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Developing critical thinking skills from clinical assignments: A pilot study on nursing students’ self-reported perceptions

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Abstract

Clinical assignments in nursing education provide opportunities for students to develop thinking skills vital to the effective delivery of patient care. The purpose of the present study was to examine students' perceived levels of confidence for using thinking skills when completing two types of clinical assignments. Clinical educators and managers are challenged to develop teaching and learning strategies that help students think critically and reflectively and transfer these skills into sound nursing practice. This study is based on the theoretical framework of critical thinking within the nursing process framework. Undergraduate nursing students (n=51) completed surveys indicating their confidence in using seven thinking skills for nursing care. Students indicated significantly more confidence when implementing the journal format as compared with the care plan format when analysing information, determining relevance, making connections, selecting appropriate information, applying relevant knowledge and evaluating outcomes. The findings of the present study propose a new approach for enhancing students' thinking skills. Journaling is an effective strategy for enhancing students' thinking skills. Nursing managers are in key organisational positions for supporting and promoting the use of the journal format and building supportive and collaborative learning environments for students to develop thinking skills for managing patient care.

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... It also serves as the basis for performance assessment for students. (26)(27)(28)(29)(30) Therefore, this study carried out to determine the effect of clinical assignment as a teaching strategy on nursing students' knowledge and practice related to patient safety measures. ...
... In relation to the ongoing clinical practice, the assignment advanced patient encounters and interaction, and bearing responsibility. (10) Also, Marchigiano et al (2011) found that learning assignment improves nursing students' critical thinking skills because assignment focused on illuminating students skills to analyze information, determine relevance, make connections, set priorities, select appropriate information, apply pertinent knowledge and evaluate outcomes. Their study provided evidence that nursing students were more confident and effective in utilizing their thinking skills when developing an assignment in the journal format. ...
... Their study provided evidence that nursing students were more confident and effective in utilizing their thinking skills when developing an assignment in the journal format. (28) This study results are supported by Wolf et al (2008), who used the assignment strategy to teach the students patient assessment from head-to-toe. Results of that study showed that after utilizing patient assessment assignment nursing students become more quickly notice patient abnormalities and patient at risk, it improved student assessment skills and assisted them in developing a good nursing care plan. ...
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Background / Objectives: Guided clinical observation assignments are an integral part of the nursing educational experiences for nursing students. A nursing student's assignment is one of the crucial requirements that used to enhance the learning of the nursing students on the various aspects of nursing studies. Assignment tasks to help learners in coping up with the stressful life of a nursing practitioner and it requires from the students essential skills to complete. The aim of the study was to determine the effect of clinical assignment teaching strategy on nursing students' knowledge and practice related to patient safety measures. Materials and Method : The study was conducted at Gamal Abed El Nasser Technical Health Institute affiliated to Health Insurance Organization in Alexandria at emergency and critical department and intensive care unit at Gamal Abed El Nasser Hospital affiliated Health Insurance Organization at Alexandria. The subjects of this study consisted of all second year students (N=48 students). They were divided randomly into two equal groups (24 nursing students for each) as follows: Group A (study group) was instructed about patient safety measures in classroom through lectures then enrolled to clinical training in hospital using Safety Assessment Assignment Tool. Group B (control group) was instructed about patient safety measures in classroom through lectures then enrolled to traditional clinical teaching strategy. Three tools were used ;Patient Safety knowledge test ,Safety Measures Observational Checklist and Safety assessment assignment tool. Results : Improvement in total knowledge regarding patient safety noticed in both groups (study and control group) after intervention without a statistically significant difference between study and control group. It was obviously notes a statistically significant improvement in nursing students' total knowledge and practice after implementation of guided observation assignment as a teaching method. Conclusion and Recommendation : Using guided observation assignment as a teaching method was statistically significant effective in improving nursing students' practice more than knowledge.based on the results of this study , it was recommended that guided observation assignment can be used as a clinical teaching strategy to develop nursing students' skills in another field. Comparative study can be conducted to compare between guided observation assignment and simulation on nursing students' performance.
... It has been defined as the "process by which nurses collect cues, process the information, come to an understanding of a patient problem or situation, plan and implement interventions, evaluate outcomes and reflect on and learn from the process" (Levett-Jones et al., 2010, p. 516). The thinking skills required for clinical reasoning in nursing practice must be developed through undergraduate nursing education (Marchigiano, Eduljee, & Harvey, 2011), in fact, "the goal of nursing education is to develop independent, purposeful critical thinkers who can support the clinical reasoning necessary for practice" (Ellermann, Kataoka-Yahiro, & Wong, 2006, p. 220). According to the Canadian Association of Schools of Nursing [CASN] (2011,2015), baccalaureate nursing education is responsible for providing a foundation for sound clinical reasoning. ...
... Although there are some qualitative studies that have described the student experience of clinical reasoning either in practice (Di Vito-Thomas, 2005;Ellerman et al., 2006;Wotton, Davis, Button, & Kelton, 2010) or through clinical assignments (Abel & Freeze, 2006;Bartlett et al., 2008;Lee & Brysewicz, 2009;Paans, Sermeus, Nieweg, & Van Der Schans, 2010), the perceptions of these experiences are not well understood. Marchigiano et al. (2011) found that "little information is available regarding how students perceive their abilities to think and process information related to their delivery of patient care" (p. 145). ...
... However, challenges have been identified in both the teaching and the learning of the nursing process (Lee & Brysiewicz, 2009;Palese, Silvestre, Valoppi, & Tomietto, 2009;Thompson & Stapley, 2011). Several studies have addressed how the nursing process might be taught differently in order to facilitate development of clinical reasoning in students (Burns, O'Donnell, & Artman, 2010;Lee & Brysiewicz, 2009;Marchigiano et al., 2011;Paans et al., 2010). High-fidelity simulation scenarios, for example, could be used to introduce students to the concept of the nursing process (Burns et al., 2010), as could playing a 3D simulation game where the game guides learners through the process (Koivisto, Multisilta, Niemi, Katajisto, & Eriksson, 2016). ...
... When comparing the journal format to the care-plan format, students felt significantly more confident writing journals for analysing information, determining the relevance of patient data, making connections, applying relevant knowledge and evaluating patient outcomes. Journaling in addition provided the possibility for reflection on context and experiences not given in the care-plan format (Marchigiano et al., 2011). ...
... Identifying one's own needs for self-development, and reflecting on one's own weaknesses and areas that needed improvement also appeared difficult. However, reflective writing enable students to engage in self-reflection and self-evaluation (Dickieson et al., 2008;Edelen and Bell, 2011;Fernández-Peña et al., 2016;Ip et al., 2012;Marchigiano et al., 2011;Ruiz-López et al., 2015), and over time, students acknowledged that the process of reflective writing made them feel responsible for own learning (Coleman and Willis, 2015;Fernández-Peña et al., 2016). ...
Article
The aim of this review was to explore the evidence of learning from reflective writing in undergraduate clinical nursing education. A combination of 17 quantitative and qualitative studies were included and three main categories emerged Development of clinical reasoning skills, Professional self-development and Facilitators and barriers for learning. The results revealed that reflective writing enhanced the students’ reasoning skills and awareness in clinical situations. However, most students reflected primarily at a descriptive level, showing only limited and varied development of reflective skills. They focused on self-assessment; on their own emotional reactions and ability to cope in clinical situations, but had difficulties reflecting on the process of thinking and learning. Learning was promoted through instructive guidelines, scaffolding and detailed feedback from a trusted, available and qualified faculty teacher. Factors that facilitated learning included student maturity, individual cognitive skills, student collaboration and mixed tools for learning. Time constraints, conflicting values, lack of feedback and support, and lack of trust acted as barriers for learning. Reflective writing is a tool for students’ professional learning, but above all for the students’ personal development in becoming a professional nurse.
... Students indicate strengthened confidence of thinking skills when challenged to reflect on specific patient care related questions as opposed to traditional care plan assignments. This is in accordance with current research indicating how students' ability of critical thinking differs between various learning styles [34,35]. Educational programs' stress on theory tends to create a neglect of students experience of care in clinical assignments [36]. ...
... The students' descriptions are in accordance with current research. The outcome seemed to affect their critical thinking ability, but the education's theoretical emphasis caused frustration [34][35][36]. ...
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Background. Nursing documentation has long traditions and represents core element of nursing, but the documentation is often criticized of being incomplete. Nursing diagnoses are an important research topic in nursing in terms of quality of nursing assessment, interventions, and outcome in addition to facilitating communication and continuity. Aim. The aim of this study was to explore the nurses' and nursing students' experiences after implementing free text format nursing diagnoses in a medical department. Method. The study design included educational intervention of free text nursing diagnoses. Data was collected through five focus group interviews with 18 nurses and 6 students as informants. The data was analyzed using qualitative content analysis. Results. The informants describe positive experiences concerning free text format nursing diagnoses' use and usefulness; it promotes reflection and discussion and is described as a useful tool in the diagnostic process, though it was challenging to find the diagnosis' appropriate formulation. Conclusion. Our findings indicate a valid usability of free text format nursing diagnoses as it promotes the diagnostic process. The use seems to enhance critical thinking and may serve as valuable preparation towards an implementation of standardized nursing diagnoses. Use and support of key personnel seem valuable in an implementation process.
... 32,60 Faced with the choice of instruments, some authors have opted for using alternative methods of evaluation, such as the rubric, 61,62 the concept map, 63 the case study 64,65 and the questionnaire. 57,66,67 From the year 2000 onward, various researchers focused their attention on an evaluation of CT by means of qualitative methods, using semistructured interviews, 68-70 group discussions, 62 online discussions 71 and questionnaires. 72,73 Strategies for promoting CT There is interest in developing postgraduate and master's training programs that include specific strategies for the development of CT skills in nursing students. ...
