Do educational interventions improve nurses' clinical decision making and judgement? A systematic review

Area of Science:

• Nursing Education
• Clinical Decision Making
• Evidence Synthesis

Background:

• Nursing curricula increasingly incorporate decision-making skills.
• The comparative effectiveness of educational interventions to enhance nursing judgment and decision-making is not well-established.

Purpose of the Study:

• To systematically review and summarize comparative evidence on educational interventions designed to improve nurses' clinical judgments and decision-making.

Main Methods:

• A systematic review of studies published since 1960 was conducted.
• Searches included multiple electronic databases and hand searching of nursing journals.
• Data were narratively synthesized due to heterogeneity in study designs, interventions, and outcomes.

Main Results:

• Twenty-four studies were included from over 5000 initial citations.
• Reported educational interventions varied, but study quality and reporting were generally poor.
• The effectiveness and efficacy of interventions showed mixed results, with limited use of decision theory.

Conclusions:

• Evidence from comparative studies offers little certainty regarding the effectiveness of educational interventions for nursing judgment and decision-making.
• Nurse educators should integrate decision theory alongside pedagogical theory in intervention design.
• Improvements in study design and reporting are crucial for maximizing the value of research on educational interventions.