Levels, antecedents, and consequences of critical thinking among clinical nurses: a quantitative literature review

Critical thinking level in nursing degree students according to sociodemographic and academic variables: A correlational study

AIMS

To determine the level of critical thinking of undergraduate nursing students during their clinical practice, as well as to identify the relationship between sociodemographic and academic variables.

BACKGROUND

Nursing degree programs should prioritize the development of critical thinking skills in their curriculum and regularly assess students to ensure the acquisition of core competencies.

DESIGN

Multicenter, descriptive, cross-sectional, correlational, descriptive study. Participants included were students from the Degree in Nursing enrolled during the academic year 2020-2021. Students were selected by convenience from three universities located in Catalonia, Spain. Data were collected from 429 students, with 98 being excluded due to incomplete data.

METHODS

Data were collected by administering the Nursing Critical Thinking in Students Questionnaire and an ad hoc form of sociodemographic and academic characteristics. The STROBE guidelines checklist were followed. The study involves a secondary analysis of data from a previous study that presented psychometric analysis.

RESULTS

No significant differences were observed in total Critical Thinking scores across various parameters including academic year, current situation, work experience in healthcare, previous academic training, family situation, or recent stressful events. On average, students demonstrated moderate critical thinking scores. However, statistically significant relationships emerged between critical thinking scores and gender (p=0.046), institution attended for undergraduate studies (p=0.019) and having satisfactory social relationships despite experiencing stressful events (p=0.330).

CONCLUSIONS

The study delves into the correlation between critical thinking skills and sociodemographic and academic factors, identifying students who may benefit from specific interventions and advocating for adaptable educational methods. It emphasizes the pivotal role of trust in fostering critical thinking in nursing education and suggests a connection between critical thinking and strong social relationships. In conclusion, evaluating critical thinking is crucial for addressing healthcare challenges, validating teaching strategies and promoting continuous improvement in nursing education.

Relationship among core competency, self-efficacy and transition shock in Chinese newly graduated nurses: a cross-sectional study

OBJECTIVES

To investigate how core competency and self-efficacy of newly graduated nurses affect their experience of transition shock, and to determine the relationship between these factors.

DESIGN

A cross-sectional study.

METHODS

262 newly graduated nurses participated in a cross-sectional study by using demographic data, the transition shock scale, the competency inventory for registered nurses scale and the self-efficacy scale.

RESULTS

Among newly graduated nurses, the score of transition shock was 77.641±24.140, the score of core competency was 125 (109.5, 163.5) and the score of self-efficacy was 2.5 (2,3), all of which were at a moderate level. The core competency and self-efficacy of the newly graduated nurses had a negative impact on the transition shock (β=-0.151, p=0.026; β=-0.379, p<0.001). Additionally, self-efficacy played a mediating role in the relationship between core competency and transition shock, with a mediating effect accounting for 57.34% of the total effect.

CONCLUSIONS

The transition shock of newly graduated nurses was at a moderate level, with the highest level of transition shock occurring within the first year of employment. Self-efficacy plays a mediating role in the relationship between core competency and transition shock. Nursing managers should create standardised training for newly graduated nurses within the first year of employment to reduce their transition shock. This will help improve newly graduated nurses' core competency, enhance self-efficacy and support the graduates. This will alleviate the impact of transition shock on newly graduated nurses, helping them transition smoothly and successfully.

The relationship between critical thinking and job performance among nurses: A descriptive survey study

AIM

This study investigated the relationship between nurses' critical thinking skills and job performance and whether critical thinking and its subdomains predict job performance.

BACKGROUND

It is expected that nurses may use critical thinking skills to provide evidence-based quality patient care in health care settings. However, there is limited evidence about whether critical thinking is related to job performance among nurses.

DESIGN

This was a descriptive, cross-sectional survey study.

