An investigation into the impact of approaches to learning on final-year student nurses’ clinical decision-making

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This research aimed to investigate whether a correlation exists between students' approach to learning and clinical decision-making and to determine whether an educational learning intervention would impact on clinical decision-making outcomes. Tait, Entwistle and McCune's Approaches to Study Skills for Students (ASSIST) and Jenkins' Clinical Decision Making Nursing Scale (CDMNS) was administered to a convenience sample of adult nursing students (n = 78) at a university in central London, UK, at the beginning of the final year of their nursing course and, following the learning intervention, again at the end of the year. Pre-intervention, 38% of participants predisposed to the surface approach to learning; post-intervention, less than 8%. Clinical decision-making scores were statistically significantly higher for students adopting the strategic approach at the pre-intervention point and significantly higher for those adopting the deep approach at the post-intervention point. At both pre- and post- intervention data collection points there was a negative correlation between the surface approach and clinical decision-making scores. Findings indicate a statistically significant relationship exists between participants' approach to learning and their clinical decision-making. Changing from the surface to either the strategic or deep approach to learning is shown to impact positively on clinical decision-making outcomes.