Educational interventions to develop clinical reasoning among trainee advanced nurse practitioners: A scoping review

To map the available evidence on educational interventions used to teach clinical reasoning skills among student advanced nurse practitioners.

As autonomous practitioners, trainee advanced nurse practitioners learn and develop effective clinical decision-making skills. Although advocated globally as core competency skills, little is known about how these skills are taught or developed in practice.

A scoping review was conducted in April 2025, using CINAHL, OVIDMEDLINE, EMBASE and WEB OF SCIENCE, aligned to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA) guidelines. In addition, a search of grey literature and reference lists of included studies were conducted. Key terms were constructed based on the Population-Concept Context (PCC). The eligibility of articles was determined by three reviewers independently.

In total, 457 articles were identified, of which 25 were eligible for inclusion. No standardised conceptual definition of clinical reasoning, underpinning theoretical framework or approach to teaching or measurement existed. Results showed that multiple educational interventions were used in practice. Several novel techniques were also identified. There was little statistically significant evidence of effectiveness from the identified studies. Significant variance exists in teaching method used globally.

There remains a lack of evidence on the effectiveness of teaching strategies for teaching clinical reasoning to trainee advance nurse practitioners and no commonly accepted validated tool to assess these skills in practice. A commonly accepted theoretical framework for clinical reasoning is needed or to develop, deliver and assess effective educational interventions.