METHODS

The study included 368 nurses working in the inpatient wards of a university hospital in Turkey. The survey included a demographic information questionnaire, the Critical Thinking Scale in Clinical Practice for Nurses and the Nurses' Job Performance Scale. The collected data were analysed using descriptive statistics, comparisons, reliability and normality tests, correlation and regression analysis.

RESULTS

Participating nurses got average scores from the critical thinking and job performance scale and sub-scales, and there was a positive, mid-level and statistically significant correlation between the scale scores. According to the multiple linear regression analysis results, personal critical thinking, interpersonal and self-management critical thinking and the total critical thinking scores positively affected the job performance scores of nurses.

CONCLUSION

As critical thinking predicts nurses' job performance, managers of hospitals and nursing services should consider training programs or activities to increase nurses' essential thinking competencies, thus improving clinical nurses' performances.

Multilevel Modeling of Individual and Group Level Influences on Critical Thinking and Clinical Decision-Making Skills among Registered Nurses: A Study Protocol

Critical thinking and clinical decision-making are two essential components of nursing services. The practice of nursing requires both components at every level of nurses' daily tasks. This paper describes the protocol for an ongoing project, which aims to examine the prevalence of critical thinking and clinical decision-making among registered nurses and determine the factors that influence the skills at individual and group levels using a multilevel modeling approach. Survey data will be collected from approximately nine states, with nine general hospitals, nine district hospitals, one private hospital, and one educational hospital in Malaysia included. We aim to recruit 800 registered nurses working shifts in hospital settings. We will use questionnaires to measure the perceived nurses' knowledge, critical thinking skills, and clinical decision-making skills. The study will have three levels as the nurses are nested within the unit and further nested within the hospitals. This study will give an insight into the nursing profession today where critical thinking and clinical decision-making skills can play a significant role in patient safety and the quality of care in nursing practice.

Development and validation of a script concordance test to assess biosciences clinical reasoning skills: A cross-sectional study of 1st year undergraduate nursing students

BACKGROUND

Developing evaluative measures that assess clinical reasoning remains a major challenge for nursing education. A thorough understanding of biosciences underpins much of nursing practice and is essential to allow nurses to reason effectively. A gap in clinical reasoning can lead to unintended harm. The Script Concordance test holds promise as a measure of clinical reasoning in the context of uncertainty, situations common in nursing practice. The aim of this study is to develop and validate a test for first year undergraduate nursing students that will evaluate how bioscience knowledge is used to clinically reason.

METHODS

An international team, teaching biosciences to undergraduate nurses constructed a test integrating common clinical cases with a series of related test items: diagnostic, investigative and treatment. An expert panel (n = 10) took the test and commented on authenticity/ambiguities/omissions etc. This step is crucial for validity and for scoring of the student test. The test was administered to 47 first year undergraduate nursing students from the author sites. Students rated educational aspects of the tool both quantitatively and qualitatively. Statistical and content analyses inform the findings.

FINDINGS

Results indicate that the test is reliable and valid, differentiating between experts and students. Students demonstrated an ability to identify relevant data, link this to their bioscience content and predict outcomes (mean score = 50.78 ± 8.89). However, they lacked confidence in their answers when the scenarios appeared incomplete to them.

CONCLUSION

Nursing practice is dependent on a thorough understanding of biosciences and the ability to clinically reason. Script concordance tests can be used to promote both competencies. This method of evaluation goes further than probing factual knowledge. It also explores capacities of data interpretation, critical analysis, and clinical reasoning. Evaluating bioscience knowledge and real-world situations encountered in practice is a unique strength of this test.

