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Liu Z, Sun N, Chen C, Zhang G, Hu Y. Comparative study of clinical reasoning competence and self-directed learning competence in nurses across varied years of experience. J Clin Nurs 2024. [PMID: 38500234 DOI: 10.1111/jocn.17051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 01/06/2024] [Accepted: 01/22/2024] [Indexed: 03/20/2024]
Abstract
OBJECTIVES To compare and analyse the differences in the clinical reasoning competence of nurses with different working years and their relationship with self-directed learning competence. METHODS A cross-sectional survey design (online investigation) was used. A total of 376 nurses were recruited from four independent hospitals in China. Online questionnaires collected data on nurses' demographic characteristics and assessed their clinical reasoning and self-directed learning competence. Pearson correlation analysis, t-test, analysis of variance (ANOVA) and multivariate regression analysis were used. RESULTS Clinical reasoning competence scores of nurses with working years >10 years were higher than those of other nurses. Self-directed learning competence scores of nurses with working years of <1 year and (from ≥1 year to <3 years) were lower than those of nurses with working years of 6-10 years and >10 years. Self-directed learning competence scores of nurses with working years of 3-5 years were lower than those of nurses with working years of >10 years. There was a positive correlation between clinical reasoning competence, self-directed learning competence and each dimension among nurses of different working years. There are differences in the influence of different dimensions of self-directed learning competence on clinical reasoning competence among different working years. CONCLUSION There were differences in clinical reasoning and self-directed learning competence among nurses with different working years. Self-directed learning competence is a positive predictor of nurses' clinical reasoning competence, which applied to nurses with all working years; however, the specific effect of self-directed learning competence on clinical reasoning competence differed among nurses with different working years. IMPLICATION FOR NURSING MANAGERS Nursing managers should pay attention to the development characteristics of clinical reasoning competence and self-directed learning competence of nurses with different working years and determine effective intervention strategies according to specific influencing factors.
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Affiliation(s)
- Zhenya Liu
- Cerebrovascular Department of Henan Provincial People's Hospital, Henan Provincial Key Medicine Laboratory of Nursing, Zhengzhou University People's Hospital, Zhengzhou, Henan, China
| | - Na Sun
- Cerebrovascular Department of Henan Provincial People's Hospital, Henan Provincial Key Medicine Laboratory of Nursing, Zhengzhou University People's Hospital, Zhengzhou, Henan, China
| | - Cancan Chen
- Henan Provincial People's Hospital, Henan Provincial Key Medicine Laboratory of Nursing, Zhengzhou University People's Hospital, Zhengzhou, Henan, China
| | - Guifang Zhang
- Cerebrovascular Department of Henan Provincial People's Hospital, Henan Provincial Key Medicine Laboratory of Nursing, Zhengzhou University People's Hospital, Zhengzhou, Henan, China
| | - Yanli Hu
- School of Nursing, Guangzhou Medical University, Guangzhou, China
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Messager G, Loewenhaupt T, Veyriere A, Ghulam S. [Developing ISP skills: the challenge facing the Sdis medical training department]. SOINS; LA REVUE DE REFERENCE INFIRMIERE 2023; 68:52-56. [PMID: 37778857 DOI: 10.1016/j.soin.2023.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
Teaching can be taught! In order to develop and maintain the skills of its caregivers, the Departemental Fire and Rescue Service 77 Health Sub-Directorate is engaged in an innovative pedagogical dynamic, combining a real engineering of its training programs in compliance with the principles of active pedagogy, full and regular training of its teaching teams.
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Affiliation(s)
- Grégory Messager
- Service départemental d'incendie et de secours de Seine-et-Marne (Sdis 77), 56 avenue de Corbeil, 77000 Melun, France.
