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Assessing Clinical Reasoning Under Uncertainty Through the Post-anesthesia Nursing Script Concordance Test: A
Lara Daniela Matos Cunha1, Pardis Rahmatpour2, Filipa Ventura3
1ICBAS School of Medicine and Biomedical Sciences - University of Porto, Porto, Portugal; Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal; Fundação para a Ciência e a Tecnologia (FCT), Lisboa, Portugal.
Summary
The Postanesthesia Nursing Script Concordance Test (PaNSCT) effectively assesses clinical reasoning in postanesthesia care. It demonstrates reliability and validity, highlighting the importance of specialized experience for nurses.
Area of Science:
- Nursing Education
- Clinical Reasoning Assessment
- Postanesthesia Care
Background:
- Clinical reasoning is vital for nurses in complex healthcare settings.
- Script Theory provides a framework for organizing nursing knowledge.
- Script Concordance Tests (SCTs) are established educational tools, but their use in specialized professional development, like postanesthesia care, is underexplored.
Purpose of the Study:
- To develop the Postanesthesia Nursing Script Concordance Test (PaNSCT).
- To evaluate the validity and reliability of the PaNSCT for assessing clinical reasoning in postanesthesia nursing.
Main Methods:
- A multimethod methodological study was conducted in three phases.
- Phase I: Construction and construct validity using expert consensus.
- Phase II: Assessed reliability, acceptability, and appropriateness via PaNSCT scores and qualitative feedback from experts and perioperative nurses.
- Phase III: Focused on sustainability and intellectual property.
Main Results:
- The PaNSCT demonstrated strong construct validity with 20 cases and 60 items.
- High reliability was shown (Cronbach's α = 0.92).
- Clinical experts scored significantly higher than nurses (P = .01), and nurses' scores correlated positively with postanesthesia care unit experience (r = 0.58, P = .009).
Conclusions:
- The PaNSCT is a reliable and valid instrument for evaluating clinical reasoning under uncertainty in postanesthesia care.
- It has the potential to enhance nursing education and develop critical reasoning skills in this specialized field.
- Findings underscore the value of specialized experience and advanced training in postanesthesia nursing.
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