Developing nursing students' clinical decision making skills

Pao Yue-kong Library Electronic Theses Database

Developing nursing students' clinical decision making skills

 

Author: Chan, Po-tai
Title: Developing nursing students' clinical decision making skills
Degree: M.Ed.
Year: 2003
Subject: Hong Kong Polytechnic University -- Dissertations
Nursing -- Decision making
Clinical competence
Department: School of Professional Education and Executive Development
Pages: ix, 131 leaves : ill. ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1733114
URI: http://theses.lib.polyu.edu.hk/handle/200/3006
Abstract: Today's nurses are facing greater demand for better care and accountability than ever before. They are required to plan, manage and co-ordinate safe care efficiently and effectively. Indeed, they can make a significant impact on the delivery of high quality patient care by making the best possible decisions. Developing skills in diagnosis and treatment decisions in nursing depends on how nurses apply the leaned knowledge, analytical thinking and practical skills. However, as a novice, a nursing student may not be able to apply or transfer his/her learned knowledge to his/her clinical situations. It is through appropriate clinical teaching methods and practical experiences to that students develop decision making skills which are necessary for them to function as accountable and competent nursing professionals. In review of its importance, an innovative teaching strategy was designed for developing nursing students' decision making skills. The teaching strategy is based on the nursing process to introduce the hypothetical deductive method to identify a patient's problems and concept mapping to prioritize a nursing diagnosis. The aim of this study is to evaluate the effectiveness of the innovative teaching strategy when compared to the currently used clinical teaching method in the following three areas: (1) identifying the health problems of the patient; (2) formulating a nursing diagnosis appropriate to the health problems of a patient; and, (3) prioritizing the importance of a nursing diagnosis. This is a quasi experimental study. Both qualitative and quantitative techniques were employed in the study because they allowed the Investigator to triangulate and validate findings. Two clinical practice groups of the Year 2 were invited to participate in the study, either in the treatment or control groups (n= 9 in each group). Two different case studies were used as instruments to find out students' decision making abilities in the pretest and posttest. A case study appraisal guide was used to score written responses and verbal protocols in the pretest and posttest respectively. Simple statistical analysis such as means, frequencies, independent and paired samples t-tests and analysis of covariance were generated. Quantitative techniques were used in the pretest to look for any statistically significant differences between two groups in: (1) composition differences between groups by comparing their clinical practice assessment results and, (2) initial decision making abilities by using question and answer format after reading the first case study. Findings showed that two groups shared no statistically significant differences in group composition and initial clinical decision making respectively. Both qualitative and quantitative techniques were employed in the posttest. The qualitative techniques were (1) verbal protocol technique and (2) students' self-reports. Verbal protocols were transcribed and: (a) scored for the accuracy of students' decision making in the three research areas and, (b) used for making inferences on strategies students employed in the decision making process. Findings from both quantitative and qualitative data supported that the hypothetical deductive method of the innovative teaching strategy could make a different in making decision between groups on the first research area. Findings of the second and third research areas showed that there was no statistically significant difference between groups. Nevertheless, concept mapping of the innovative teaching strategy could be useful to help students link up relationships of problems in complex situations. The study concluded that the innovative teaching strategy could be an alternative to assist students in developing students' decision making skills.

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