Gaining Insight into Student Nurses’ Clinical Decisionmaking Process

Abstract

The purpose of this study was to gain a clearer understanding of the clinical decision-making process of generic baccalaureate student nurses during patient care. A descriptive qualitative design, using semi-structured open-ended questions, was employed to obtain information about the choices culturally diverse student nurses made in the care of adult patients in a variety of clinical settings. Connectedness, knowing, heroism, anxiety and frustration were the emerging themes. The findings indicate that students used mutual goal setting throughout the decision-making process. The author applied Imogene King’s theory of goal attainment to interpret the findings of the study and to link theory to practice. Clinical decision-making is an important topic in nursing education and practice. Faculty understanding of thought processes precedes the design of specific strategies to enhance clinical reasoning. Helping students to advance from reliance on memorization of textbook information to the application of concepts from the liberal arts and from biological and nursing science is part of that process. This is a special challenge for nursing faculty and staff educators who teach nursing students and new graduates from diverse experiential and educational backgrounds. Numerous clinical decision-making studies offer conflicting and inconclusive findings concerning predictive outcomes and related factors. This investigator chose to study the decision-making phenomenon from a holistic point of view, using a qualitative methodology. As opposed to focusing solely on the outcome of clinical choices, the aim of the study was to gain a clearer understanding of the ways in which student nurses make clinical decisions