Learning Support for Clinical Judgment Processes Using a “Think-Aloud” Method in Nursing Practice

Abstract

Purpose: This study aims to determine whether clinical coaches can contribute to improving clinical judgment skills of learners when providing learning support in the clinical judgment process while communicating what the clinical coaches are thinking in nursing practices using a "think-aloud method."

Methods: Participants (learners) were 16 nurses with 2–3 years of clinical nursing experience who were provided learning support with the "think-aloud" method by clinical coaches during one-year on-the-job training. The learners assessed their clinical judgment skills before and after the one-year learning support, using a clinical judgement skill assessment scale developed by the researcher based on Tanners Clinical Judgement Model (2006). Scores of clinical judgement skills before and after the one-year learning support were compared using the Wilcoxon signed-rank test.

Results: Scores in clinical judgement skills were 118.0 before the learning support and 120.5 one year later, showing improvements after the support. Of the aspects of clinical judgement skills, there was a significant improvement in "Interpreting" with a score of 23.0 before and 23.5 one year later. There were also improvements in the other aspects, but no statistically significant differences (p<.05). Learners stated that learning some parts of thinking processes from expert nurses enables understanding of key points.

Conclusions: The findings suggest that learning support where clinical coaches verbalize their thinking process may enable learners to understand cognitive thinking processes to conduct meaning-making and interpret information, and so contribute to improving the clinical judgment skills of learners.