Poetry, Paintings, and a Short Story: Humanities Foster Success in Developing Clinical Reasoning Skills

Sunday, 30 July 2017: 3:30 PM

Josette Brodhead, PhD, MSHS, CNE, RNC
Nursing, Daemen College, Amherst, NY, USA
Patricia M. Burke, PhD, CNE, RNC
Nursing, Touro College, Brooklyn, NY, USA


Implementing humanities-based teaching/learning strategies can support the development of clinical reasoning skills in pre-licensure nursing students. The ability to function effectively in a dynamic, culturally diverse healthcare environment requires both critical thinking and clinical reasoning skills. The American Association of Colleges of Nursing (AACN, 2008) recognizes the importance of humanities in the baccalaureate nursing curriculum. The purpose of this quantitative study was to examine the use of humanities-based teaching/learning strategies on nursing students’ critical thinking and clinical reasoning skills.


A quasi-experimental, nonrandomized pretest-posttest study examined the impact of humanities-based teaching/learning strategies on the development of critical thinking and clinical reasoning skills among BSN students enrolled in a maternal/newborn nursing course. Participants were selected from two private, faith based colleges, one in the mid-west and one in the north-east. The educational interventions were threaded throughout the course; a total of 9 students from each site completed the study. A lesson plan with scripted questions was provided to each instructor to ensure consistency and the researcher was available for consultation regarding implementation strategies. The humanities-based teaching/learning strategies that included the analysis of a poem, three paintings, and a short story provoked emotional and somatic responses, thus stimulating inner reflection. The collaborative sharing nature of open discourse encouraged students to view the unique perspectives of their peers.The use of educational strategies that evokes emotional and cognitive dissonance provides the platform for transformative learning to occur (Clifford & Montgomery, 2015; Haber-Curran & Tillapaugh, 2015). At the end of the activities, the value of uniqueness and differences was reinforced providing a new frame of reference to see the world. Participants completed the California Critical Thinking Skills Test (CCTST) to assess differences in critical thinking (Insight Assessment, 2015). The Self-Assessment of Clinical Reflection and Reasoning tool (SACRR) was used to assess changes in clinical reasoning (Royeen, Mu, Barrett, & Lubben, 2000). Both the Watson’s theory of caring (Watson, 2008) and transformational learning (Cranton, 2006) philosophical underpinnings were used to develop the framework, to implement the educational interventions, and to interpret the results of the study.


The findings indicated that the humanities-based teaching/learning strategies did significantly impact the development of clinical reasoning skills (p< .05). However, there was no significant difference between pretest and posttest scores (p > 0.5) for critical thinking skills.

Conclusion:  The humanities-based teaching learning strategies did positively impact clinical reasoning skills. Although critical thinking scores did not significantly improve, one site did show growth. Further exploration of the research questions is warranted.