Effects of Problem-Based Learning on Clinical Reasoning Ability: From Rhetoric to Reality

Friday, 3 August 2012: 8:30 AM

Chee Lien Poh, MHSc (Education), BN, AdvDipNursing (Gerontology), RN
Centre for Mental Health Education / Nursing Training Department, Institute of Mental Health, Singapore, Singapore

Learning Objective 1: state the effects of problem-based learning in enhancing clinical reasoning among student nurses

Learning Objective 2: determine if problem-based learning is effective in enhancing clinical education

Clinical reasoning is an important skill and competency required for all nurses. Despite of its importance, clinical reasoning remains poorly exercised by nurses in various clinical settings (Greenwood, 2000; Greenwood, Sullivan, Spence, & McDonald, 2000), seriously endangering patient care and outcomes (Happell & Platania-Phung, 2005; Higgs, et al., 2001). Many researchers attribute this crucial theory-practice gap to the lack of effective teaching and learning methodologies that foster clinical reasoning abilities and demonstrate its application in reality (Banning, 2008a; Bucknall, 2003). Hence, it is imperative to explore alternative education methodologies that address this challenge. One such methodology is problem-based learning.

The purpose of this study was to examine the effects of problem-based and traditional mental health clinical attachment programmes on student nurses’ clinical reasoning abilities. This study focused specifically on the use of problem-based learning in a mental health clinical attachment programme designed to facilitate the development of clinical reasoning among student nurses.

This study used a between-group pre- and post-test experiment design to ascertain the effects of problem-based and non-problem-based mental health clinical nursing education on the clinical reasoning abilities of student nurses on 2-week mental health clinical attachment programme. A total of 212 Year 2 student nurses, who were pursuing their 3-year Diploma in Nursing or Diploma in Health Science (Nursing) programmes with any of the two academic tertiary institutions that offer these programmes in Singapore, were recruited over a period of two months during their clinical attachment programme at a mental health hospital in Singapore. The findings from this study provided useful evidence-based information that assisted nurse educators in making informed decisions when adopting problem-based learning as a teaching and learning methodology for clinical nursing education. Eventually, this would benefit the patients, their families, the society and the nursing profession.