Clinical reasoning of nursing students on clinical placement: Clinical educators' perceptions

• Published in: Nurse education in practice 2016-05, Vol.18, p.73-79
• Main Authors: Hunter, Sharyn, Arthur, Carol
• Format: Article
• Language: English
• Subjects: Acknowledgment; Appraisal; Attitude of Health Personnel; Clinical assessment; Clinical Clerkship; Clinical Competence; Clinical decision making; Clinical educators; Clinical medicine; Clinical nursing; Clinical placement; Clinical placements; Clinical reasoning; Clinical skills; College students; Concept formation; Curriculum; Data Analysis; Decision making; Education, Nursing, Baccalaureate; Facilitation; Faculty, Nursing; Graduate students; Humans; Interviews as Topic; Learning; Nurses; Nursing; Nursing Education Research; Nursing Students; Professional knowledge; Professional practice; Simulation; Structured interviews; Students, Nursing - psychology; Teachers; Teaching methods; Thinking; Thinking Skills; Variability
• ISSN: 1471-5953; 1873-5223
• DOI: 10.1016/j.nepr.2016.03.002

Graduate nurses may have knowledge and adequate clinical psychomotor skills however they have been identified as lacking the clinical reasoning skills to deliver safe, effective care suggesting contemporary educational approaches do not always facilitate the development of nursing students' clinical reasoning. While nursing literature explicates the concept of clinical reasoning and develops models that demonstrate clinical reasoning, there is very little published about nursing students and clinical reasoning during clinical placements. Semi-structured interviews were conducted with ten clinical educators to gain an understanding of how they recognised, developed and appraised nursing students' clinical reasoning while on clinical placement. This study found variability in the clinical educators' conceptualisation, recognition, and facilitation of students' clinical reasoning. Although most of the clinical educators conceptualised clinical reasoning as a process those who did not demonstrated the greatest variability in the recognition and facilitation of students' clinical reasoning. The clinical educators in this study also described being unable to adequately appraise a student's clinical reasoning during clinical placement with the use of the current performance assessment tool. •Variability exists in clinical educators' understanding of nursing students' clinical reasoning while on clinical placement.•Clinical educators who did not conceptualise clinical reasoning as a process had the greatest variability.•Clinical educators are unable to adequately appraise a student's clinical reasoning with current tools.