Learning Objective 1: The learner will be able to identify underlying self-regulatory factors characteristic of novice nurses’ approaches to clinical reasoning
Learning Objective 2: The learner will be able to identify instructional strategies aimed at facilitating higher-level competency in clinical reasoning
Methods: 87 final year undergraduate nursing students completed a simulated clinical task relating to the conduct of a pre-operative clinical interview and assessment. Two self-report questionnaires relating to aspects of metacognitive beliefs were completed: Biggs’ (1987) “Study Process Questionnaire”, a measure of dispositional motivational and strategy choices in learning (surface, deep and achieving approaches), and Cantwell and Moore’s (1996) “Strategic Flexibility Questionnaire”, a measure of disposition towards active or passive self-regulation (adaptive, inflexible or irresolute regulation). The clinical interview was completed in three phases: a “Planning” phase in which students gave written responses to five aspects of the pre-interview planning; a “Note-taking” phase in which students generated case notes whilst viewing a simulated interview; and a “Clinical Reasoning” component in which students generated a “Mental Status Assessment” and four Nursing Diagnoses. Data from each phase were analysed against expert templates.
Results: Analyses indicated that a disposition towards active and coherent self-regulation, combined with a disposition towards meaning construction (deep processing) as opposed to symptom reproduction (surface processing), was associated with higher quality performance across all phases of the clinical task.
Conclusion: The results of the study are discussed in relation to both attributes of developing expertise and instructional implications.
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