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Reframing clinical reasoning in Pediatric nursing education: A case-based socio-clinical model for family-Centered
Maria Antuna-Casal1, Marta Rios2
1Nursing Area, Department of Medicine. Faculty of Medicine and Health Sciences, University of Oviedo, Oviedo, Spain.
Background:
Undergraduate pediatric nursing education must prepare students to integrate clinical information with developmental interpretation, family perspectives, communication, and uncertainty. Although case-based learning supports knowledge application, its conventional framing may underrepresent the relational, linguistic, and information-rich conditions in which pediatric judgment is formed.
Aim:
To propose and justify a socio-clinical, case-based model of pediatric nursing clinical reasoning for undergraduate education.
Methodological Approach:
A structured conceptual development process combined theory derivation and theory synthesis, guided by conceptual framework analysis. Sources from nursing science, educational theory, social theory, and contemporary information environments were selected for explanatory relevance. Concepts were retained according to theoretical relevance, definitional clarity, disciplinary compatibility, explanatory distinctiveness, and pedagogical operationalizability.
Findings:
The resulting framework integrates four mutually reinforcing dimensions-phenomenological-clinical, dialogical-relational, sociotechnical-critical, and linguistic-epistemic-and translates them into three interacting pedagogical layers: instructional, cognitive-clinical, and sociotechnical-relational. Linguistic mediation operates across the model to make reasoning visible, shareable, and assessable.
Conclusion:
Pediatric nursing clinical reasoning is reframed as situated, developmentally informed, family-centered, and communicatively accountable judgment rather than as individual problem solving alone.
Implications For Practice:
The model offers educators a course-level architecture for sequencing authentic cases, focused conceptual scaffolding, structured dialogue, reasoning with evolving information, and assessment tasks that require students to interpret, prioritize, justify, and communicate decisions. It provides a testable basis for faculty development, curricular implementation, and evaluation across comparable undergraduate pediatric nursing settings.
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