2.50
Hdl Handle:
http://hdl.handle.net/10755/157795
Type:
Presentation
Title:
A Tool to Enhance Clinical Thinking
Abstract:
A Tool to Enhance Clinical Thinking
Conference Sponsor:Western Institute of Nursing
Conference Year:2009
Author:Marquette, Lois, MS, RN
P.I. Institution Name:Idaho State University, School of Nursing
Title:Clinical Assistant Professor
Contact Address:921 South 8th Ave, Stop 8101, Pocatello, ID, 83209, USA
Contact Telephone:208-282-5994
Co-Authors:Deana Molinari, PhD, RN, CNE, Associate Professor; Kathy Olsen, PhD, RN, Assistant Professor
Purpose: Medical/surgical students learn to apply critical thinking skills to clinical challenges. This paper will present an analysis of medical/surgical students using the PAC model and present the history and use of a clinical thinking tool meant to structure student clinical decision making. Rationale: Students need to develop a framework for making clinical judgment. Students were taught to think using a tool which focuses on gathering information. Faculty use the tool to help students process the information for clinical decisions. Faculty developed the tool to enhance student information gathering and processing for hypothesis making and testing. The tool promotes clinical decision justification. Methods: As part of a baseline analysis for a long term study of critical thinking, a qualitative descriptive study of 74 student responses to a case study before and after a medical/surgical course was conducted. No intervention about critical thinking was provided to this class. Comparison with other class results was also conducted. The faculty worked to increase clinical reasoning by developing and improving a tool to guide the types of information students gathered and processed. Dr Bobbi Branch, a critical thinking researcher, proposed the structural aid based on concept mapping Beitz, J. (1998) and evolving into a clinical organizing framework. The tool covers aspects of holistic care: pathophysiology, medical history, signs and symptoms, diagnostic tests with significance, interventions, medications, Gordon's health assessment criteria, patient education needs, nursing diagnoses, interventions, and rationales. The tool requires an analysis of outcomes: evaluation of individual interventions and diagnosis outcomes. The final part of the tool calls for self-reflection. The tool structures data collection, clustering, synthesis, and analysis. Students use colors to link concepts and synthesize material. Faculty examines student papers at the end of each term. Results: The clinical reasoning tool was used by 350 students over five years and with about 35 nursing faculty. Students report initially disliking the amount of weekly work required. Several students have reported after graduation the most effective method of learning clinical reasoning was the clinical thinking tool. Faculty found the tool provides data for early teacher intervention. The course focuses on psychosocial issues, feelings and holistic linking data into meanings, interventions, and evaluations. Analysis of student thinking using the PAC model uncovered only one significant difference between pre/post-testing: Reflection (t=2.807, p=0.006). Conclusions: Juniors demonstrate introspection and reflection. They question their competence and their knowledge. Learning clinical thinking takes time and effort. Explicitly teaching information gathering and processing skills before clinical courses begin and providing structured clinical thinking tools may aid novices frame the skills needed for patient care.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleA Tool to Enhance Clinical Thinkingen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157795-
dc.description.abstract<table><tr><td colspan="2" class="item-title">A Tool to Enhance Clinical Thinking</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Marquette, Lois, MS, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Idaho State University, School of Nursing</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Clinical Assistant Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">921 South 8th Ave, Stop 8101, Pocatello, ID, 83209, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">208-282-5994</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">marqlois@isu.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Deana Molinari, PhD, RN, CNE, Associate Professor; Kathy Olsen, PhD, RN, Assistant Professor</td></tr><tr><td colspan="2" class="item-abstract">Purpose: Medical/surgical students learn to apply critical thinking skills to clinical challenges. This paper will present an analysis of medical/surgical students using the PAC model and present the history and use of a clinical thinking tool meant to structure student clinical decision making. Rationale: Students need to develop a framework for making clinical judgment. Students were taught to think using a tool which focuses on gathering information. Faculty use the tool to help students process the information for clinical decisions. Faculty developed the tool to enhance student information gathering and processing for hypothesis making and testing. The tool promotes clinical decision justification. Methods: As part of a baseline analysis for a long term study of critical thinking, a qualitative descriptive study of 74 student responses to a case study before and after a medical/surgical course was conducted. No intervention about critical thinking was provided to this class. Comparison with other class results was also conducted. The faculty worked to increase clinical reasoning by developing and improving a tool to guide the types of information students gathered and processed. Dr Bobbi Branch, a critical thinking researcher, proposed the structural aid based on concept mapping Beitz, J. (1998) and evolving into a clinical organizing framework. The tool covers aspects of holistic care: pathophysiology, medical history, signs and symptoms, diagnostic tests with significance, interventions, medications, Gordon's health assessment criteria, patient education needs, nursing diagnoses, interventions, and rationales. The tool requires an analysis of outcomes: evaluation of individual interventions and diagnosis outcomes. The final part of the tool calls for self-reflection. The tool structures data collection, clustering, synthesis, and analysis. Students use colors to link concepts and synthesize material. Faculty examines student papers at the end of each term. Results: The clinical reasoning tool was used by 350 students over five years and with about 35 nursing faculty. Students report initially disliking the amount of weekly work required. Several students have reported after graduation the most effective method of learning clinical reasoning was the clinical thinking tool. Faculty found the tool provides data for early teacher intervention. The course focuses on psychosocial issues, feelings and holistic linking data into meanings, interventions, and evaluations. Analysis of student thinking using the PAC model uncovered only one significant difference between pre/post-testing: Reflection (t=2.807, p=0.006). Conclusions: Juniors demonstrate introspection and reflection. They question their competence and their knowledge. Learning clinical thinking takes time and effort. Explicitly teaching information gathering and processing skills before clinical courses begin and providing structured clinical thinking tools may aid novices frame the skills needed for patient care.</td></tr></table>en_GB
dc.date.available2011-10-26T20:12:43Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:12:43Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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