Assessment of Clinical Reasoning

ASSESSMENT OF CLINICAL
REASONING AMONG B.SC

NURSING STUDENTS
PROF. LATHA DAMODARAN
INTRODUCTION
Todays nurses are facing very complex and challenging clinical
situations in an uncertain environment due to
- changing healthcare settings
- higher patient acuity levels
- shortage of nurses belonging to all categories
- increased use of technology
INTRODUCTION- CONTD
- greater emphasis on cost containment,
and
- emergence of new illnesses.
As a result, nurses must be able to quickly analyze clinical
situations and make best decisions in time to ensure high
quality patient care.
NEED AND SIGNIFICANCE

Clinical reasoning is an expected part of competent
nursing practice.
Nurses with effective clinical reasoning skills have a
positive impact on patient outcomes. Conversely, those
with poor clinical reasoning skills often fail to detect
impending patient deterioration resulting in a failureto-rescue

The top three reasons for adverse patient outcomes
are:
failure to properly diagnose,
failure to institute appropriate treatment, and
inappropriate management of complications.
Each of these is related to poor clinical reasoning
skills.
Education must begin at the undergraduate level to

promote recognition and management of the deteriorating
patient, the use of escalation systems and effective
communication (bright, walker, and bion, 2004).

Contemporary learning and teaching approaches do not
always facilitate the development of a requisite level of
clinical reasoning skills. While universities are committed to
the education of nurses who are adequately prepared to
work in complex and challenging clinical environments,
health services frequently complain that graduates are not
work ready.
CLINICAL REASONING
The process by which nurses (and other clinicians) collect
cues, process the information, come to an understanding
of a patient problem or situation, plan and implement
interventions, evaluate outcomes, and reflect on and learn
from the process. Levett-jones, T
CLINICAL REASONING
Clinical reasoning is central to clinical Practice. Health
professionals often need to make decisions based on their
professional knowledge and judgment in situations
where there are no right answers, and where textbook
and research knowledge is insufficient or needs to be
adapted to the particular client.
Hence assessment of clinical reasoning is very important

so that measures can be taken to promote clinical
reasoning ability of nursing students.
OBJECTIVES
1. Assess the clinical reasoning skills among B.Sc.Nursing
students.
2. Find out the association between clinical reasoning
skills and selected variables.
MATERIALS AND METHODS

Design: Descriptive survey design
Setting: Sivagiri Sree Narayana Medical Mission College
of Nursing, Varkala

Study population: IV year B.Sc nursing students
Sampling strategy: Convenience sampling
Sample size: 60

Instrument: Script Concordance Test. It is based on
script theory.
DATA COLLECTION
Formal permission from Principal of the college and
informed consent from students were obtained. Sociopersonal data was collected, followed by the
administration of script concordance test to assess the
clinical reasoning skills.
ANALYSIS
The data were analysed and presented in the form of
frequency, percentage and mean
FINDINGS
All the students were in the age group of 19-20 years.
Only 6.67% of the students were boys.
Majority (86.67%) of the students had cleared the
previous years university examination.
FINDINGS
The mean scores obtained for clinical reasoning was 24.58.
None of the students were having good clinical reasoning
skill.
Students having moderate and poor clinical reasoning were
53.33% and 46.67% respectively.
No significant association was found between clinical
reasoning and variables such as gender and previous years
academic performance
CONCLUSION
The findings of the study are shocking

and it is high time to take initiatives to
promote clinical reasoning skills of
nursing students

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ASSESSMENT OF CLINICAL

REASONING AMONG B.SC

NEED AND SIGNIFICANCE

NEED AND SIGNIFICANCE

NEED AND SIGNIFICANCE

Education must begin at the undergraduate level to

NEED AND SIGNIFICANCE

Hence assessment of clinical reasoning is very important

MATERIALS AND METHODS

MATERIALS AND METHODS

MATERIALS AND METHODS

The findings of the study are shocking

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