... 65,83 Group dynamics encourages the development of CT skills in students 6 without, however, showing any improvement among working nurses. 36 The reflective diary is reported to be an effective strategy for increasing CT skills in students 6,57,65 in that it encourages reflection, the assimilation of newly learned material and the creation of new knowledge. ...
Article
This article seeks to analyse the current state of scientific knowledge concerning critical thinking in nursing. The methodology used consisted of a scoping review of the main scientific databases using an applied search strategy. A total of 1518 studies published from January 1999 to June 2013 were identified, of which 90 met the inclusion criteria. The main conclusion drawn is that critical thinking in nursing is experiencing a growing interest in the study of both its concepts and its dimensions, as well as in the development of training strategies to further its development among both students and professionals. Furthermore, the analysis reveals that critical thinking has been investigated principally in the university setting, independent of conceptual models, with a variety of instruments used for its measurement. We recommend (i) the investigation of critical thinking among working professionals, (ii) the designing of evaluative instruments linked to conceptual models and (iii) the identification of strategies to promote critical thinking in the context of providing nursing care.
... As an example, students in the sport and exercise science major should be encouraged to partner with other students to master skills taught (e.g., explaining and demonstrating an exercise). Students in the nursing major can practice individual skills (e.g., inserting an IV tube) but also be encouraged to participate in group work and projects, write short reflective papers, complete peer assessments (Hudson & Carrasco, 2015), and complete student journals to facilitate thinking reflectively and transfer skills into nursing practice (Marchigiano et al., 2010). ...
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This empirical study examined preferences between teacher-centered and student-centered teaching methods and academic major with 507 undergraduate college students. Surveys were administered to the students that assessed their level of agreement with teaching methods utilized in the classroom. The results indicate that across all academic majors, students’ preferences included a mix of teacher-centered and student-centered approaches, some of which include lecture with student interaction, demonstrations and practice, lecture with use of PowerPoint, free flowing classroom discussion, guest speakers, and games in the classroom. The least preferred teaching methods were predominantly teacher-centered and included the use of unscheduled quizzes, lecture with no visuals, lecture with handwritten notes, and watching a long film. Significant differences were obtained for preferred teaching methods between academic majors.
... Hemşirelik eğitimi, mesleki bilgiye, eleştirel düşünme ve karar verme yeteneklerine sahip profesyonel hemşire yetiştirmek için gerekli olan teorik bilgi ve uygulamaları içerir 1,2 . Etkili hemşirelik bakımının gerçekleşmesi için hemşirelik eğitimi ve uygulama alanında bilimsel temele dayalı hemşirelik yaklaşımı sergilenmelidir 3 . ...
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Amaç: Bu çalışma, İç Hastalıkları Hemşireliği dersi klinik uygulamasında öğrencilerin hazırladıkları bakım planlarının incelenmesi amacıyla yapılmıştır.Yöntem: Tanımlayıcı tipte olan araştırmanın evrenini bir Sağlık Bilimleri Yüksekokulunda İç Hastalıkları Hemşireliği dersini alan öğrencilerin hazırladığı 320 bakım planı oluşturmaktadır. Örneklemi ise, çalışmaya dâhil edilme kriterlerine uyan 182 bakım planı oluşturmuştur. Veriler “2015-2017 Kuzey Amerika Hemşirelik Tanıları Birliği (NANDA)”, “İç Hastalıkları Hemşireliği Uygulama Öğrenci Eğitim Modülü” ve “İç Hastalıkları Hemşireliği Dersi Bakım Planı Değerlendirme Kriterleri Formu” kullanılarak toplanmıştır.Bulgular: 13 NANDA alanından 10’nuna yönelik en az bir tane olmak üzere toplam 52 hemşirelik tanısının belirlendiği saptanmıştır. İlk üç sırada belirlenen hemşirelik tanılarının “aktivite intoleransı”, “akut ağrı” ve “uyku örüntüsünde bozulma” olduğu bulunmuştur. Öğrencilerin hemşirelik süreci aşamalarını uygulama durumlarına bakıldığında; tanımlayıcı özellik, ilişkili faktörler, sonuç belirleme ve planlama aşamalarında yeterli olanların daha yüksek olduğu görülmüştür.Sonuç: Fizyolojik sorunlara yönelik bakım planı hazırlamada yeterli olan öğrencilerin çoğunlukta olduğu görülürken, en çok değerlendirme aşamasında sorun yaşadıkları belirlenmiştir.
... Profesyonel hemşirelik eğitimi, öğrencilerin eleştirel düşünme ve problem çözme becerilerini geliştirmeye odaklanmalı ve özellikle hemşirelik müfredatlarında yer alan temel mesleki derslerin öğrencilerin eleştirel düşünme eğilimleri üzerine etkisini gözden geçirmelidir (7). İç hastalıkları hemşireliği ikinci sınıfta okutulan önemli uygulamalı mesleki derslerden birisidir. ...
... The majority of the recent literature alludes to the future challenges facing all nurses, and the challenges nursing education faces in meeting the needs of an aging, retiring, and novice workforce. Nurse's roles are expanding; they have more responsibility, more complex and complicated patients, and the increased need for cerebral, astute, knowledgeable, and critical thinking (Marchigiano, Eduljee, & Harvey, 2011). ...
... The majority of the recent literature alludes to the future challenges facing all nurses, and the challenges nursing education faces in meeting the needs of an aging, retiring, and novice workforce. Nurse's roles are expanding; they have more responsibility, more complex and complicated patients, and the increased need for cerebral, astute, knowledgeable, and critical thinking (Marchigiano, Eduljee, & Harvey, 2011). ...
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Thesis
Student nurse perceptions of teaching strategies commonly used in nursing programs. Qualitative study using interviews.
... (4,5) Clinical assignments in nursing education provide opportunities for students to develop thinking skills vital to the effective delivery of patient care. (9) Clinical Assignment means either (a) the specific client with whom a student has contact for the purpose of performing nursing practice activities in clinical learning experiences; or (b) the opportunities within health care agencies or in settings in which the student has contact with the client(s) and performs some nursing practice activities as part of clinical learning experiences. This method represents the most consistent strategy in planning learning activities in clinical instruction. ...
Full-text available
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Preparation of nursing students is an important component in the clinical experience. It includes: orientation to the clinical setting (patient, environment), using communication skills, patient education, nursing management and leadership, specifically, the educational preparation of nurses must provide the necessary skills and foundation for graduates to practice at a basic level of competency and safety. This study aims to investigate nursing interns' perception about their clinical assignment preparation requirement. The study subjects included 70 nursing students who were enrolled in internship year from1st September 2011 to 31 August 2012. The study was conducted at Minia University Hospital and Maternity University Hospital affiliated to Minia University. Clinical assignment preparation questionnaire was used for data collection. The current study revealed that both psychomotor skills and steps of nursing process were perceived as highly important requirements for clinical preparation assignments. It is concluded that interns in this study identified a variety of areas they needed to prepare for successful clinical assignment, these area include professional development and patient teaching. It was recommended to conduct a Study to examine the relationship between faculty and student perceptions of baccalaureate students' preparation for clinical assignments.
... (4,5) Clinical assignments in nursing education provide opportunities for students to develop thinking skills vital to the effective delivery of patient care. (9) Clinical Assignment means either (a) the specific client with whom a student has contact for the purpose of performing nursing practice activities in clinical learning experiences; or (b) the opportunities within health care agencies or in settings in which the student has contact with the client(s) and performs some nursing practice activities as part of clinical learning experiences. This method represents the most consistent strategy in planning learning activities in clinical instruction. ...
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Unethical behaviors in nursing education are emergent problems that seriously disrupts the teaching-learning environment and often results in stressful student/faculty relationships. Nursing educator who demonstrate positive, respectful behaviors, encourage similar behaviors from their students. Conversely, educator who is aloof, disinterested, and demeaning may invoke their students' hostility. Nurse educators need to apply ethical behaviors in order to encourage a positive student–instructor relationship and to create a safe and nurturing environment. This study aims to identify the perception of unethical behaviors in nursing education among nursing educators, students and staff at El-Minia Faculty of Nursing. This study was carried out at faculty of nursing and Minia University Hospital. The study sample included a total number of 300: 200 students were enrolled in the four academic years (50 from each academic year), 50 Nursing educators, and 50 Nursing staff. Unethical behaviors in nursing education questionnaire was used for data collection. The study revealed that the most perceived academic unethical behaviors by the study sample were aggression, disregard for others and abuse of position. There were also a highly statistically significant difference between mean scores of academic unethical behaviors by the study sample, it is concluded that, the most perceived academic unethical behaviors by the study subjects were aggression, disregard for others and, abuse of position. Also, there was highly statistical significant difference between mean scores of academic unethical behaviors by the study sample. It was recommended to conduct a study to examine impact of student unethical behavior on the nursing profession and nursing educators.
... Indeed, reflective journaling is a popular and effective pedagogical tool to promote learning in medicine, nursing, and education (e.g., Nanda et al., 2013;Rocklein, 2014). In particular, journaling has been shown to increase critical thinking and application of new knowledge (Marchigiano, Eduljee, & Harvey, 2011) and improve professional practice through critical reflection (Mathieson, 2016). More specifically, research has shown that mental health professionals who have the additive component of reflective worksheets in addition to a standard cognitivebehavioral therapy training model, report greater use of skills and awareness compared with those who do not use reflective worksheets (Bennett-Levy & Padesky, 2014). ...
