An Educational Method to Enable Nursing Students to Develop the Skills Needed for Clinical Reasoning

One of the challenges in nursing education is the need to enable students to internalize the skills needed to implement the thought processes of critical thinking and clinical reasoning. The research of Patricia Benner has been instrumental in explaining the need to improve the critical thinking and clinical reasoning skills of newly licensed registered nurses. Dr. Benner’s research has changed the focus of nursing to include these skills in the education process. The

 study was designed to evaluate the efficacy of a classroom educational method designed to help students improve these skills. The ex post facto study was conducted at one Southern community college with students enrolled in an Associate Degree nursing program. The study used the nursing educational theory of Patricia Benner and the general educational theory of constructivist educational theory as a theoretical base. Archived data was collected from the results of two cohorts of nursing students based on their performance on two separate administrations of the Assessment Technologies Institute (ATI) critical thinking examination. The data was analyzed using central tendency statistics, a paired sample t-test to determine the differences between ATI scores for each group and an independent sample t-test to determine the differences in the change in ATI scores for the two groups.

The results of the investigation indicate that the education method was effective in assisting students to improve the cognitive skills needed for clinical reasoning. The cohort that used the method had significant increase in the ATI critical thinking examination scores from the initial administration to the second administration. It was interesting to note that the most growth occurred with those students who struggled with the critical thinking process at the beginning of their education. It was also noted that there was no significant change in the scores for the cohort of students who did not use the educational method. This was the case even though both cohorts had the same curriculum, resources, faculty, and facilities.

The conclusions from the research were that the method should be researched further to identify if similar results would be obtained if a different curriculum were involved and with Baccalaureate programs to compare results. Research could be conducted to determine the growth of specific cognitive skills related to clinical reasoning. It is also suggested that qualitative research be initiated related to the method. In general, this research suggested that the method was effective and would be appropriate for implementation in nursing education programs.