Promoting the Self-Regulation of Clinical Reasoning Skills in Nursing Students

R Kuiper,D Kautz,D Pesut

doi:10.2174/1874434600903010076

Abstract

Aim:The purpose of this paper is to describe the research surrounding the theories and models the authors united to describe the essential components of clinical reasoning in nursing practice education. The research was conducted with nursing students in health care settings through the application of teaching and learning strategies with the Self-Regulated Learning Model (SRL) and the Outcome-Present-State-Test (OPT) Model of Reflective Clinical Reasoning. Standardized nursing languages provided the content and clinical vocabulary for the clinical reasoning task. Materials and Methods:This descriptive study described the application of the OPT model of clinical reasoning, use of nursing language content, and reflective journals based on the SRL model with 66 undergraduate nursing students over an 8 month period of time. The study tested the idea that self-regulation of clinical reasoning skills can be developed using self-regulation theory and the OPT model.Results:This research supports a framework for effective teaching and learning methods to promote and document learner progress in mastering clinical reasoning skills. Self-regulated Learning strategies coupled with the OPT model suggest benefits of self-observation and self-monitoring during clinical reasoning activities, and pinpoints where guidance is needed for the development of cognitive and metacognitive awareness.Recommendations and Conclusions:Thinking and reasoning about the complexities of patient care needs requires attention to the content, processes and outcomes that make a nursing care difference. These principles and concepts are valuable to clinical decision making for nurses globally as they deal with local, regional, national and international health care issues.

Highlights

The purpose of this paper is to describe the authors’ reflection on research and scholarly activities from the past 5 years surrounding the theories and models which were united to evaluate the essential components of clinical reasoning in nursing education
Self-regulated Learning strategies coupled with the OPT model suggest benefits of self-observation and self-monitoring during clinical reasoning activities, and pinpoints where guidance is needed for the development of cognitive and metacognitive awareness
The uniqueness of the OPT model of clinical reasoning provides structure is its attention to systems thinking, reflective thinking, the contrast between a present and desired state and the focus on judgment which is often omitted in other decision making models that rely on algorithms, procedures, and protocols [31]

Summary

Introduction

The purpose of this paper is to describe the authors’ reflection on research and scholarly activities from the past 5 years surrounding the theories and models which were united to evaluate the essential components of clinical reasoning in nursing education. Students need to master the cognitive and metacognitive thinking skills that support clinical reasoning. The development of metacognitive (reflective) strategies and patterns of thinking are difficult for novice nurses to master because their decision making skills are rule dependent, deliberate, and slow, due to a lack of automatic thought and memory encoded experiential patterns [1, 9,10,11,12]. Effective and efficient clinical reasoning requires knowledge, skills, and abilities grounded in reflection supported by an individual’s capacity for self-regulation and lead to the development of expertise [1,2,3, 5]

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