| Learning Objective #1: Describe two learning models that promote reflection on practice to enhance clinical reasoning in novice nurses | |||
| Learning Objective #2: Identify teaching-learning strategies that can be used to enhance critical thinking skill acquisition among novice nurses |
Objectives: The aim of this project was to test the combined use of the Outcome-Present state Test Model of Clinical Reasoning (OPT) and Reflective Self-Regulated Learning (SRL) to enhance reflective practice and critical thinking skill acquisition among nursing students in acute care settings. Design: A descriptive correlation design evaluated the use of Self Regulation Learning prompts for guided reflective journal entries with OPT Model teaching-learning tools, over a 10-week period. Pre-test and post-test surveys were administered to ascertain changes in perceived clinical reasoning abilities. Population, Sample, Setting: A convenience sample of 25 subjects were recruited from a diverse population of students in a Historically Black College and University. The model application occurred on acute care medical/surgical units during clinical experiences of junior level baccalaureate nursing students from September 2002 to December 2002. Concepts: Reflective journaling prompts supported metacognitive observation and self-evaluation. The OPT work sheets and clinical reasoning webs were tools to support the teaching-learning of clinical reasoning skills during didactic and clinical experiences. Methods: Qualitative and quantitative analyses include verbal protocol techniques and concept analysis of narrative data. Correlations and multivariate analyses are applied to conceptual relationships and clinical reasoning survey results. Findings: There was a total of 250 journal entries, OPT work sheets and clinical reasoning webs for 10 weeks. Verbal protocol technique reveals the content of noun referents, cognitive operators and assertions. Concept analysis reveals the themes of the journal scripts and conceptual use of the OPT model and clinical reasoning webs. Conclusions: Self-regulated learning strategies coupled with the OPT model of clinical reasoning revealed the benefits of guiding cognitive and metacognitive activities to enhance the clinical judgments of junior level baccalaureate nursing students. Implications: Embracing both a cognitive and metacognitive approach to clinical reasoning expands teaching-learning strategies and accelerates critical thinking skill acquisition among novice nurses.
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