Article
As part of a longitudinal investigation on implementation of 2 evidence-based psychotherapies (EBPs) for posttraumatic stress disorder, psychotherapists from 38 Department of Veterans Affairs residential treatment programs across the United States were asked to complete reflective journals every 4 months for a 1-year time period in regard to their successes and challenges in using prolonged exposure and cognitive processing therapy. This paper provides content analysis on the reflective journals of 24 of these providers. Five main themes were identified: EBPs are great but not sufficient for patients in residential treatment with chronic posttraumatic stress disorder and complicated life circumstances, and thus, more treatment is necessary after discharge. Modifications were made or thought needed for optimal outcome and successful delivery of these 2 EBPs; some providers blended aspects of prolonged exposure and cognitive processing therapy; what happens when providers and patients do not agree on choice of which EBP to first implement; and provider concerns on when to discontinue an EBP. Reflective journaling appears to be a promising way for trainers and treatment developers to gather important information about the clinical application and decision-making process for front-line providers, which may offer insight into how to improve EBP implementation and sustainability. Incorporating reflective journaling and strategies for accomplishing this into training, supervision, and consultation may also be 1 strategy for increasing feedback, expanding implementation, and informing ways to increase sustainability of EBPs in populations with multiple clinical and psychosocial needs.
... The findings of this study support our prediction that students in the strategic thinking group would score significantly higher on critical thinking skill and critical thinking disposition after the program period, compared to students in the control group who did not perform the strategic thinking program. Moreover, these findings support the notion that thinking training can be effective in the ability to critical thinking (Cota Bekavac, 2001;Schauer, 2003;Doddington, 2007;Grosser & Lombard, 2008;Demir et al., 2011;Popil, 2011;Dunn, Halonen & Smith, 2009;Zembal-Saul, 2009;Aizikovitsh-Udi & Amit, 2011;Marchigiano et al., 2011;Piawa, 2010;Gjoci & Kërënxhi, 2010;Yang, 2008;Dunn, Curko & Kragic, 2008Ku, 2009;Wells, 2009;Cruz et al., 2009, Yu,2017;Yung,2017. ...
Article
Today's experts believe that critical thinking is a major output in higher education and teaching thinking is a basic point to learning. The aim of this study was to explore whether a strategic thinking training program could improve student’s scores on a standardized measure of critical thinking. Sixty-six students aged between 20 and 35 were tested at their college on before the program CCTST and CCTDI. Thirty-nine of these students volunteered to be randomly allocated to the strategic thinking or control group. Students in the strategic thinking group received a strategic thinking training program, but not the students in the control group. The experimental and control groups were then re-tested on CCTST and CCTDI at after the intervention. Students in the strategic thinking group significantly improved their critical thinking skill and critical thinking disposition scores compared to the control group. On average, we observed no group differences between the strategic thinking and control groups. These results have important implications for implementing a strategic thinking training program to protect students from a decrease in critical thinking skill and critical thinking disposition during the achievement of educational goals.
... Un diseño descriptivo, transversal (23), que se utilizó para conocer los niveles de percepción en 51 estudiantes de pregrado de Enfermería sobre su confianza en el uso de siete habilidades de pensamiento crítico dentro del marco del proceso de enfermería. Las variables dependientes fueron las calificaciones de confianza para las siete habilidades de pensamiento. ...
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Article
Introduction: The nursing process is a method that involves knowledge, skills, abilities, attitudes and values acquired during training, so it is essential to ensure the achievement of this competition in clinical practice. The aim was to assess the level of compliance and scope of the Nursing Process skills in nursing students. Materials and Methods: Sectional design, with a sample being all the students ' enrolled (73 students) in IV and VI level nursing program in the city of Bucaramanga that rotated through clinical and community areas. Results: In the opinion of the students, the skills of the nursing process were reached between 2.63 % to 100 % and a level of compliance with 2.7 and 4, which according to the scale established are fair to very good. The skill "provides care using the nursing process " was common among rotations in IV level and were found no differences in the perceived level of achievement (p = 0.3180 ANVOVA test), but there were also significant differences between the level reached between IV and VI semesters. Discussion: Although there are few studies on the measurement of skills in nursing process for university level education, a large number of scientific publications have made evident the results of the application of this method in clinical practice. Conclusions: Knowing the extent to which nursing skills are being achieved and at what level, makes easy to adjust curricular aspects of the study program
... En cuanto a los estudios que han analizado la resolución de problemas clínicos en el marco de la aplicación del proceso enfermero, Chabeli identificó e integró el pensamiento crítico y las habilidades cognitivas como conceptos fundamentales en las 5 etapas del proceso enfermero 24 . Sin embargo, Marchigiano et al. señalaron que en la etapa de evaluación es muy difícil evaluar la transferencia de las nuevas habilidades aprendidas al cuidado profesional 25 . ...
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Article
Dada la importancia de la formación de profesionales reflexivos, y en el marco de la búsqueda de una nueva epistemología de la práctica de enfermería, este artículo de revisión analiza diversas fuentes teóricas que representan evidencias científicas relativas a la resolución de problemas, toma de decisiones clínicas y su relación con las características de los recién egresados del pregrado, quienes al realizar servicio social (residencias), vivencian un proceso de transición: dejar de ser estudiante, pero a la vez enfrentarse a situaciones de ejercicio profesional que requieren habilidades para resolver problemas y tomar decisiones en situaciones inciertas y complejas. La revisión implicó búsquedas sistemáticas en bases de datos como Medline, CINAHL, Scielo, Lilacs, Cochrane, Cuiden y Redalyc, que permitieron localizar: 3 revisiones sistemáticas, 11 estudios con enfoque cuantitativo, 11 con enfoque cualitativo y 2 mixto, 14 artículos de revisión y 5 libros, publicados en los últimos 15años. Aunque las publicaciones analizadas proceden de todos los continentes, predominan las de América en un 50%, seguidas por las europeas en un 22%.
... Reflective journaling has been associated with CT (Kennison, 2006;Hoffman & Elwin, 2004;Twibell et al., 2005). Marchigiano, Eduljee, and Harvey (2011) found that nursing students preferred reflective journaling to written care plans as a method of improving their thinking skills. Tanner (2006) stated that reflection is essential for the development of clinical knowledge and clinical reasoning. ...
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Article
Background: Simulation and guided reflective journaling have been identified as effective teaching and learning methods to develop critical thinking (CT) and clinical reasoning skills in nursing students. Method: A descriptive correlational design was used to determine the relationship between CT and level of reflection using the Holistic Critical Thinking Skills Rubric (HCTSR) and the level of reflection on action assessment (LORAA), respectively, to evaluate 23 baccalaureate student-guided reflective journal entries after a simulation exercise with guided debriefing and after two subsequent clinical experiences. Results: A statistically significant positive relationship (p < .01) was found between mean HCTSR and LORAA scores on all three journal entries, but no relationship to CT during simulation or on standardized test scores. The results also indicated support for use of the guided reflection after significant learning experiences. Conclusions: The LORAA and the HCTSR are effective measures of level of reflection and CT to evaluate learning from simulation and clinical experiences. [J Nurs Educ. 2016;55(11):645-650.].
... Because skilled nursing practice requires thinking skills for clinical reasoning and decision making, it is logical that development of these skills is an essential aspect of nursing education. [12] These new responsibilities are challenging the education of both pre-and post-licensed nurses in order to provide them with skills needed in health care settings that have been redesigned around quality and safety. To prepare the next generation of nurses, educators are being asked to examine current content and pedagogies. ...
Article
The purpose of this study was to determine the factors that may lead to effective education. A self-administered questionnaire was distributed in a hospital, with 156 nurses of the total nursing staff in the hospital completing the questionnaire (response rate, 74.3%). This study determined the background of the nurses according to their response as either in agreement or against the concept of learning venepuncture on human subjects at nursing schools. Most factors in the agreement group were evaluated according to experience or lack of experience. This showed venepunctures “Performed while still a student” (OR = 5.56, 95% CI: 2.06-15.01) were a contributing factor in the nurses’ responses. The proportion of participants who performed their first venepuncture as a nursing student was 86.0% in the agreement group and 51.9% in the against group. The percentage of nurses who never had practical training on a simulated model was 15.4%. It may be expected that one person’s experience may be passed onto the next generation in the same way. The first venepuncture will shift from a nursing student to a novice nurse, and because this may be a late decision the safety of the peer nurse needs to be considered. It is therefore necessary to expand prior practise exercises such as with a simulator. The venepuncture learning program starts after the nursing license is obtained. The program will be called into question as to whether or not it was carried out safely in the patients.
... (4,5) Clinical assignments in nursing education provide opportunities for students to develop thinking skills vital to the effective delivery of patient care. (9) Clinical Assignment means either (a) the specific client with whom a student has contact for the purpose of performing nursing practice activities in clinical learning experiences; or (b) the opportunities within health care agencies or in settings in which the student has contact with the client(s) and performs some nursing practice activities as part of clinical learning experiences. This method represents the most consistent strategy in planning learning activities in clinical instruction. ...
Full-text available
Article
Preparation of nursing students is an important component in the clinical experience. It includes: orientation to the clinical setting (patient, environment), using communication skills, patient education, nursing management and leadership, specifically, the educational preparation of nurses must provide the necessary skills and foundation for graduates to practice at a basic level of competency and safety. This study aims to investigate nursing interns' perception about their clinical assignment preparation requirement. The study subjects included 70 nursing students who were enrolled in internship year from1st September 2011 to 31 August 2012. The study was conducted at Minia University Hospital and Maternity University Hospital affiliated to Minia University. Clinical assignment preparation questionnaire was used for data collection. The current study revealed that both psychomotor skills and steps of nursing process were perceived as highly important requirements for clinical preparation assignments. It is concluded that interns in this study identified a variety of areas they needed to prepare for successful clinical assignment, these area include professional development and patient teaching. It was recommended to conduct a Study to examine the relationship between faculty and student perceptions of baccalaureate students' preparation for clinical assignments. [Abdel Kader A M, Mohamed EA and Abood SA. Perception of Nurse Interns about Clinical Assignment Preparation Requirements. J Am Sci 2012;8(12):676-682]. (ISSN: 1545-1003). http://www.americanscience.org. 95
... Un diseño descriptivo, transversal (23), que se utilizó para conocer los niveles de percepción en 51 estudiantes de pregrado de Enfermería sobre su confianza en el uso de siete habilidades de pensamiento crítico dentro del marco del proceso de enfermería. Las variables dependientes fueron las calificaciones de confianza para las siete habilidades de pensamiento. ...
