An Innovative Educational Approach to Facilitating Student Nurses' Clinical Reasoning Skills Development in Indonesia: A Quasi-Experimental Study

Introduction: Developing clinical judgment is one of top three training needs identified for nurses in North Sulawesi regions, Indonesia [1].Accordingly, curricula and teaching approaches that facilitate the development of skills which underpin nurses’ clinical judgment, such as clinical reasoning skills are of prime importance to enable graduates to provide effective care. This study aims to examine the effect of the educational package on students’ attitudes regarding clinical reasoning.

 

Methods: A sample of 85 nursing students in the high-risk pregnancy subject was recruited in a quasi-experimental design study. The Indonesian version of California Critical Thinking Disposition Inventory (CCTDI) (Cronbach’s alpha 0.90) [2] was used to collect data on pre- and post a 6-week Educational Intervention (EI). Both Independent and paired sample t-tests were conducted and eta squared effect size (ES) was identified. A significant level of p<0.05 was employed.

Results: At Time 2 there was no statistically significant difference between the overall CCTDI scores for the intervention (IG) and control groups (IG) (p=.40). The ES was very small (eta squared = .008). However, the IG scored significantly higher than the CG on the Systematicity sub-scale (p=.006). A moderate ES (eta squared = .08) was identified. The scores of IG and CG were significantly higher on the Truth-seeking sub-scale: IG (p =. 02) and CG: (p =. 008) and, although not statistically significant, the Confidence in Reasoning scores increased for the IG but decreased for the CG.

Conclusion: This study highlights the complexities involved in examining clinical reasoning skills. Although the CCTDI can measure some students’ attitudes regarding clinical reasoning, It is imperative to employ more specific clinical reasoning measurement tools to gather more inclusive results.

Implication: The results will make a significant and unique contribution to knowledge about educational strategies for facilitating the application and the evaluation of clinical reasoning skills.