Clinical Reasoning: Optimizing Teaching and Learning in Nursing Education

Monday, 30 October 2017

Stephanie L. Turrise, PhD, RN, BC, APRN, CNE1
Sandra M. O'Donnell, MSN1
Tamatha Arms, DNP, RN, PMHNP-BC, NP-C1
RuthAnne Kuiper, PhD, MN, BSN1
Daniel J. Pesut, PhD2
(1)School of Nursing, University of North Carolina Wilmington, Wilmington, NC, USA
(2)Katharine Densford International Center for Nursing Leadership, University of Minnesota School of Nursing, Minnepolis, MN, USA

As nursing practice and the profession have evolved, nursing educators have been called upon to change the way in which students are educated. Teaching novices how to reason in clinical situations, think critically and use multiple ways of thinking are challenges nurse educators face. The Outcome-Present State-Test (OPT) Model was developed to help students and clinicians reason about the dynamic nursing care needs of their patients within the contexts in which patients receive care. Clinical reasoning activates many types of thinking and the model is especially useful in helping students reason about the dynamics of patients’ nursing care needs and master both the cognitive and metacognitive complexities of critical, creative, systems and complexity thinking. Nursing students encounter patient situations and care opportunities throughout their respective educational programs which encompass the classroom, clinical and simulation settings. As students and nurses clinically reason with patients, families, and other providers within organizations and systems, they continuously develop critical, creative, systems, and complexity thinking skills. Mastery of clinical reasoning necessitates the development of metacognitive (thinking about thinking) self-regulation skills as well as cognitive thinking tactics and strategies. Tools such as the Clinical Reasoning Web, OPT Model Worksheet and Thinking Strategies Worksheet help students organize thinking and reasoning about complex situations and can support the teaching-learning and clinical supervisory process.

The OPT Model of Clinical Reasoning has been used as an education tool in classroom, clinical and simulation settings to develop essential thinking skills in one school of nursing for over 15 years. The purpose of this presentation is to describe how faculty have used the OPT Model of Clinical Reasoning to teach clinical reasoning to pre-licensure baccalaureate nursing students and the various teaching strategies employed. This model has facilitated students’ abilities to reflect and reason thereby facilitating the development of the thinking skills and spirit of inquiry essential for today’s professional practice.