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Introducción El proceso de enfermería es un método que involucra conocimientos, habilidades, destrezas, capacidades, actitudes y valores adquiridos durante la formación profesional, por tanto es fundamental garantizar el logro de esta competencia en la práctica clínica. El objetivo consistió en evaluar el nivel de cumplimiento y alcance de las competencias en Proceso de Enfermería en los estudiantes de Enfermería. Materiales y Métodos Diseño de corte transversal, cuya muestra correspondió al total de estudiantes matriculados (73 estudiantes) en IV y VI nivel de un programa de enfermería de la ciudad de Bucaramanga que rotaban por áreas clínicas y comunitarias. Resultados Según la opinión de los estudiantes, las competencias de proceso de enfermería fueron alcanzadas entre 2.63% a un 100% y un nivel de cumplimiento de 2.7 y 4, que según la escala establecida están entre regular y muy bueno. La competencia “Brinda cuidado aplicando el proceso de enfermería” fue común entre rotaciones de IV nivel y no se encontraron diferencias en el nivel de logro percibido (p=0.3180 test ANVOVA), además evidenció una diferencia significativa entre el nivel alcanzado entre IV y VI semestre. Discusión Aunque existen pocos estudios sobre la medición de las competencias en proceso de enfermería durante la formación universitaria, un gran número de publicaciones científicas han hecho evidente los resultados de la aplicación de este método en la práctica clínica. Conclusiones El conocer en qué medida las competencias en proceso de Enfermería son alcanzadas y en qué nivel, facilita el ajuste de aspectos curriculares del programa del estudio.
... Respect for their partner's learning, for their own learning, and for the information needs of the client and family in their shared care is a feature of authentic collaboration (San Martin-Rodriguez, Beaulieu, D'Amour, & Ferrada-Videla, 2005) and fundamental to task completion. Integration of nursing knowledge and aesthetic knowing with client goals is essential for profi cient clinical reasoning and client-centered decision making (Marchigiano, Eduljee, & Harvey, 2011). It follows then that nursing students develop their own critical thinking and clinical reasoning skills when collaborating with stakeholders, allied professionals, and support staff to fully meet client and family goals. ...
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This article describes a unique learning project designed to address the praxis gap between baccalaureate nursing students' clinical learning and theoretic principles of collaborative practice on an acute medical-surgical unit in Canada. The study was framed by the active engagement model to provide second-year nursing students a nontraditional approach to develop their nursing practice. Clinical faculty partnered with medical-surgical nursing staff and eight baccalaureate nursing students to explore the experience of collaborative learning and stakeholders' anticipated learning outcomes while working in dyads. A modified phenomenological approach was used in understanding the experience of dyadic learning through reflective journals, course evaluation data, and a semistructured exit interview for analysis. Four themes were revealed based on students' reflection of their experience: work engagement, relational practice, autonomy, and empowerment. These themes underscore the strengths and opportunities associated with this nontraditional approach to clinical learning. [J Nurs Educ. 2014;53(9, Suppl.):S65-S72.].
... Chabeli (2007) identified and integrated critical thinking concepts and core cognitive skills into the five-stage nursing process mentioned. However, assessing how effectively learned skills are transferred into practice is difficult to assess (Marchigiano, Eduljee, & Harvey, 2011). Lunney (2010) presented a case study to show the use of critical thinking in formulating nursing diagnoses. ...
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Critical thinking is an essential skill in the nursing process. Although several studies have evaluated the critical thinking skills of nurses, there is limited information related to the indicators of critical thinking or evaluation of critical thinking in the context of the nursing process. This study investigated the potential indicators of critical thinking and the attributes of critical thinkers in clinical nursing practice. Knowledge of these indicators can aid the development of tools to assess nursing students' critical thinking skills. The study was conducted between September 2009 and August 2010. In phase 1, a literature review and four focus groups were conducted to identify the indicators of critical thinking in the context of nursing and the attributes of critical thinkers. In phase 2, 30 nursing professionals participated in a modified Delphi research survey to establish consensus and the appropriateness of each indicator and attribute identified in phase 1. We identified 37 indicators of critical thinking and 10 attributes of critical thinkers. The indicators were categorized into five subscales within the context of the nursing process toreflect nursing clinical practice: assessment, 16 indicators of ability to apply professional knowledge and skills to analyze and interpret patient problems; diagnosis, five indicators of ability to propose preliminary suppositions; planning, five indicators of ability to develop problem-solving strategies; implementation, five indicators of ability to implement planning; and evaluation, six indicators of ability to self-assess and reflect. The study operationalized critical thinking into a practical indicator suitable for nursing contexts in which critical thinking is required for clinical problem solving. Identified indicators and attributes can assist clinical instructors to evaluate student critical thought skills and development-related teaching strategies.
... 90). It is argued, however, that many educators are challenged in developing strategies that assist students to think critically and transfer this competency into nursing practice (Marchigiano et al., 2011) and that "separating learning from working has limited the development of critical thinking skills" (Grealish and Smale, 2011, p. 57). ...
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AIM: To describe the experience of a group of postgraduate Norwegian nurses with academic writing and its impact on their engagement with continuing education. BACKGROUND: Nurses are required to be lifelong learners and increasing numbers are seeking further knowledge and skills for clinical practice through courses in institutions of higher education. In higher education they are often being assessed on their ability to produce an academic essay not on the development of their clinical competence. METHOD: A descriptive design was used, where participants were asked to complete in writing two open-ended statements. The data was then subject to inductive content analysis to extract categories and themes to describe the phenomenon. FINDINGS: Participants had little experience and were challenged by academic writing. It was perceived as difficult, time consuming and of little relevance to their clinical practice. CONCLUSION: There is disconnection between the assessment of learning in higher education and increased workplace competency. Rather than promoting a deep approach to learning educators may be creating barriers to engagement with lifelong learning through using traditional assessment practices. There is an imperative to develop assessments which allow demonstration of understanding, ability to use current evidence and the development of critical analytic skills for reflection on problems encountered in participants' work lives.
... As a result, students were reportedly able to recognize and address personal stigma and to develop empathy towards individuals diagnosed with mental illness. Marchigiano et al. (2011) used both journaling and care planning as methods of evaluation in a pre-licensure adult nursing course and found that students perceived journaling as superior to care planning in developing critical thinking skills, and believed it was an efficient use of time in achieving learning outcomes. ...
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With the popularity of accelerated pre-licensure nursing programmes and the growth in nursing student enrolments, traditional clinical education continues to be a challenge to deliver. Nursing faculty members are required to develop and implement educational innovations that achieve effective learning outcomes, while using fewer resources. The purpose of this qualitative study was to explore the effectiveness of a constructivism-based learning project to achieve specific learning outcomes and to supplement approximately 30 clinical hours in a psychiatric-mental health nursing course. Students participated in a 10-week, multistage project that examined life histories, treatment resources, and evidence-based practice, as applied to a single individual with a mental illness. Students reported increased understanding of mental health and illness, developed personal relevance associated with the knowledge gained, and learned to problem solve with regard to nursing care of individuals diagnosed with mental illness. For many students, there also appeared to be a reduction in stigmatized attitudes towards mental illness. Constructivism-based learning is a promising alternative to supplement clinical hours, while effectively achieving learning outcomes. Future research is needed to further validate the use of this method for the learning of course content, as well as the reduction of stigma.
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Clinical teaching practice of nurse educators is important in the development of clinical competence of undergraduate nursing students, but it is often not done according to best practice standards. This study aimed to summarise the best clinical teaching practices of nurse educators teaching undergraduate nursing programmes. An integrative literature review was conducted according to Whittemore and Knafl’s adapted stages. A systematic search of electronic databases, including EBSCOhost and ScienceDirect, for applicable papers from January 2001 to June 2021, was followed by a manual search. The review resulted in selection of 67 papers, and critical appraisal had been completed by two independent reviewers using relevant critical appraisal tools. Papers that were selected revealed six main themes, with sub-themes, outlining best practices for clinical teaching, namely: (1) planning for clinical teaching practice: self-preparation and planning for clinical placement; (2) facilitation of students’ clinical learning: orientation of students, planning for clinical teaching and the clinical teaching process; (3) evaluation of students’ clinical skills: reflection by the nursing student and feedback; (4) modelling professional clinical teaching practice: emotional intelligence, self-evaluation, role modelling and continuous professional development; (5) work-based assessment in the clinical environment: clinical assessment process and clinical assessment tools and (6) clinical teaching in the simulation laboratory. The six identified best practices could assist nurse educators to provide comprehensive clinical teaching. Contribution: The review’s results can be used in the development of a best practice guideline for clinical teaching. This guideline will aid nurse educators in achieving best clinical teaching practices.
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Purpose Students have an opportunity to integrate their theoretical knowledge into practice, develop skills to provide quality nursing care and gain clinical experience by using care plans. For this reason, it is important and necessary to identify students’ feelings, opinions and behaviors regarding care plans. This study aims to evaluate students’ opinions about working with a care plan to develop a realistic practice and achievable goals in clinical training of mental health nursing education. Design/methodology/approach A total of 90 senior nursing students were enrolled in this study, and data were collected from 63 students who received informed consent. In the data collection, a structured “Learning-Teaching Process Assessment Form” which consists of two parts created by the researchers in accordance with the qualitative research model was applied at the end of training period. The data were analyzed manually by researchers with “thematic analysis” method. Findings The analysis of data revealed three categories and ten themes. More than half of the students stated that they were not satisfied with the care plan, but they found working with a care plan as realistic, whereas the majority of them found it difficult planning a care plan, but found it beneficial to working with the care plan. Originality/value This study results show that different strategies are needed for students to implement nursing process effectively.
