Using "think aloud" to capture clinical reasoning during patient simulation

Area of Science:

• Nursing Education
• Clinical Reasoning
• Simulation-Based Learning

Background:

• Think Aloud (TA) is a strategy where individuals verbalize thoughts during tasks.
• Its application in nursing education research using high-fidelity patient simulation is novel.
• Understanding student clinical reasoning is crucial for effective nursing practice.

Purpose of the Study:

• To integrate Think Aloud (TA) methods into the study of clinical reasoning.
• To explore the utility of concurrent and retrospective TA in high-fidelity patient simulation.
• To analyze the data collected on baccalaureate nursing students' clinical reasoning processes.

Main Methods:

• Concurrent Think Aloud (TA): Students verbalized thoughts in real-time during simulation.
• Retrospective Think Aloud (TA): Students reflected on their actions in a post-simulation interview.
• High-fidelity patient simulation was used as the learning environment.

Main Results:

• Concurrent TA revealed distinct verbalization patterns: public/private thoughts, care narration, and strategic pauses.
• Retrospective TA yielded rich data on students' reflection-on-action.
• TA effectively captured the nuances of student clinical reasoning.

Conclusions:

• Think Aloud (TA) is a valuable tool for collecting rich data on clinical reasoning in nursing students.
• This method provides unique insights into the cognitive processes during patient simulation.
• TA enhances the understanding of clinical reasoning development in nursing education.