Student's Decision Making Using an Educational Model Focused on Patient Safety

Abstract

Session presented on: Wednesday, July 24, 2013: Purpose: To describe the theoretical framework of the Developing Nurses' Thinking (DNT) model and discuss its use to facilitate clinical decision making in pre licensure and RN to BS nursing students. Methods: The DNT model was initially tested with 83 students from two schools in a two-group pre and posttest quasi-experimental study. Clinical groups in the first clinical course were randomly assigned to control and intervention groups. Students in the intervention group used the DNT model during post conference and students in the control group attended traditional post conferences over a two week period. Statistical analyses included independent t test, paired t test, and general linear regression modeling to determine changes in diagnostic accuracy. Subsequent testing of the model included an evaluation study of two online clinical decision making courses with registered nurses in which the DNT model was taught and used throughout the course. Diagnostic accuracy and student perceptions were explored regarding effects of teaching strategies on the student's thinking habits. Results: The intervention group realized statistically significant improvement in accuracy posttest scores compared to those in the control group. While there was statistical improvement in diagnostic accuracy in the intervention group, students in one school had greater improvements in diagnostic accuracy than the other. A follow up evaluation study revealed some improvement in diagnostic accuracy scores however it was not statistically significant. Most students who responded to the survey (n =63) identified use of the DNT model as an effective framework to analyze patient conditions, plan care, and consider patient safety. All student responses reflected the importance of patient safety and diagnostic reasoning and felt that their diagnostic reasoning had improved by the end of the class. Conclusion: Students liked using the DNT model to structure their thinking and its use may help nursing students to develop effective thinking habits in the context of patient safety.