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Background: Nursing students often experience anxiety and stress from the expectations to develop clinical reasoning skills, internalize new knowledge, and learn to care for patients. Previous research has proposed reflective thinking as a tool to lessen anxiety and promote metacognition. This article examines the role of journaling in promoting reflection among undergraduate nursing students. Method: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were used to conduct the review. Concepts for journaling and nursing students were searched in four databases. Data were extracted from 19 sources to identify study type, participants, descriptions of journaling, and findings. Results: Studies took place in a variety of clinical and classroom settings; the majority used a guided format. Various frameworks and tools were used to provide conceptual support. Conclusion: Most studies found journaling to be effective in promoting reflection and the development of clinical judgment and emotional competency. However, more studies are needed to develop appropriate rubrics for assessment. [J Nurs Educ. 2022;61(1):29-35.].
Chapter
This chapter explains the overview of critical thinking (CT); the emerging trends of CT in the modern learning environments; CT in nursing education and health care; reflective judgment and CT; constructivist learning and CT; metacognitive strategies, cognitive strategies, and CT; and the promotion of CT in the modern learning environments. The promotion of CT is essential for the learning organizations that seek to serve educators, increase educational performance, strengthen competitiveness, and achieve continuous success in the modern learning environments. Therefore, it is required for the learning organizations to promote their CT and develop a learning plan to regularly check their practical advancements toward satisfying educator requirements. The chapter argues that promoting CT has the potential to enhance organizational performance and reach strategic goals in the modern learning environments.
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Background:The need ofcritical thinking dispositions are increased in nursing profession.It could be helpful to motivate nurses and encourage them to think critically. Itmay be contributing to enable them to analyze, solve surrounding problemsand provide safe and competent patient care. Aim of the study: It aimed to compare critical thinking dispositions among students at Faculty of Nursing in Suez Canal University. Subjects and methods:Comparative descriptive design was conducted on 251 nursing students from four academic years by using stratified random sample. Data were collected using California Critical Thinking DispositionsInventory to assess critical thinking dispositions among nursing students. Results: Total critical thinking dispositions and its characteristics of truth seeking, open mindedness, self-confidence and inquisitiveness had higher mean scores among third year students than others, with statistically significant differences. Conclusion:Critical thinking disposition has statistically significant differences among four academic years' nursing students. Recommendations:Conducting training programs, targeting critical thinking dispositions and various teaching strategies contributing to improve it for students and tutors, are needed to be implemented.
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Critical Thinking (CT) in the nurse graduate continues to be a topic of concern in the academic and acute care settings. Few studies focus on early evaluation of Critical Thinking Skills (CTS). The purpose of this chapter is to show how the non-experimental, explanatory, quantitative study, the Kaplan CTIT, was employed to determine if a transformation in the level of CTS occurs within the first semester of associate degree nursing students. Participants completed the pretest in the first three weeks of classes. Posttests were given after course finals. A significant transformation in the level of CT occurred. The estimated change in CT test scores was 2.04, with 95% confidence. Implications for early measurement of CTS in nursing programs reveals if teaching methodology is providing the necessary input for developing CTS or if evaluation and changes are needed.
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Critical thinking is the ability to raise discriminating questions in an attempt to search for better ideas, a deeper understanding and better solutions relating to a given issue. This systematic review provides a summary of efforts that have been made to enhance and assess critical thinking in medical education. Nine databases [Ovid MEDLINE(R), AMED, Academic Search Premier, ERIC, CINAHL, Web of Science, JSTOR, SCOPUS and PsycINFO] were searched to identify journal articles published from the start of each database to October 2012. A total of 41 articles published from 1981 to 2012 were categorised into two main themes: (i) evaluation of current education on critical thinking and (ii) development of new strategies about critical thinking. Under each theme, the teaching strategies, assessment tools, uses of multimedia and stakeholders were analysed. While a majority of studies developed teaching strategies and multimedia tools, a further examination of their quality and variety could yield some insights. The articles on assessment placed a greater focus on learning outcomes than on learning processes. It is expected that more research will be conducted on teacher development and students' voices.
Chapter
This chapter explains the overview of critical thinking (CT); the emerging trends of CT in the modern learning environments; CT in nursing education and health care; reflective judgment and CT; constructivist learning and CT; metacognitive strategies, cognitive strategies, and CT; and the promotion of CT in the modern learning environments. The promotion of CT is essential for the learning organizations that seek to serve educators, increase educational performance, strengthen competitiveness, and achieve continuous success in the modern learning environments. Therefore, it is required for the learning organizations to promote their CT and develop a learning plan to regularly check their practical advancements toward satisfying educator requirements. The chapter argues that promoting CT has the potential to enhance organizational performance and reach strategic goals in the modern learning environments.
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Research in the use of adaptive thinking training methodology for the development of critical thinking development.
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PurposeThis study aimed to determine the relationship between problem-solving and nursing process application skills of nursing.Methods This is a longitudinal and correlational study. The sample included 71 students. An information form, Problem-Solving Inventory, and nursing processes the students presented at the end of clinical courses were used for data collection.FindingsAlthough there was no significant relationship between problem-solving skills and nursing process grades, improving problem-solving skills increased successful grades.Conclusions Problem-solving skills and nursing process skills can be concomitantly increased.Clinical RevelanceStudents were suggested to use critical thinking, practical approaches, and care plans, as well as revising nursing processes in order to improve their problem-solving skills and nursing process application skills.
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Reflective journaling can be an effective teaching strategy in undergraduate nursing education. In particular, reflective journaling has been shown to increase the learner’s critical thinking and future application of new knowledge. This personal reflective paper describes and discusses the design, implementation, evaluation and effectiveness of a reflective journaling assignment in assisting undergraduate nursing students with developing nursing leadership skills. The assignment was implemented across seven sections of a collaborative nursing degree program and students were given the opportunity to provide their feedback on the usefulness of reflective journaling in helping them develop stronger leadership skills. This paper concludes with a discussion of revisions and recommendations for a more successful implementation of this assignment.
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Background: Life Story Work (LSW) argues that listening to patients’ life stories providesindividualized knowledge based upon the patients’ values and understanding of their lives. This facilitates the provision of care that respects the personhood of the recipient. Aim: To describe the experiences of a group of healthcare workers (HCW) in applying Life Story Work in nursing practice. Method: LSW was implemented at a Norwegian nursing home to examine whether a partnership between patient and HCW could emerge which would facilitate the provision of individualized and specific patient care. Data were collected from interviews conducted with eight HCWs and analyzed for thematic content. Results: Integrating LSW into care was not time-consuming. The participants described new insights and increased engagement with their patients and a strengthened relationship leading to new caring interventions. The main difficulty encountered by the HCWs was listening to sad memories, even though the patients themselves welcomed the opportunity to talk about such experiences. Conclusion: LSW was incorporated into the work at the unit, allowing the individuality of each resident to be seen; strengthening the relationship between them and the HCW. For the HCW such an intervention can provide new meaning and satisfaction in their work.
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Can G, Erol O. International Journal of Nursing Practice 2012; 18: 12–19 Nursing students' perceptions about nursing care plans: A Turkish perspective This descriptive study was planned in order to assess self-perceived sufficiency levels of nursing students at preparing nursing care plans and also determine the effect of these plans on students' occupational development. Sample of the study was consisted of 55 nursing students who were taking oncological training. Data were collected by using Personal Information Form and Student Care Plan Evaluation Form. Non-parametric tests were used in data analysis. Students perceived themselves ‘insufficient’ although assessing reproductive neurological and cardiovascular systems, respectively, and also interpreting results of hemogram and urine tests. No significant difference was found between the initial and last nursing care plans prepared by the students during clinical training. Sixty % of students reported that preparing and implementing nursing care plans had favourable effects on their occupational development. Results suggest that students should be well prepared before clinical training programmes and also nursing care plans should be revised and used in more proper and practical ways in order to enhance students' occupational development.
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This article intends to describe how critical thinking of learners can be facilitated or infused in clinical nursing education using the identified core cognitive critical thinking skills, their related sub-skills and the affective dispositions. Opsomming Hierdie artikel het ten doel om te beskryf hoe kritiese denke by leerders in kliniese verpleegonderwys gefasiliteer kan word deur die geïdentifiseerde kern-kognitiewe kritiese denkvaardighede, hul verwante sub-vaardighede asook affektiewe disposisies te gebruik. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.
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This paper explores educational strategies for nurses that focus on reflectivity and promote the development of self-awareness, relationship and communication skills and ability to lead with presence and compassion in the midst of change. Today nurses move rapidly from carefully-controlled educational experiences to a fast-paced clinical world of increasing patient complexity amid calls for improved quality of care. Making the transition to clinical competence and leadership in practice requires a strong sense of self and emotional intelligence. Pedagogies that integrate theoretical and data-based textbook learning with experiential learning and reflection are a foundation for the development of emotionally- and intellectually-competent leaders and requires new ways of assessing learner outcomes. Reflection is a key instructional strategy for preparing transformational nurse leaders for interdisciplinary settings where they lead patient care management. The remarkable global spread of reflection in nursing education, practice and research follows an emphasis on developing self-awareness as a leadership strategy for improving individual and organizational performance. Empirical, experiential and anecdotal evidence suggests that reflection has the potential to prepare emotionally-capable nurse leaders. As educators create more reflective and nurturing learning environments, they will promote the development of emotionally-competent nurse leaders who will, in turn, inspire individual and organizational growth and positive change in society.
