Promoting clinical reasoning in undergraduate nursing students: Application and evaluation of the outcome present state test (OPT) model of clinical reasoning (original) (raw)
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Jurnal Keperawatan Padjadjaran
Well-developed clinical reasoning skills are central to the process of clinical judgement. However, the results of recent studies suggest that curricula and teaching approaches that support student nurses’ development of clinical reasoning skills have not yet been fully achieved. Cognitive apprenticeship offers a new approach to facilitate the development of complex thinking skills, for example, reasoning skills in making clinical decisions. This study examined the effect of an educational intervention utilizing principles of cognitive apprenticeship on students’ ability to apply clinical reasoning skills within the context of a purpose-built clinical vignette.A quasi-experimental, non-equivalent control-group design was used to evaluate the effect of the educational intervention on students’ accuracy, inaccuracy and self-confidence in clinical reasoning. Eighty-five undergraduate nursing students participated in the study. A purpose-built clinical vignette was utilised to collect d...
Journal of Advanced Nursing, 2004
Promoting cognitive and metacognitive reflective reasoning skills in nursing practice: self-regulated learning theory Background. Effective clinical reasoning in nursing practice depends on the development of both cognitive and metacognitive skills. While a number of strategies have been implemented and tested to promote these skills, educators have not been able consistently to predict their development. Self-regulated learning theory suggests that this development requires concurrent attention to both the cognitive and metacognitive dimensions of reasoning in nursing care contexts. Aims. This paper reports on a study to explore the impact of self-regulated learning theory on reflective practice in nursing, and to advance the idea that both cognitive and metacognitive skills support the development of clinical reasoning skills. Methods. Integrative review of published literature in social science, educational psychology, nursing education, and professional education using the Cumulative Index to Nursing and Allied Health (CINAHL), Educational Resource Information Center (ERIC), and American Psychological Association (PsychInfo) Databases. The search included all English language articles with the key words clinical reasoning, cognition, critical thinking, metacognition, reflection, reflective practice, self-regulation and thinking. Findings. Reflective clinical reasoning in nursing practice depends on the development of both cognitive and metacognitive skill acquisition. This skill acquisition is best accomplished through teaching-learning attention to self-regulation learning theory. A critical analysis of the literature in the areas of critical thinking and reflective practice are described as a background for contemporary work with self-regulated learning theory. It is apparent that single-minded attention to critical thinking, without attention to the influence of metacognition or reflection, is but one perspective on clinical reasoning development. Likewise, single-minded attention to metacognition or reflection, without attention to the influence of critical thinking, is another perspective on clinical reasoning development. While strategies to facilitate critical thinking and reflective practice have been used in isolation from each other, there is evidence to suggest that they are inextricably linked and come together with the use of self-regulated learning prompts. Conclusions. Students and practising nurses are able to improve their cognitive and metacognitive skills in clinical contexts by using self-regulated learning Ó 2004 Blackwell Publishing Ltd 381 strategies. The self-regulated learning model in nursing is offered to support teaching and learning of reflective clinical reasoning in nursing practice contexts.
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Patient safety is seriously threatened by the lack of fundamental clinical reasoning abilities. Competent nurses play a signi cant role in maintaining safety and effective healthcare services by integrating knowledge, abilities and attitudes that enable them to adapt to a changing health environment. Nursing clinical competence is the synthesis of knowledge, skills, clinical reasoning, values, beliefs and attitudes. The purpose of this study was to compare the three teaching and learning methods (conversational, journaling and combined conversational and journaling re ective learning strategy in determine its effect on perceived self-directed learning and clinical reasoning in nursing education. The study was conducted using a prospective quasi-experimental with pre-and post-evaluation. Participants received brief training on re ective practices and started to collect their clinical experiences based on the current clinical rotation department, write re ective journals, and conduct re ective conversations guided with Gibbs's model of re ection. Data collection was performed before and after the intervention on their perceived clinical reasoning using the Nurses Clinical Reasoning Descriptive analysis and inferential statistics such as DID model were used. The study included 143 participants with mean age of 24.10 ± 2.12 where 74.8% of them were male. There was a statistically signi cant mean score change on perceived clinical reasoning among participants over time. The mean score performance of the participants ranged from 2.98 ± 0.94 to 4.43 ± 0.50. The overall effect size of the intervention on perceived clinical reasoning among participants accounted for β = 1.7091 to 2.2217. which is a huge effect size as compared to when they had no exposed on a combined re ective practice. The ndings revealed that integrated conversational and journaling re ective learning strategy has signi cant academic potentials of empowering the nursing students clinical reasoning skills before the provision of care to patients. Thus, combined re ective learning strategy can be used as a clinical teaching and learning strategy in nursing education.
Educational practices for promoting student nurses' clinical reasoning skills
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Educational practices for promoting student nurses' clinical reasoning skills i DECLARATION Student Number: 20216760 I, Angeline van Wyngaarden, declare that EDUCATIONAL PRACTICES FOR PROMOTING STUDENT NURSES' CLINICAL REASONING SKILLS, is my own work and that all sources that have been used or quoted have been indicated and acknowledged by means of complete references. I further declare that this work has not been submitted for any other degree at any other institution.
Challenges nurse educators experience with development of student nurses’ clinical reasoning skills
Nurse Education in Practice, 2019
Traditional teacher-centred teaching strategies do not always facilitate the development of desired clinical reasoning skills required for nursing practice. A multiphase study was conducted to facilitate a process of change towards improving educational practices in order to promote the development of undergraduate student nurses' clinical reasoning skills. The study was conducted at a military nursing education institution. This paper reflects on Phase 1, where a descriptive, qualitative study was conducted to explore the challenges nurse educators experienced in utilizing teaching and learning strategies that could promote the development of clinical reasoning skills in undergraduate student nurses. Unstructured interviews were conducted with 16 nurse educators who were selected purposively. Interviews were recorded, transcribed and data were analysed for content. The findings indicate that the clinical learning environment, the military environment, and various role players in the environment are instrumental in nurse educators not utilizing educational practices that promote the development of clinical reasoning skills in undergraduate student nurses. Addressing nurse educator challenges and empowering them with the means, opportunity and skills to utilize student-centred teaching and learning strategies may contribute to the development of undergraduate student nurses' clinical reasoning skills. Raising awareness of challenges nurse educators experience in implementing student-centred facilitation of learning can assist in developing strategies to ensure nurse educators become more student-centred in their teaching.