| | - Thomas Loewenhaupt
- Service départemental d'incendie et de secours de Seine-et-Marne (Sdis 77), 56 avenue de Corbeil, 77000 Melun, France
| | - Aurore Veyriere
- Service départemental d'incendie et de secours de Seine-et-Marne (Sdis 77), 56 avenue de Corbeil, 77000 Melun, France
| | - Saïqa Ghulam
- Service départemental d'incendie et de secours de Seine-et-Marne (Sdis 77), 56 avenue de Corbeil, 77000 Melun, France
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Vreugdenhil J, Somra S, Ket H, Custers EJFM, Reinders ME, Dobber J, Kusurkar RA. Reasoning like a doctor or like a nurse? A systematic integrative review. Front Med (Lausanne) 2023; 10:1017783. [PMID: 36936242 PMCID: PMC10020202 DOI: 10.3389/fmed.2023.1017783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 02/20/2023] [Indexed: 03/06/2023] Open
Abstract
When physicians and nurses are looking at the same patient, they may not see the same picture. If assuming that the clinical reasoning of both professions is alike and ignoring possible differences, aspects essential for care can be overlooked. Understanding the multifaceted concept of clinical reasoning of both professions may provide insight into the nature and purpose of their practices and benefit patient care, education and research. We aimed to identify, compare and contrast the documented features of clinical reasoning of physicians and nurses through the lens of layered analysis and to conduct a simultaneous concept analysis. The protocol of this systematic integrative review was published doi: 10.1136/bmjopen-2021-049862. A comprehensive search was performed in four databases (PubMed, CINAHL, Psychinfo, and Web of Science) from 30th March 2020 to 27th May 2020. A total of 69 Empirical and theoretical journal articles about clinical reasoning of practitioners were included: 27 nursing, 37 medical, and five combining both perspectives. Two reviewers screened the identified papers for eligibility and assessed the quality of the methodologically diverse articles. We used an onion model, based on three layers: Philosophy, Principles, and Techniques to extract and organize the data. Commonalities and differences were identified on professional paradigms, theories, intentions, content, antecedents, attributes, outcomes, and contextual factors. The detected philosophical differences were located on a care-cure and subjective-objective continuum. We observed four principle contrasts: a broad or narrow focus, consideration of the patient as such or of the patient and his relatives, hypotheses to explain or to understand, and argumentation based on causality or association. In the technical layer a difference in the professional concepts of diagnosis and the degree of patient involvement in the reasoning process were perceived. Clinical reasoning can be analysed by breaking it down into layers, and the onion model resulted in detailed features. Subsequently insight was obtained in the differences between nursing and medical reasoning. The origin of these differences is in the philosophical layer (professional paradigms, intentions). This review can be used as a first step toward gaining a better understanding and collaboration in patient care, education and research across the nursing and medical professions.
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Affiliation(s)
- Jettie Vreugdenhil
- Research in Education, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- VUmc Amstel Academie, Institute for Education and Training, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Faculty of Psychology and Education, LEARN! Research Institute for Learning and Education, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | - Hans Ket
- Medical Library, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | - Marcel E. Reinders
- Family Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Jos Dobber
- Center of Expertise Urban Vitality, Faculty of Health, Amsterdam School of Nursing, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Rashmi A. Kusurkar
- Research in Education, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Faculty of Psychology and Education, LEARN! Research Institute for Learning and Education, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health, Quality of Care, Amsterdam, Netherlands
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Ahayan S, Celis-Geradin MT, Ghulam S. [The advanced practice nurse as a health care influencer]. SOINS; LA REVUE DE REFERENCE INFIRMIERE 2022; 67:26-29. [PMID: 36127016 DOI: 10.1016/j.soin.2022.05.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The skills that advanced practice nurses use with patients, health care professionals and within the health care system enable them to exercise real leadership. The use of conceptual models and theories in nursing, tools for tracking and valuing clinical judgment, and nursing diagnoses and other concepts are essential to guaranteeing their disciplinary identity and ensuring interprofessional collaboration.
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Affiliation(s)
- Samira Ahayan
- Association nationale française des infirmier·ère·s en pratique avancée, 20 rue des Aubépines, 14120 Sainte-Honorine-du-Fay, France.
| | - Marie-Thérèse Celis-Geradin
- Association francophone européenne des diagnostics, interventions et résultats infirmiers, rue royale 336, 1030 Bruxelles, Belgique
| | - Saïqa Ghulam
- Association nationale française des infirmier·ère·s en pratique avancée, 20 rue des Aubépines, 14120 Sainte-Honorine-du-Fay, France; Centre municipal de santé du Gâtinais, 98 avenue de Fontainebleau, 77310 Saint-Fargeau-Ponthierry, France; Maison de santé pluriprofessionnelle Les Allées, 23-25 allée Aristide-Briand, 91100 Corbeil-Essonnes, France
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Chenault C. [The place of smell in clinical nursing reasoning]. REVUE DE L'INFIRMIERE 2021; 70:18-20. [PMID: 34893168 DOI: 10.1016/j.revinf.2021.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Pleasant, annoying or unbearable, odours are part of the daily life of nurses. Difficult to describe, they are nevertheless at the origin of the nurse's clinical reasoning process by leading her to collect additional data in order to analyse the patient's situation and make decisions.
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Affiliation(s)
- Céline Chenault
- Institut de formation en soins infirmiers de Périgueux, centre hospitalier de Périgueux, 80 avenue Georges-Pompidou, 24000 Périgueux, France.
