Author

Robin Weaver

Defense Date

6-30-2014

Graduation Date

2014

Availability

Immediate Access

Submission Type

dissertation

Degree Name

PhD

Department

Nursing

School

School of Nursing

Committee Chair

Lynn Simko

Committee Member

Bonnie Dean

Committee Member

Bette Mariani

Keywords

Clinical Judgment, Clinical Reasoning, debriefing, Nursing, Nursing Education, simulation

Abstract

The necessity of appropriate clinical reasoning and clinical judgment skills is recognized as essential for the development of a competent practitioner. In response to the Institute of Medicine (IOM) report which called for a re-evaluation of the educational processes used to prepare practitioners, nursing educators have embraced the use of simulation technology as an innovative approach to enhance student learning. Simulation has been recognized as a vehicle to support student development of knowledge, skills, and attitudes necessary to become a competent practitioner. Recognized in the literature as the most essential element of simulation, debriefing practices vary throughout nursing education. Recently an increasing presence, yet still minimal amount of evidenced-based literature, is available to guide debriefing practice. This quasi-experimental pretest, post-test design study with subsequent open-ended follow-up questions analyzed the impact a specific structured debriefing approach had on student development of clinical reasoning and clinical judgment skills. The theoretical underpinnings of this study include Kolb's Experiential Learning Theory, as well as, Gibb's reflective cycle. The structured debriefing method utilized for this study was Dreifuerst's (2009) Debriefing for Meaningful Learning© (DML). The study was conducted with (N=93) participants enrolled in a medical-surgical nursing course within their junior year in a northeastern Pennsylvania Baccalaureate nursing program. Changes in clinical reasoning and clinical judgment were measured based upon scores achieve on the Health Sciences Reasoning Test© (HSRT) and the California Critical Thinking Disposition Inventory © (CCTDI) test. In addition, four supplemental questions were posed to students within the experimental group to obtain feedback regarding their perception of the DML© method.

The intent of the study was to determine if an improvement in critical thinking, clinical reasoning, and clinical judgment skills would result if students were exposed to the DML© method for debriefing. The data did not reveal statistically significant findings when comparing the mean overall scores of the experimental and control groups as indicated by the HSRT ©and CCTDI© mean scores. However, responses to the open-ended follow-up questions indicated a perceived improved quality of learning experience resultant from the utilization of the DML© method.

Format

PDF

Language

English

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