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Registered nurses' clinical reasoning skills and reasoning process: A think-aloud study

Authors
 JuHee Lee  ;  Young Joo Lee  ;  JuYeon Bae  ;  Minjeong Seo 
Citation
 NURSE EDUCATION TODAY, Vol.46 : 75-80, 2016 
Journal Title
 NURSE EDUCATION TODAY 
ISSN
 0260-6917 
Issue Date
2016
MeSH
Chronic Disease/nursing* ; Clinical Competence* ; Clinical Decision-Making* ; Humans ; Nursing Staff, Hospital/psychology* ; Problem Solving ; Qualitative Research ; Reproducibility of Results ; Republic of Korea ; Thinking*
Keywords
Clinical reasoning ; Content analysis ; Registered nurses ; Think-aloud
Abstract
BACKGROUND: As complex chronic diseases are increasing, nurses' prompt and accurate clinical reasoning skills are essential. However, little is known about the reasoning skills of registered nurses. OBJECTIVE: This study aimed to determine how registered nurses use their clinical reasoning skills and to identify how the reasoning process proceeds in the complex clinical situation of hospital setting. DESIGN: A qualitative exploratory design was used with a think-aloud method. METHODS: A total of 13 registered nurses (mean years of experience=11.4) participated in the study, solving an ill-structured clinical problem based on complex chronic patients cases in a hospital setting. Data were analyzed using deductive content analysis. RESULTS: Findings showed that the registered nurses used a variety of clinical reasoning skills. The most commonly used skill was 'checking accuracy and reliability.' The reasoning process of registered nurses covered assessment, analysis, diagnosis, planning/implementation, and evaluation phase. CONCLUSIONS: It is critical that registered nurses apply appropriate clinical reasoning skills in complex clinical practice. The main focus of registered nurses' reasoning in this study was assessing a patient's health problem, and their reasoning process was cyclic, rather than linear. There is a need for educational strategy development to enhance registered nurses' competency in determining appropriate interventions in a timely and accurate fashion.
Full Text
http://www.sciencedirect.com/science/article/pii/S0260691716301642?via%3Dihub
DOI
10.1016/j.nedt.2016.08.017
Appears in Collections:
3. College of Nursing (간호대학) > Dept. of Nursing (간호학과) > 1. Journal Papers
Yonsei Authors
Lee, JuHee(이주희) ORCID logo https://orcid.org/0000-0002-2805-1622
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/151973
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