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Jovic L, Lecordier D. La clinique infirmière : manière singulière de penser et d’agir dans le champ de la santé. Rech Soins Infirm 2021; 144:87-104. [DOI: 10.3917/rsi.144.0087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Delmas P, Fiorentino A, Antonini M, Vuilleumier S, Stotzer G, Kollbrunner A, Jaccard D, Hulaas J, Rutschmann O, Simon J, Hugli O, Gilart de Keranflec'h C, Pasquier J. Effects of environmental distractors on nurse emergency triage accuracy: a pilot study protocol. Pilot Feasibility Stud 2020; 6:171. [PMID: 33292718 PMCID: PMC7648299 DOI: 10.1186/s40814-020-00717-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 10/27/2020] [Indexed: 11/30/2022] Open
Abstract
Background The clinical decisions of emergency department triage nurses need to be of the highest accuracy. However, studies have found repeatedly that these nurses over- or underestimate the severity of patient health conditions. This has major consequences for patient safety and patient flow management. Workplace distractors such as noise and task interruptions have been pointed to as factors that might explain this inaccuracy. The use of a serious game reproducing the work environment during triage affords the opportunity to explore the impact of these distractors on nurse emergency triage accuracy, in a safe setting. Methods/design A pilot study with a factorial design will be carried out to test the acceptability and feasibility of a serious game developed specifically to simulate the triage process in emergency departments and to explore the primary effects of distractors on nurse emergency triage accuracy. Eighty emergency nurses will be randomized into four groups: three groups exposed to different distractors (A, noise; B, task interruptions; C, noise and task interruptions) and one control group. All nurses will have to complete 20 clinical vignettes within 2 h. For each vignette, a gold standard assessment will be determined by experts. Pre-tests will be conducted with clinicians and certified emergency nurses to evaluate the appeal of the serious game. Discussion Study results will inform the design of large-scale investigations and will help identify teaching, training, and research areas that require further development.
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Affiliation(s)
- Philippe Delmas
- La Source School of Nursing, University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland.
| | - Assunta Fiorentino
- La Source School of Nursing, University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland
| | - Matteo Antonini
- La Source School of Nursing, University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland
| | - Séverine Vuilleumier
- La Source School of Nursing, University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland
| | - Guy Stotzer
- La Source School of Nursing, University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland
| | - Aurélien Kollbrunner
- La Source School of Nursing, University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland
| | - Dominique Jaccard
- School of Management and Engineering Vaud, Yverdon-les-Bains, Switzerland
| | - Jarle Hulaas
- School of Management and Engineering Vaud, Yverdon-les-Bains, Switzerland
| | | | - Josette Simon
- Emergency Department, Geneva University Hospital, Geneva, Switzerland
| | - Olivier Hugli
- Emergency Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Charlotte Gilart de Keranflec'h
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland
| | - Jérome Pasquier
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
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Merisier S, Larue C, Boyer L. How does questioning influence nursing students' clinical reasoning in problem-based learning? A scoping review. NURSE EDUCATION TODAY 2018; 65:108-115. [PMID: 29550674 DOI: 10.1016/j.nedt.2018.03.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 02/16/2018] [Accepted: 03/08/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Problem-based learning is an educational method promoting clinical reasoning that has been implemented in many fields of health education. Questioning is a learning strategy often employed in problem-based learning sessions. AIM To explore what is known about the influence of questioning on the promotion of clinical reasoning of students in health care education, specifically in the field of nursing and using the educational method of problem-based learning. METHODS A scoping review following Arksey and O'Malley's five stages was conducted. The CINAHL, EMBASE, ERIC, Medline, and PubMed databases were searched for articles published between the years of 2000 and 2017. Each article was summarized and analyzed using a data extraction sheet in relation to its purpose, population group, setting, methods, and results. A descriptive explication of the studies based on an inductive analysis of their findings to address the aim of the review was made. RESULTS Nineteen studies were included in the analysis. The studies explored the influence of questioning on critical thinking rather than on clinical reasoning. The nature of the questions asked and the effect of higher-order questions on critical thinking were the most commonly occurring themes. Few studies addressed the use of questioning in problem-based learning. CONCLUSIONS More empirical evidence is needed to gain a better understanding of the benefit of questioning in problem-based learning to promote students' clinical reasoning.
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Affiliation(s)
- Sophia Merisier
- Faculty of Nursing, University of Montreal, Montreal, Canada.
| | - Caroline Larue
- Faculty of Nursing, University of Montreal, Montreal, Canada
| | - Louise Boyer
- Faculty of Nursing, University of Montreal, Montreal, Canada
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Nagels M. Le jugement clinique est un schème. Propositions conceptuelles et perspectives en formation. Rech Soins Infirm 2017:6-17. [DOI: 10.3917/rsi.129.0006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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