Wednesday, July 11, 2007
This presentation is part of : Creating tools and building evidence to evaluate the Outcome-Present State-Test (OPT) Model of clinical reasoning
Using the OPT Model to Teach Clinical Reasoning to Undergraduate Nursing Students in a Psychiatric-Mental Health Nursing Course: Lessons Learned
Robin Bartlett, PhD, RN, BC1, Eileen Rossen, PhD, RN1, Ann R. Bland, PhD, APRN, BC2, and Charlotte A. Herrick, PhD, RN1. (1) School of Nursing, University of North Carolina at Greensboro, Greensboro, NC, USA, (2) Department of Baccalaureate & Graduate Nursing, Eastern Kentucky University, Richmond, KY, USA

Background: There is little evidence about what constitutes ‘best practice’ in teaching undergraduate nursing students. Care plans or concept maps and interpersonal process recordings (IPRs) are the strategies most often used in psychiatric and mental health clinical courses. The OPT Model is designed to help students develop clinical reasoning skills. Purpose: To examine the strengths and weaknesses of using the Model as a teaching strategy. Method: Students’ ability to use the Model was examined by determining how long it took them to achieve competence with their Models. Students’ abilities to identify the correct keystone issue and ‘frame’ their client’s situation were also examined. Based on these findings and faculty round table discussions, strengths and weaknesses of the Model were identified. Findings: Twenty-nine of 43 students achieved the criterion score for successful completion of the Model and more students correctly identified the keystone issue and appropriately framed the client story by the course’s end. Lessons learned included: 1) the Model must include client strengths and student self-evaluation, 2) need qualitative approaches to examine students’ responses, 3) need to develop approaches for using the Model over time, 4) need to develop formative and summative evaluation methods for integration of the student’s past learning to new situations. Conclusions: Using the Model uncritically provides no information about the quality of the care planned. The Model forms and instructions need to be adapted to promote the inclusion of client strengths and priority interventions. The Model needs streamlining so that students do not find it cumbersome. Determining other ways to measure the quality of student responses, and comparisons of student work using the Model with student work using care plans and IPRs is needed. Finally, the validity of the Model as a method needs to be examined by testing it against other measures of clinical reasoning.