10.1016/j.teln.2014.12.001
Aitken LM. Critical care nurses' use of decision-making strategies. J Clin Nurs. 2003;12(4):476-83. doi: 10.1046/j.1365-2702.2003.00763.x pmid: 12790860
Burrell LA. Integrating critical thinking strategies into nursing curricula. Teach Learn Nurs. 2014;9(2):53-8. doi: 10.1016/j.teln.2013.12.005
Rencic J. Twelve tips for teaching expertise in clinical reasoning. Med Teach. 2011;33(11):887-92. doi: 10.3109/0142159X.2011.558142 pmid: 21711217
Marsha E, Fonteyn B, J. Ritter, Clinical reasoning in nursing2008.
Hunter S, Arthur C. Clinical reasoning of nursing students on clinical placement: Clinical educators' perceptions. Nurse Educ Pract. 2016;18:73-9. doi: 10.1016/j.nepr.2016.03.002 pmid: 27235568
Jensen R. Clinical reasoning during simulation: comparison of student and faculty ratings. Nurse Educ Pract. 2013;13(1):23-8. doi: 10.1016/j.nepr.2012.07.001 pmid: 22836097
Levett-Jones T, Hoffman K, Dempsey J, Jeong SY, Noble D, Norton CA, et al. The 'five rights' of clinical reasoning: an educational model to enhance nursing students' ability to identify and manage clinically 'at risk' patients. Nurse Educ Today. 2010;30(6):515-20. doi: 10.1016/j.nedt.2009.10.020 pmid: 19948370
Norman G. Research in clinical reasoning: past history and current trends. Med Educ. 2005;39(4):418-27. doi: 10.1111/j.1365-2929.2005.02127.x pmid: 15813765
Banning M. Clinical reasoning and its application to nursing: concepts and research studies. Nurse Educ Pract. 2008;8(3):177-83. doi: 10.1016/j.nepr.2007.06.004 pmid: 17869587
Delany C, Golding C. Teaching clinical reasoning by making thinking visible: an action research project with allied health clinical educators. BMC Med Educ. 2014;14:20. doi: 10.1186/1472-6920-14-20 pmid: 24479414
Ironside PM, McNelis AM, Ebright P. Clinical education in nursing: rethinking learning in practice settings. Nurs Outlook. 2014;62(3):185-91. doi: 10.1016/j.outlook.2013.12.004 pmid: 24576446
Menezes SS, Correa CG, Silva Rde C, Cruz Dde A. [Clinical reasoning in undergraduate nursing education: a scoping review]. Rev Esc Enferm USP. 2015;49(6):1037-44. doi: 10.1590/S0080-623420150000600021 pmid: 27419689
Mirmolaei TSH, Babaei G, Abdehagh Z. Comparison of critical thinking among first and last trimester baccalaureate midwifery students. Hayat. 2004;10(3):69-77.
Page G, Bordage G. The Medical Council of Canada's key features project: a more valid written examination of clinical decision-making skills. Acad Med. 1995;70(2):104-10. doi: 10.1097/00001888-199502000-00012 pmid: 7865034
Farmer EA, Page G. A practical guide to assessing clinical decision-making skills using the key features approach. Med Educ. 2005;39(12):1188-94. doi: 10.1111/j.1365-2929.2005.02339.x pmid: 16313577
Hurtz GM, Chinn RN, Barnhill GC, Hertz NR. Measuring clinical decision making: do key features problems measure higher level cognitive processes? Eval Health Prof. 2012;35(4):396-415. doi: 10.1177/0163278712446639 pmid: 22605792
Noone T, Seery A. Critical thinking dispositions in undergraduate nursing students: A case study approach. Nurse Educ Today. 2018;68:203-7. doi: 10.1016/j.nedt.2018.06.014 pmid: 29966881
Azizi-Fini I, Hajibagheri A, Adib-Hajbaghery M. Critical thinking skills in nursing students: a comparison between freshmen and senior students. Nurs Midwifery Stud. 2015;4(1):e25721. doi: 10.17795/nmsjournal25721 pmid: 25830160
Noohi EAA. Effect of patient-centered collaborative learning on students' scores of the nursing process and critical thinking of nursing trainers. J Med Educat Develop. 2013;8(3):53-62.
Ramazani Badr FSM. Clinical Decision-Making Skills among the Fourth-Year Baccalaureate Nursing Students in Tehran University of Medical Sciences. J Med Educ Dev. 2010;2(3):17-25.
Paryad E, Javadi N, Atrkar roshan Z, Fadakar K, Asiri SH. Relationship between Critical Thinking and Clinical Decision Making in Nursing Students. Iran J Nurs (IJN). 2011;24(73):63-71.
- Abstract Viewed: 581 times
- pdf Downloaded: 268 times