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This article highlights eight leadership competencies likely to be an essential part of the nurse leader's repertoire in 2020. Planning for the future is difficult, even when environments are relatively static. When environments are dynamic, the challenges multiply exponentially. Unfortunately, few environments have been more unpredictable in the 21st century than health care. The healthcare system is in chaos, as is much of the business world. It is critical then that contemporary nursing and healthcare leaders identify skill sets that will be needed by nurse leaders in 2020 and begin now to create the educational models and management development programs necessary to assure these skills are present. Essential nurse leader competencies for 2020 include: (i) A global perspective or mindset regarding healthcare and professional nursing issues. (ii) Technology skills which facilitate mobility and portability of relationships, interactions, and operational processes. (iii) Expert decision-making skills rooted in empirical science. (iv) The ability to create organization cultures that permeate quality healthcare and patient/worker safety. (v) Understanding and appropriately intervening in political processes. (vi) Highly developed collaborative and team building skills. (vii) The ability to balance authenticity and performance expectations. (viii) Being able to envision and proactively adapt to a healthcare system characterized by rapid change and chaos. Nursing education programmes and healthcare organizations must be begin now to prepare nurses to be effective leaders in 2020. This will require the formal education and training that are a part of most management development programmes as well as a development of appropriate attitudes through social learning. Proactive succession planning will also be key to having nurse leaders who can respond effectively to the new challenges and opportunities that will be presented to them in 2020.
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Unlabelled: The objective of this literature review is to describe the perceived or real barriers to men seeking a career in nursing, and to suggest strategies for ameliorating barriers. A literature search exploring barriers existing for men pursuing nursing was conducted. Although the literature underscored the structure of nursing has changed substantially over the last fifty years, these changes have not always provoked a change in the public's perception of nursing. Barriers for men entering nursing still exist. Implications for gender diversity in nursing are discussed. Precis: Strategies for decreasing barriers experienced by males entering nursing are warranted.
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Effective clinical reasoning in nursing practice depends on the development of both cognitive and metacognitive skills. While a number of strategies have been implemented and tested to promote these skills, educators have not been able consistently to predict their development. Self-regulated learning theory suggests that this development requires concurrent attention to both the cognitive and metacognitive dimensions of reasoning in nursing care contexts. This paper reports on a study to explore the impact of self-regulated learning theory on reflective practice in nursing, and to advance the idea that both cognitive and metacognitive skills support the development of clinical reasoning skills. Integrative review of published literature in social science, educational psychology, nursing education, and professional education using the Cumulative Index to Nursing and Allied Health (CINAHL), Educational Resource Information Center (ERIC), and American Psychological Association (PsychInfo) Databases. The search included all English language articles with the key words clinical reasoning, cognition, critical thinking, metacognition, reflection, reflective practice, self-regulation and thinking. Reflective clinical reasoning in nursing practice depends on the development of both cognitive and metacognitive skill acquisition. This skill acquisition is best accomplished through teaching-learning attention to self-regulation learning theory. A critical analysis of the literature in the areas of critical thinking and reflective practice are described as a background for contemporary work with self-regulated learning theory. It is apparent that single-minded attention to critical thinking, without attention to the influence of metacognition or reflection, is but one perspective on clinical reasoning development. Likewise, single-minded attention to metacognition or reflection, without attention to the influence of critical thinking, is another perspective on clinical reasoning development. While strategies to facilitate critical thinking and reflective practice have been used in isolation from each other, there is evidence to suggest that they are inextricably linked and come together with the use of self-regulated learning prompts. Students and practising nurses are able to improve their cognitive and metacognitive skills in clinical contexts by using self-regulated learning strategies. The self-regulated learning model in nursing is offered to support teaching and learning of reflective clinical reasoning in nursing practice contexts.
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Critical thinking skills are essential to function in today's complex health care environment and to ensure continuing competence for the future. This article provides a review of various definitions and research studies related to critical thinking. Educators and researchers need to clearly define critical thinking, because there has been wide variation in definitions and descriptions of critical thinking. Research studies have shown inconsistent findings, and many have used a one-group pretest-posttest design over a single course or during the length of a nursing program. Studies have not shown an association between critical thinking and competence; rigorous research studies are needed to understand the process of critical thinking.
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This article introduces the University of Maryland Baltimore School of Nursing clinical simulation protocol structure and lessons learned while using this protocol in a mandatory learning experience for over 190 adult health students. Students use a SimMan manikin in a high-fidelity, interactive clinical simulation to provide care to "unstable patients." Benner's concepts regarding the performance characteristics and learning needs of nurses with varying levels of clinical competency were incorporated into the development of the simulation. The simulation provides a positive learning experience in which students refine their patient management skills and collaborate with multidisciplinary team members to resolve common postoperative problems.
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This study investigated the critical thinking dispositions and skills of senior nursing students. Study participants were students enrolled in associate (n = 137), baccalaureate (n = 102), and RN-to-BSN (n = 66) programs accredited by the Korean Ministry of Education. The California Critical Thinking Disposition Inventory (CCTDI) and California Critical Thinking Skills Test (CCTST) were used. A comparison of the CCTDI scores revealed a statistically significant difference between the students enrolled in different programs (F = 4.159, p = 0.017), as did a comparison of the CCTST scores (F = 24.205, p < 0.0001). Within the total sample (n = 305), the relationship between CCTDI and CCTST scores was significant (r = 0.305, p = 0.000). Developments in medical technology, the growing number of older adults and patients with chronic illnesses, and the demand for high-quality nursing care have led to various, increasingly complex, professional, legal, and educational issues within the nursing workplace. Therefore, nurses need creativity and critical thinking skills to make the decisions required of them in their nursing practice. In line with this, when conducting a survey of the effectiveness of nursing education, the necessity of critical thinking skills cannot be overlooked. In fact, the National League for Nursing Accrediting Commission (NLNAC) (1999) and American Association of Colleges of Nursing (AACN) (1998) require the concept of critical thinking be included as one of the core elements of curricula and that it be measured as an outcome when evaluating nursing education. In 1998, during the evaluation of colleges of nursing conducted by the South Korean Council for University Education, several universities presented the fostering of critical thinking as one of the terminal learning goals of nursing education based on the idea that critical thinking is important not only in the nursing workplace, but also in nursing education. To evaluate the effectiveness of Korea's current nursing education curriculum, focus was placed on current students in South Korea's three systems of nursing education. Each curriculum's effectiveness can be evaluated by indexing critical thinking dispositions and skills. This article intends to offer insight into the first steps necessary in reorganizing nursing education by comparing these evaluations of each of the three systems. To this end, we conducted a comparative study of the critical thinking dispositions and skills of students in 3-year associate degree (ADN), 4-year baccalaureate (BSN), and 5-year RN-to-BSN programs. The RN-to-BSN program requires students to finish a separate 2-year program after the initial 3-year ADN program.
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When critical thinking was identified as an explicit program outcome by the National League for Nursing in 1991, nursing programs were thrust into frenzied activity defining critical thinking and selecting instruments to evaluate it. This drove research on the measurement of critical thinking among nursing programs and the concomitant search for reliable and valid methodologies to systematically assess changes in critical thinking in their students. Although the ultimate goal of this process was curricular improvement, nearly 15 years later, faculty struggle to make sense of the data they have.
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When critical thinking was identified as an explicit program outcome by the National League for Nursing in 1991, nursing programs were thrust into frenzied activity defining critical thinking and selecting instruments to evaluate it. This drove research on the measurement of critical thinking among nursing programs and the concomitant search for reliable and valid methodologies to systematically assess changes in critical thinking in their students. Although the ultimate goal of this process was curricular improvement, nearly 15 years later, faculty struggle to make sense of the data they have.
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College student employment has been increasing steadily for at least four decades. At present, approximately 80% of all college students are employed while completing their undergraduate education. Even among students under the age of 24 at 4-year colleges, more than 50% are employed during the school year. Although some general trends are suggested by empirical research completed to date, studies that evaluate student employment and higher education are at times inconsistent and even contradictory. Despite the high prevalence of student employment, no theoretical models have been developed to explain the relationship between employment and student outcomes. This article briefly reviews the student employment–higher education empirical literature. Possible reasons for inconsistencies are suggested, including challenges posed by methodological issues and the absence of theoretical conceptualization. Some concluding suggestions are offered for addressing these empirical challenges.
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Educators are thwarted by inconsistent critical thinking definitions, poor understandings about measurable ways to teach critical thought processes, and a lack of reliable and valid nursing-specific assessment tools to effectively evaluate student reasoning. Standardized measures of students' critical thinking show contradictory measurement results. Assumptions that nurse educators possess highly evolved critical thinking skills need to be examined. It appears that continued attention and new approaches to critical thinking are still needed. More still needs to be known about relationships between the critical thinking abilities of the nursing faculty and the ways students are taught these skills through the curriculum and clinical experiences.
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Simulation has become the innovative method of incorporating clinical and theoretical knowledge and experiences for nursing students. It is essential for educators to offer strategies that develop students' critical- thinking abilities. This experiment used the Health Sciences Reasoning Test to determine if critical-thinking scores improved in the associate degree in nursing student after exposure to multiple clinical simulation scenarios (Facione & Facione. Health Sciences Reasoning Test (HSRT): a test for critical thinking skills for health care professionals. Test manual. Millbrae, CA: The California Academic Press LLC; 2006). Participants were 53 students from the medical-surgical course of an associate degree in nursing program of a college of nursing in the Midwest. Control participants received two simulation scenarios, and experimental participants received five scenarios. As predicted, experimental participants showed a greater increase in critical-thinking scores, demonstrating that simulation can enhance the quality of nursing education providing guaranteed clinical experiences that increase critical-thinking skills, as well as providing high-tech training for nursing students. Implications for nursing education and further research are discussed.
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The need for critical thinking in nursing has been accentuated in response to the rapidly changing health-care environment. Nurses must think critically to provide effective care while coping with the expansion in role associated with the complexities of current health-care systems. This literature review will present a history of inquiry into critical thinking and research to support the conclusion that critical thinking is necessary not only in the clinical practice setting, but also as an integral component of nursing-education programmes to promote the development of nurses’ critical-thinking abilities. The aims of this paper are to: (i) review the literature on critical thinking; (ii) examine the dimensions of critical thinking; (iii) investigate the various critical thinking strategies for their appropriateness to enhance critical thinking in nurses; and (iv) examine issues relating to the evaluation of critical-thinking skills in nursing.
