Development of a support program to improve clinical reasoning of nurses with 2-3 years of work experience

Abstract

Objective: Herein, we aimed to develop and evaluate a program to improve clinical reasoning among competent-level nurses (i.e., nurses with 2-3 years of work experience). The primary hypothesis of the study is as follows: "Upon completing the program, competent-level nurses can understand the patient from multiple perspectives, resulting in the best nursing care for the patient." Methods: A quasiexperimental design was employed. The program incorporated the attributes and consequences of a conceptual analysis of clinical reasoning into an experiential learning model and consisted of a prior learning module and two training sessions. The Problem-Solving Client Support Behavior Self-Rating Scale for Nurses (9 subscales, 45 items) and the Mann-Whitney U test were used to evaluate the effectiveness of the intervention and between-group comparisons, respectively. Results: Data from 57 participants were analyzed. The intervention group showed improved scores for the subscales "determine the priority of solving problems and respond flexibly to the requests of clients" (U = 241.5, p = .012), "persuade and convince clients to accept help that they initially refuse" (U = 226.0, p = .006), "customize assistance depending on the particular situation" (U = 214.5, p = .003), and "assess the effectiveness of assistance and provide support" (U = 221.0, p = .004). Conclusions: This program improved the ability of competent-level nurses to use multiple reasoning patterns to gain a rich, multifaceted understanding of patients and make decisions about the optimal care for patients based on that understanding.