Date of Conferral

1-1-2021

Degree

Ph.D.

School

Nursing

Advisor

Janice Long

Abstract

Clinical reasoning is the basis for every clinical decision a nurse makes; however, only 23% of newly graduated nurses are safely able to recognize urgent clinical patient problems and demonstrate appropriate management of those problems. Furthermore, new nurses make 50% of medical errors. This leaves nurse educators looking for evidenced-based teaching/learning strategies to help their students develop clinical reasoning skills. The purpose of this study was to investigate the influence of questioning as a problem-based teaching/learning strategy on clinical reasoning in undergraduate nursing students. The theoretical framework used to guide this study was Tanner’s clinical judgment model. Using Lasater’s clinical judgment rubric, a quantitative comparative ex post facto design was used to examine the difference in students’ levels of clinical reasoning before and after undergoing a simulation intervention with questioning. The sample (N = 35) for this retrospective data consisted of undergraduate nursing students’ responses obtained by course faculty between 2017 and 2019 from a small community college in the southeastern United States. Results of the paired t test analysis indicated a significant difference (p < 0.05) in clinical judgement in the pre (M = 26.57, SD = 3.432) and post (M = 31.00, SD = 3.106) intervention scores indicating an increase in clinical reasoning. Results may promote positive social change as nurse educators incorporate questioning as a strategy used after clinical simulation to aid in clinical reasoning and judgement development for students. Future studies might include randomization with a larger sample controlling for student demographics or previous degree status.

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