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The need to attend to quality and safety competency development, increase capacity in nursing education programs, address the faculty and nursing shortages, and find new ways to keep step with an ever-changing health care environment has brought forth numerous creative curricular responses and collaborative efforts. To tackle these multiple needs and challenges simultaneously, a new academic-service partnership was created to collaboratively develop an innovative clinical education delivery model. The designed dedicated education unit model not only promoted student learning about quality and safety competencies via unit-based projects but also supported quality improvements in nursing care delivery. Following the initial semester of the model's implementation, a pilot study was conducted. The findings generated the evidence required to take this innovation to the next level. Moreover, the education-practice partnership, which was created to implement the clinical education delivery model, was strengthened as a result of this preliminary evaluation.
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The use of clinical simulation in nursing education provides many opportunities for students to learn and apply theoretical principles of nursing care in a safe environment. The purpose of this study was to evaluate simulated clinical experiences as a teaching/learning method to increase the self-efficacy of nursing students during their initial clinical course in a prelicensure program. An integrated, quasi-experimental, repeated measures design was used. A sample of 112 students completed surveys, indicating their confidence in various skills necessary for postpartum and newborn nursing, both before and after the simulation experience. Results indicated that students experienced a significant increase in overall self-efficacy (p < .01). Students also experienced an increase in confidence in assessing vital signs (p < .01), breasts (p < .01), the fundus (p < .001), and lochia (p < .001), and in providing patient education (p < .001). Three themes that emerged in the qualitative results were communication, confidence, and clinical judgment.
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At the beginning of the 21st century, public policy attention is being drawn to the profession of nursing by reports identifying demographic trends that are expected to lead to a significant shortage of nurses, given an aging population, a lengthening life span, and the increasing use of medical interventions to prevent or treat disease. This shortage is alleged to be more profound than the cyclic shortages experienced during the previous century, primarily for 2 reasons: (1) the nursing workforce is older, on average, than other professional groups, with more nurses entering practice at older ages with shorter expected work life, and (2) the capacity of the educational system to provide replacements for retiring nurses is inadequate due to a shortage of qualified faculty and limitations in clinical training sites.
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Teaching students to think critically is an important component of nursing education. A literature review suggests that a conceptual approach and a concept map may help facilitate critical thinking in the nursing student. Currently, there are patients in various health care settings who manifest psychosis and need treatment for the disorder. This article proposes using both a concept map and a conceptual approach to teach the concept of psychosis instead of focusing on content. If students understand the general concept of psychosis, they can identify and implement nursing actions for patients with psychosis regardless of the etiology or health care setting.
Article
To date, little has been written on specifically what critical thinking is and what the scores reported on critical thinking instruments actually represent. This lack of specificity provided the impetus to examine critical thinking skills and dispositions of baccalaureate nursing students, to ascertain whether or not a significant difference exists between academic levels, and to ascertain, using the California Critical Thinking Skills Test (CCTST) and the California Critical Thinking Disposition Inventory (CCTDI), whether a relationship exists between nursing students' critical thinking skills and their critical thinking dispositions. The conceptualization of critical thinking consisting of two dimensions, cognitive skills and affective dispositions, developed by a panel of experts comprised the conceptual framework for this study. A cross-sectional, descriptive, comparative, and correlational study was undertaken in which two instruments, CCTST, Form A, and the CCTDI were administered to a convenience sample of nursing students representing five academic levels. The sample in the statistical analyses comprised 328 students. Results indicated that the total critical thinking mean score for students at each level reflected percentile ranking ranging between 48 and 65 per cent. The mean score for the critical thinking subscale, inference, had the lowest percentile rankings, ranging between 37 and 55 per cent. The analysis of variance (ANOVA) statistical analysis indicated that students at the junior I level had the highest critical thinking mean scores, and students at the sophomore II level attained the lowest scores, reflecting a significant difference (P < or = .05). ANOVA also indicated a significant difference in the total critical thinking disposition mean scores between students at the junior I and senior I and II levels and those at the sophomore II level (P < or = .0000). Results indicated weak truth-seeking disposition scores among students at all levels. Pearson Product Moment Correlation Coefficient yielded a significant positive relationship between critical thinking skills and critical thinking dispositions (P < or = .01). The conceptual model, as well as its relevancy to the professional standards of Essentials for College and University Education for Professional Nursing (AACN, 1986), is presented. Recommendations are discussed in regard to nursing education, curriculum, and research.
Article
This integrative review summarizes 20 research studies reported from 1977 to 1995 that review change in the critical thinking abilities of professional nursing students. The Watson-Glaser Critical Thinking Analysis was used in 18 of 20 studies. The primary assumption was that critical thinking skills would increase during nursing education. However, the results of this review are mixed and contradictory. Possible reasons for these results are discussed.
Article
Following a curriculum revision, which emphasized critical thinking, a school of nursing selected the California Critical Thinking Skills Test (CCTST) as a standardized outcomes measure for its bachelor's of science in nursing (BSN) program. Students in three tracks of the program were administered the CCTST on entry into the nursing curriculum and again on exit. Paired t tests for dependent samples were used to analyze pretest-posttest differences of all students (N = 136) in the program. Results for students in each of the three tracks demonstrated significantly improved (P < or = .05) CCTST scores on all subscales and total scores, with one exception. RN to BSN students' scores on the Analysis subscale approached but did not reach significance (P = .058). Implications for evaluation are discussed.
Article
Critical thinking is essential to nursing practice; therefore, knowledge and understanding of nursing students' critical thinking skills (CTS) and related dispositions are important to nurse educators. This paper presents the results of a non-experimental study conducted in spring 1998, identifies implications for nurse educators, and offers recommendations for future research. The aim of the study was to investigate the CTS and critical thinking dispositions (CTD) of students enrolled in a 4-year baccalaureate programme at a university in Western Canada. The study used a cross-sectional design. Data collection occurred during regularly scheduled classes. A volunteer sample of 228 students from all 4 years of the baccalaureate programme completed a background/demographic questionnaire, the California Critical Thinking Skills Test, and the California Critical Thinking Disposition Inventory. The reliability of the test and inventory were established using the Kuder Richardson 20 and Cronbach Alpha respectively. Both descriptive and inferential statistical analyses were carried out. Critical thinking mean scores increased from years 1 to 4 with the exception of year 3. However, there was no statistically significant difference among the four student groups. Although differences in critical thinking disposition scores were not statistically significant, students' scores differed significantly on the systematicity subscale. There was a significant relationship between students' overall CTS and CTD scores. Approximately 38% of the students in the current study had adequate levels of CTS and 85.5% of the students had adequate levels of CTD. Results indicate a need for students' continued development in these areas. Dispositions are crucial to critical thinking; without them critical thinking does not happen or may be substandard.
Article
Journal writing is one of many strategies that can help promote learning in a process-oriented curriculum. This article explores the experience of implementing journal writing as an expectation of second-year baccalaureate nursing students in a clinical practicum. Faculty had a vital role in facilitating this experience. The journals provided a medium within which students explored in depth significant events that occurred in their practicum. Their analysis of these events included application of theoretical frameworks and concepts that supported and strengthened the arguments made in the journals. Students responded very favorably to their experiences in journal writing. In the evaluation of this experience, students reported increased abilities in critical thinking and self-directed learning. These two important concepts complement each other in the students' learning processes.
Article
The aim of this paper is to report a study exploring, from the perspective of key stakeholders (mentors of nurses, managers of nurses, and modern matrons) in one English acute sector hospital, how decisions are made on how many learner nurses can be supported in clinical practice. The objective was to identify what factors are taken into consideration in making these decisions. Supporting increasing numbers of students is a demand of current service provision in the English National Health Service, as part of an expansion in the numbers of all healthcare professionals. This is particularly the case in nursing, where the government announced a required increase in numbers of qualified nurses of 20 000. This expansion of numbers has implications for the quality of placement learning in clinical placements. Data were collected using three focus group interviews with a total of 12 participants in 2003/04. Recruitment was on a purposive basis. Subsequent analysis identified themes, which were compared across groups. A short questionnaire was also used to establish participants' biographical details prior to the focus groups. Three key themes were identified: 'capacity issues', 'enhancing support in practice' and 'issues impacting on learning in practice'. 'Capacity issues' identified factors that impact on the capacity of placements to support learners. 'Enhancing support in practice' identified necessary roles and strategies to enhance learning in practice. Finally, 'issues impacting on learning in practice' identified learner groups where support could be enhanced through structured management of the placement experience. Decisions on learner numbers to be supported at any one time are complex, with a multitude of dimensions. These include identification of types of learners and numbers of mentors available to support them and other operational issues. 'Educational staff' are needed at operational and strategic levels to support learning in practice. Timely and appropriate audit information to support allocation decisions and identify strategies to enhance the quality and support of learning in practice, are also required. Increases in learner numbers and National Health Service modernization have had an impact on clinical placements' capacity to support learning, and potentially, on learners' achievements in practice. Findings from this study are thus important in evaluating the impact of these policy initiatives.
Article
The purpose of this project was to evaluate concept mapping as a clinical teaching-learning activity that reflects critical thinking by promoting identification of nonlinear relationships among the components of the nursing process. The sample involved 28 associate degree nursing students from one graduating class. Students completed one map each in the second and fourth semesters and two maps in the fifth semester, for a total of four concept maps. The students' learning activity was to create a concept map on a blank sheet of paper describing the clients' physiological and psychosocial needs and nursing care and the relationships among concepts. As students progressed through the curriculum, there was a steady increase in the mean scores and the average number of cross-links in their concept maps. Cross-links indicated students' ability to use nonlinear thinking to identify relationships among concepts. The results of this study support the use of concept maps as an effective teaching-learning activity and support concept mapping as an evidence-based nursing education strategy.
