Establishing the competences of clinical reasoning for nursing students in Taiwan: From the nurse educators' perspectives.
Huang Hui-Man,Huang Chu-Yu,Lee-Hsieh Jane,Cheng Su-Fen
Nurse education today
BACKGROUND:Clinical reasoning is an essential core competence for nurses. Maintaining quality of care and safety of patients results from cultivation of student's clinical reasoning competency. However, the concept of clinical reasoning in nursing students is complex and its meaning and process needs further clarification. OBJECTIVES:The objectives were to explore the meaning of clinical reasoning competency in Taiwanese nursing students and to operationalize the concept in order to structure a framework illustrating the process of clinical reasoning. SETTING AND PARTICIPANTS:Thirteen seasoned nursing experts who had more than ten years of experience in nursing education or clinical practice participated in the interviews. The interviews were conducted in settings that the participants perceived as convenient, quiet and free of disturbance. METHODS:Semi-structured interviews were conducted. The interviews were audio-recorded and field notes were taken. The data were analyzed using Waltz et al.'s (2010) method of content analysis. RESULTS:The data revealed four domains and 11 competency indicators. The four domains include: awareness of clinical cues, confirmation of clinical problems, determination and implementation of actions, and evaluation and self-reflection. Each domain comprises of 2-4 indicators of clinical reasoning competency. In addition, this study established a framework for cultivation of clinical reasoning competency in nursing students. CONCLUSION:The indicators of clinical reasoning competency in nursing students are interwoven, interactive and interdependent to form a dynamic process. The findings of this study may facilitate evaluation of nursing students' clinical reasoning competency and development of instruments to assess clinical reasoning in nursing students.
Evidence-Based Practice Competence in Nursing Students: An Exploratory Study With Important Implications for Educators.
Lam Christina K,Schubert Carolyn
Worldviews on evidence-based nursing
BACKGROUND:Evidence-based practice (EBP) is a core pillar of nursing education and an expectation in clinical practice. Students struggle to conceptualize the use of EBP into actual clinical practice despite the development of EBP competencies. AIMS:This study explored perceptions of EBP education and competence in baccalaureate students using Melnyk's (Worldviews on Evidence-Based Nursing, 11, 2014 and 5) EBP competencies for practicing registered nurses as a basis for comparison. METHODS:The researchers used a sequential, mixed-methods design. A survey was developed to assess information sources and patterns of use, and semistructured interviews explored factors affecting students' understanding of EBP and information-seeking behaviors in the clinical setting. FINDINGS:There were 118 participants in the survey and 12 in follow-up interviews. A major theme was that participants had difficulties distinguishing between EBP and research. Students were able to identify experiences that fostered attainment of basic EBP competencies, such as searching for evidence, but were less able to describe higher-order activities such as integrating evidence to plan EBP changes or disseminating best practices. LINKING EVIDENCE TO ACTION:Clinical learning environments are an ideal place to apply and see EBP in action, but nurse educators cannot assume students arrive ready to apply EBP knowledge and skills to clinical practice. Nurse educators need evidence-based tools to assess student EBP competence across a variety of settings. Research examining the generalizability of the EBP competencies in varying curricular models as well as didactic and clinical settings is needed.