Cognitions and clinical performance: a comparison of high and low performing baccalaureate nursing students.

Studies to date have employed a variety of methods to elucidate the cognitive processes that underlie nursing actions in clinical situations. Most studies relied on clinical case scenarios rather than actual patient care situations, and did not supplement cognitive measures with quantitative measures of performance or physiologic outcomes of care. The present study employed a quasi-experimental design to describe and compare the verbal report data of baccalaureate nursing students who were assigned to high and low performing groups based on their ability to alter the physiological trajectory of the patient in a simulated task environment. Low performing participants observed many irrelevant cues and failed to perform vital actions in lieu of extraneous actions that were not directly related to the patient's condition. Higher performing students were better able to recognize salient symptoms suggestive of deterioration in the patient's condition and were more expeditious intervening to improve the patient's physiological status.