Article
Today, the complexities in the health care system are challenging nurses to be skillful and knowledgeable critical thinkers and decision makers. To adequately prepare future nurses to meet the challenges, nurse educators must nurture and facilitate critical thinking. One strategy believed to promote critical thinking in nursing education is concept maps. The purpose of this pilot study was to determine the level of critical thinking in the clinical concept maps developed by second year baccalaureate nursing students. Students enrolled in a five-week clinical practicum course were asked to submit their final concept map and participate in a focus group. The data for the study included eighteen concept maps, 1 student focus group and 1 instructor focus group. The Holistic Critical Thinking Scoring Rubric (Facione & Facione, 1994) was used to measure levels of critical thinking, and content analysis was used to analyze focus group data. Results from this study indicated that developing concept maps in the clinical setting fostered critical thinking and improved clinical preparedness.
Article
This article describes the implementation and evaluation of the Dedicated Education Unit (DEU) as an innovative model of clinical nursing education. A partnership of nurse executives, staff nurses and faculty transformed patient care units into environments of support for nursing students and staff nurses while continuing the critical work of providing quality care to acutely ill adults. Various methods were used to obtain formative data during the implementation of this model in which staff nurses assumed the role of nursing instructors. Results showed high student and nurse satisfaction and a marked increase in clinical capacity that allowed for increased enrollment. This article reports on a 3-year project to operationalize the DEU concept with 6 nursing units in 3 hospitals. The development of staff nurses as clinical instructors, best practices to teach and evaluate critical thinking in students, and the mix of student learners continue as focus areas.
Article
This paper reports a study to explore nursing students' experience of learning in the clinical setting of a Dedicated Education Unit using a communities of practice framework. The Bachelor of Nursing curriculum at the University of Canberra is clinically focused, recognizing the importance of learning to be a nurse in and from practice. A communities of practice framework underpins the philosophy of the Dedicated Education Unit model of clinical practicum. In this exploratory qualitative study, a convenience sample of 25 second and third year nursing students participated in focus group discussions, conducted in 2004, to share their views of learning in the Dedicated Education Unit, a newly established model of clinical education. Three major themes were identified: acceptance, learning and reciprocity, and accountability. Acceptance of students by clinicians assisted students to engage in nursing work. Students acknowledged the importance of peer learning in sharing experiences, reinforcing knowledge and enhancing confidence. Students accepted responsibility for their work and they valued this responsibility, but some questioned whether participation in all aspects of work constituted a learning opportunity. Engagement and participation in the clinical workplace are valuable for nursing students. Strategies to support learning in the workplace can be shared with students and clinicians. Further research to test the theoretical premises of the communities of practice framework in clinical nursing education is required.
Article
Novice graduate nurses (GNs) are often deficient in the critical thinking skills needed to assess and handle patient problems and life-threatening situations. Concept mapping is an effective teaching strategy for developing critical thinking and clinical decision-making skills. This small descriptive comparison study was undertaken to determine whether concept mapping improved critical thinking skills in GNs during a hospital orientation program. Schuster's (2002) Concept Map Care Plan Evaluation Tool was adapted to measure GNs' critical thinking in concept maps based on case studies at the beginning and end of orientation. A paired t test was computed on pre- and post-mean map scores of 14.071 and 16.428, respectively. Concept mapping was a valuable teaching and evaluation strategy for this group that could be used by nursing educators to improve critical thinking and identify and correct areas of theoretical and clinical deficiency.
Article
To report a literature study of leadership for learning in clinical practice in the United Kingdom. Background Previous research in the United Kingdom showed that the ward sister was central to creating a positive learning environment for student nurses. Since the 1990s, the ward mentor has emerged as the key to student nurses' learning in the United Kingdom. A literature study of new leadership roles and their influence on student nurse learning (restricted to the United Kingdom) which includes an analysis of ten qualitative interviews with stakeholders in higher education in the United Kingdom undertaken as part of the literature study. Learning in clinical placements is led by practice teaching roles such as mentors, clinical practice facilitators and practice educators rather than new leadership roles. However, workforce changes in clinical placements has restricted the opportunities for trained nurses to role model caring activities for student nurses and university based lecturers are increasingly distant from clinical practice. Leadership for learning in clinical practice poses three unresolved questions for nurse managers, practitioners and educators - what is nursing, what should student nurses learn and from whom? Leadership for student nurse learning has passed to new learning and teaching roles with Trusts and away from nursing managers. This has implications for workforce planning and role modelling within the profession.
Nursing Process in Action: A Critical Thinking Approach
  • J Wilkinson
Wilkinson J. (1991) Nursing Process in Action: A Critical Thinking Approach. Addison-Wesley Nursing, Redwood City, CA.
Critical thinking: A statement of expert con-sensus for purposes of educational assessment and instruction. Research findings and recommendations [WWW document 20th-century reports on nursing and nursing education
  • P Facione
Facione P. (1990) Critical thinking: A statement of expert con-sensus for purposes of educational assessment and instruction. Research findings and recommendations [WWW document]. Available at: URL http://www.insightassessment.com/pdf_files/ DEXadobe.PDF, accessed 15 August 2009. Gebbie K. (2009) 20th-century reports on nursing and nursing education. Nursing Outlook 57 (2), 84–92.
Critical Thinking Tactics for Nurses: Tracking, Assessing, and Cultivating Thinking to Im-prove Competency-based Strategies Critical thinking dispositions and skills of senior nursing students in associate, baccalaureate, and RN-to-BSN programs
  • Rubenfeld M Scheffer
  • B Jones
  • Bartlett Pub-Lishers
  • Inc
  • Ma Sudbury
  • K Shin
  • D Jung
  • S Shin
  • M Kim
Rubenfeld M. & Scheffer B. (2006) Critical Thinking Tactics for Nurses: Tracking, Assessing, and Cultivating Thinking to Im-prove Competency-based Strategies. Jones and Bartlett Pub-lishers, Inc., Sudbury, MA. Shin K., Jung D., Shin S. & Kim M. (2006) Critical thinking dispositions and skills of senior nursing students in associate, baccalaureate, and RN-to-BSN programs. Journal of Nursing Education 45 (6), 233–237.
Essentials of Baccalaureate Education for Professional Nursing Practice American Association of Colleges of Nursing Outcomes of clinical simulation for novice nursing students: communication, confi-dence, clinical judgment
  • Dc Bambini
  • D Wasburn
  • J Perkins
American Association of Colleges of Nursing (2008) Essentials of Baccalaureate Education for Professional Nursing Practice. American Association of Colleges of Nursing, Washington, DC. Bambini D., Wasburn J. & Perkins R. (2009) Outcomes of clinical simulation for novice nursing students: communication, confi-dence, clinical judgment. Nursing Education Perspectives 30 (2), 79–82.
Choice theory and student success
  • Glasser
Glasser W. (1997) Choice theory and student success. Education Digest 63 (3), 16.
Developing critical-thinking skills from clinical assignments: a pilot study on nursing studentsÕ self-reported perceptions''. Paper presented at the 22nd annual scientific sessions of the Eastern Nursing Research Society Dedicated educational unit: an innova-tive clinical partner education model
  • G Marchigiano
  • N Eduljee
  • K Harvey
Marchigiano G., Eduljee N. & Harvey K. (2010) ''Developing critical-thinking skills from clinical assignments: a pilot study on nursing studentsÕ self-reported perceptions''. Paper presented at the 22nd annual scientific sessions of the Eastern Nursing Research Society, Providence, RI, USA, 24–26 March. Moscato S., Miller J., Logsdon K., Weinberg S. & Chor-penning L. (2007) Dedicated educational unit: an innova-tive clinical partner education model. Nursing Outlook 55 (1), 31–37.
Nursing Process: A Critical Thinking Approach
  • J Wilkinson
Wilkinson J. (1996) Nursing Process: A Critical Thinking Approach, 2nd edn. Addison-Wesley Nursing, Menlo Park, CA.
Critical Thinking Tactics for Nurses: Tracking, Assessing, and Cultivating Thinking to Improve Competency-based Strategies
  • M Rubenfeld
  • B Scheffer
Rubenfeld M. & Scheffer B. (2006) Critical Thinking Tactics for Nurses: Tracking, Assessing, and Cultivating Thinking to Improve Competency-based Strategies. Jones and Bartlett Publishers, Inc., Sudbury, MA.
NLN think tank on transforming clinical nursing education [WWW document] Available at: URL http
National League for Nursing (2008). NLN think tank on transforming clinical nursing education [WWW document]. Available at: URL http://www.nln.org/facultydevelopment/pdf/ think_tank.pdf, accessed 13 July 2009.
The Global Nursing Shortage: Priority Areas for Intervention. International Council of Nurses
International Council of Nurses/Florence Nightingale International Foundation (2006) The Global Nursing Shortage: Priority Areas for Intervention. International Council of Nurses/Florence Nightingale International Foundation, Geneva.
Essentials of Baccalaureate Education for Professional Nursing Practice. American Association of Colleges of Nursing
American Association of Colleges of Nursing (2008) Essentials of Baccalaureate Education for Professional Nursing Practice. American Association of Colleges of Nursing, Washington, DC.
Evaluating critical thinking in clinical concept maps: a pilot study
  • W Glasser
Glasser W. (1997) Choice theory and student success. Education Digest 63 (3), 16. Hicks-Moore S. & Pastirik P. (2006) Evaluating critical thinking in clinical concept maps: a pilot study. International Journal of Nursing Education Scholarship 3 (1), article-27.
NLN think tank on transforming clinical nursing education [WWW document
National League for Nursing (2005) Transforming nursing education. Nursing Education Perspectives 26 (3), 195-197. National League for Nursing (2008). NLN think tank on transforming clinical nursing education [WWW document]. Available at: URL http://www.nln.org/facultydevelopment/pdf/ think_tank.pdf, accessed 13 July 2009.