Impact of Nurse-Physician Collaboration, Moral Distress, and Professional Autonomy on Job Satisfaction among Nurses Acting as Physician Assistants

Although there is considerable literature on job satisfaction among nurses in various settings, there is little research about contributing factors, including moral distress to job satisfaction among a certain group of nurses, such as nurses acting as physician assistants. The purpose of this study was to verify the impact of nurse-physician collaboration, moral distress, and professional autonomy on job satisfaction among nurses acting as physician assistants. Descriptive and correlational research was conducted on a convenience sample of 130 nurses from five general hospitals in South Korea. In the final regression model, the adjusted R square was significant, explaining 38.2% of the variance of job satisfaction (F = 8.303, p < 0.001), where 'cooperativeness' (β = 0.469, p = 0.001) from nurse-physician collaboration, 'institutional and contextual factor' from moral distress (β = -0.292, p = 0.014), and professional autonomy (β = 0.247, p = 0.015) were included. In hospital environments, a more cooperative inter-professional relationship between nurses and physicians led to less moral distress caused by organisational constraints. A higher level of professional autonomy among nurses acting as physician assistants is required to increase their job satisfaction.

Critical thinking among clinical nurses and related factors: A survey study in public hospitals

AIMS AND OBJECTIVES

The study investigated clinical nurses' critical thinking levels in public hospitals and related factors.

BACKGROUND

Since health care environments have become more complex, the critical thinking skills of clinical nurses are more important in daily problem-solving and decision-making processes. However, little research was conducted on this topic among clinical nurses.

METHODS

It was a cross-sectional study at five public hospitals between December 2018 and January 2019. The study followed the STROBE guideline. Data were collected from 559 nurses by a survey consisted of a data form and the Turkish version of the Nursing Critical Thinking in Clinical Practice Questionnaire.

RESULTS

Nurses' mean critical thinking scores were moderate level. Total critical thinking scores of the clinical nurses significantly differed according to education, hospital type, shift work, professional category and role. There was a significant effect on the total critical thinking scores of the clinical nurses according to variables.

CONCLUSION

This study found that critical thinking levels of nurses' working in clinical settings in public hospitals were moderate level. Hospital type, shift work, professional and educational level and role were significantly associated with clinical nurses' critical thinking levels.

RELEVANCE TO CLINICAL PRACTICE

This study provides evidence related to the levels of critical thinking of clinical nurses working in public hospitals. Since the critical thinking scores of the manager nurses, daytime working nurses' and nurses with bachelor's and master's degree education are higher, hospital managers may benefit from the study to implement effective strategies to improve the competence of critical thinking levels of nurses.

Transition shock, preceptor support and nursing competency among newly graduated registered nurses: A cross-sectional study

BACKGROUND

Transition shock is highly prevalent among newly graduated registered nurses in their early career. Preceptors are widely used to support them in acquiring clinical nursing competencies and to promote their successful transition to practice. However, the mechanism by which transition shock and preceptor support are linked to nursing competency among newly graduated registered nurses remains unknown.

OBJECTIVES

The aim of the study was to examine the relationship between transition shock, preceptor support, and nursing competency in a sample of newly graduated registered nurses.

DESIGN

A descriptive, cross-sectional design.

SETTINGS

Six tertiary hospitals in the southeast of mainland China.

PARTICIPANTS

Newly graduated registered nurses undertaking their professional role in the first year.

METHODS

Convenience sampling was used to recruit 215 newly graduated registered nurses [184 female, 31 male] from six hospitals. Data on transition shock, preceptor support, and nursing competency were collected using questionnaires from November to December 2019.

RESULTS

The nursing competency of critical thinking/research aptitude (mean = 2.68, SD = 0.63) was scored the lowest among participants. Transition shock (r = -0.21, p < .01) and perceptions of preceptor support (r = 0.56, p < .01) were statistically significantly correlated with nursing competency. Preceptor context, whether the assigned preceptor varied day by day, and the emotional challenges of transition shock were the main predictors of nursing competency (F = 36.86, p = .00), accounting for 34% of the variance in nursing competency.

CONCLUSIONS

Educational programs aimed at increasing critical thinking and research aptitude in the educational stage and the continuing educational stage can benefit newly graduated registered nurses. A well-organized transition program in hospitals including awareness and recognition of transition shock in newly graduated registered nurses is essential to enhance their competency in providing quality nursing. More support and assistance would be useful in promoting the preceptor's role in improving nursing competency of newly graduated registered nurses.