Clinical decision making among fourth-year nursing students: an interpretive study

Area of Science:

• Nursing Education
• Clinical Decision Making
• Healthcare Professional Development

Background:

• Clinical decision-making is a core competency for registered nurses.
• Understanding the learning process of clinical decision-making in nursing students is essential for curriculum development.
• Fourth-year baccalaureate nursing students represent a critical stage in skill acquisition before independent practice.

Purpose of the Study:

• To investigate the learning process of clinical decision-making among fourth-year baccalaureate nursing students.
• To identify key themes and essential components contributing to the development of clinical decision-making skills in nursing students.

Main Methods:

• Qualitative study involving semi-structured interviews with seventeen fourth-year nursing students.
• Data analysis employed a modified seven-step process developed by Diekelmann and Allen.
• Focus on understanding students' lived experiences in learning clinical decision-making.

Main Results:

• Five essential themes emerged: gaining confidence, building staff relationships, connecting with patients, self-comfort as a nurse, and understanding the clinical picture.
• Students' development of clinical decision-making is a multifaceted process influenced by interpersonal and intrapersonal factors.
• Confidence and understanding the broader clinical context were significant components of skill acquisition.

Conclusions:

• The learning of clinical decision-making is an integrated process involving skill, relationship, and contextual understanding.
• Educational strategies should foster confidence, interpersonal skills, and holistic patient assessment in nursing students.
• Findings provide insights for enhancing nursing curricula to better prepare students for complex clinical environments.