The Outcome-Present State Test (OPT) Model of Clinical Reasoning is a nursing process model designed to help students develop clinical reasoning skills. Although many nurse educators are using the OPT model as a teaching strategy, few are formally evaluating its use as a method. We used the OPT model as a teaching tool in an undergraduate psychiatric and mental health clinical nursing course and evaluated how quickly students became adept at using it. Most students mastered the use of the model; 29 of 43 students achieved the criterion score (a score greater than 65 on 3 or more models completed over 4 weeks). Not only did the students gain clinical reasoning skills, but they also used and learned more about the North American Nursing Diagnosis Association, Nursing Interventions Classification, and Nursing Outcomes Classification languages. Recommendations for future use of the model include adding client strengths and increasing focus on the quality of students' responses.

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Relationship skills building is the focus of an innovative clinical experience with older adults for junior level nursing students in a psychiatric mental health course. The clinical experience is designed to help students apply, integrate, and validate previously learned therapeutic communication skills and experience discovery of self and others. This article describes a clinical experience that introduces students to older adults, who will make up the majority of health care recipients in the students' future careers, and helps students explore the nurse's role in mental health care for older adults. Not only did students engaged in the clinical experience learn to develop a relationship with the older adults, but they learned much more--they learned to appreciate the value of life, the importance of listening, and the rich and varied life stories of older adults.

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