JuHee Lee1, Young Joo Lee2, JuYeon Bae3, Minjeong Seo4. 1. Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, 510 College of Nursing, Yonsei-ro 50, Seodaemun-gu, Seoul, Republic of Korea 03722. Electronic address: JHL@yuhs.ac. 2. The Graduate School of Yonsei University, 403 College of Nursing, Yonsei-ro 50, Seodaemun-gu, Seoul, Republic of Korea 03722. Electronic address: yjlee2013@yuhs.ac. 3. College of Nursing, Yonsei University, 306 College of Nursing, Yonsei-ro 50, Seodaemun-gu, Seoul, Republic of Korea 03722. Electronic address: porester@yuhs.ac. 4. College of Nursing, Gyeongsang National University, 816-15 Jinju-daero, Jinju, Gyeongnam, Korea 52727. Electronic address: mjseo@gnu.ac.kr.
Abstract
BACKGROUND: As complex chronic diseases are increasing, nurses' prompt and accurate clinical reasoning skills are essential. However, little is known about the reasoning skills of registered nurses. OBJECTIVE: This study aimed to determine how registered nurses use their clinical reasoning skills and to identify how the reasoning process proceeds in the complex clinical situation of hospital setting. DESIGN: A qualitative exploratory design was used with a think-aloud method. METHODS: A total of 13 registered nurses (mean years of experience=11.4) participated in the study, solving an ill-structured clinical problem based on complex chronic patients cases in a hospital setting. Data were analyzed using deductive content analysis. RESULTS: Findings showed that the registered nurses used a variety of clinical reasoning skills. The most commonly used skill was 'checking accuracy and reliability.' The reasoning process of registered nurses covered assessment, analysis, diagnosis, planning/implementation, and evaluation phase. CONCLUSIONS: It is critical that registered nurses apply appropriate clinical reasoning skills in complex clinical practice. The main focus of registered nurses' reasoning in this study was assessing a patient's health problem, and their reasoning process was cyclic, rather than linear. There is a need for educational strategy development to enhance registered nurses' competency in determining appropriate interventions in a timely and accurate fashion.
BACKGROUND: As complex chronic diseases are increasing, nurses' prompt and accurate clinical reasoning skills are essential. However, little is known about the reasoning skills of registered nurses. OBJECTIVE: This study aimed to determine how registered nurses use their clinical reasoning skills and to identify how the reasoning process proceeds in the complex clinical situation of hospital setting. DESIGN: A qualitative exploratory design was used with a think-aloud method. METHODS: A total of 13 registered nurses (mean years of experience=11.4) participated in the study, solving an ill-structured clinical problem based on complex chronic patients cases in a hospital setting. Data were analyzed using deductive content analysis. RESULTS: Findings showed that the registered nurses used a variety of clinical reasoning skills. The most commonly used skill was 'checking accuracy and reliability.' The reasoning process of registered nurses covered assessment, analysis, diagnosis, planning/implementation, and evaluation phase. CONCLUSIONS: It is critical that registered nurses apply appropriate clinical reasoning skills in complex clinical practice. The main focus of registered nurses' reasoning in this study was assessing a patient's health problem, and their reasoning process was cyclic, rather than linear. There is a need for educational strategy development to enhance registered nurses' competency in determining appropriate interventions in a timely and accurate fashion.