Aim: The aim of this analysis is to clarify the concept of clinical reasoning in nursing students.Background: Sound clinical reasoning is the most important skill required in professional nursing and understanding of this concept is emphasized as a basis for clinical reasoning development in nursing education curricula.Design: Rodgers' concept analysis method was used to achieve a clear and understandable definition.Data Source: Resources published from 2000 to 2020 were identified via electronic databases.Review Methods: A review of the literature was completed, and the data were analyzed to identify the Surrogate and related terms, attributes, antecedents and consequences of the concept.Results: This concept is a holistic and recursive cognitive process that has a dynamic and flexible nature to perceive the patient's condition, select the best practice to respond to the situation, and learn from the situation. Clinical reasoning in nursing students emerges despite professional standards; discipline-specific knowledge, cognitive perception, critical thinking, learning experiences, and intuitive ability, and the requirements of the professional system affect its establishment in the nursing discipline. Clinical reasoning is the cognitive process underlying clinical judgment, appropriate decision making, improvement of nursing quality, metacognitive awareness, and professional competence in nursing, whose achievement, generally, paves the way for nursing professionalization and development that are important steps toward independence in the nursing profession. Conclusions:The present concept analysis clarifies the concept of clinical reasoning as a complex thinking process that should be considered as a fundamental thinking skill in nursing program.

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Introduction Clinical reasoning (CR) is the most important competency for safe and quality care delivery in coronary care unit (CCU). Nonetheless, evidence shows that nurses in CCU do not have the necessary CR skills to manage challenging situations and provide quality care in these units. Identifying the possible strategies for CR skill improvement is a key step in improving nurses' CR skills. Aim The aim of the study was to explore and prioritize strategies for CR skill improvement among nurses in CCU. Design A qualitative design was used. Methods This qualitative study was conducted in 2020 in the CCU of a subspecialty heart hospital. Participants were nurses, head nurses, nursing supervisors, nursing manager, clinical nursing instructors, and cardiologists. Initially, necessary data to identify strategies for CR skill improvement were collected through semistructured interviews with 16 participants and were analyzed through conventional content analysis. Then, the determined strategies were prioritized through quantitative scoring by 24 participants in three focus group discussions. The Suitability, Feasibility, and Flexibility matrix was used for scoring. Results The main three strategies of CR skill improvement were improvement of the efficiency of nursing education, effective management in nursing, and development of professional nursing. The mean scores of these categories in the possible range of 3–9 were 8.20, 8.04, and 7.83, respectively. Conclusion This study provides a firm scientific basis for strategies to improve CR skills among nurses in CCU. Strategies determined in the present study can be used to develop interventions to improve nurses' CR skills and promote strength‐based nursing.

Introduction: Determining the research priorities in Evidence-Based Nursing Care is considered as a regular method to provide substantive information for developing the nursing science and taking evidence-based practical steps but such research is currently minimal. Therefore, a Delphi survey was conducted to determine the research priorities in Evidence-Based Nursing Care in the North of Iran. Methods: A three-round Delphi study was conducted to identify research priorities in Evidence-Based Nursing Care. The study comprised of research nurses, who have attended a Research Methodology course and did have published research. A Delphi expert panel consists of a group of credible experts within the field attending in consensus meetings to determine the nursing research top priorities. Open-ended questions were analyzed using thematic content analysis. Analysis of questionnaires 2 and 3 entailed an examination of the mean scores for each priority ranked on the five-point Likert scale. Results: Round 1 had 42 themes across 174 topics, identified by analyzing the data. In Round 2, respondents ranked all themes and 30 themes were selected. Finally, in Round 3, the top five research priorities emerged as the following: Assurance in health care, nurse-patient communication, pain management, taking care of the patients under mechanical ventilation and drug care. Conclusions: Determining research priorities in the Evidence-Based Nursing Care would optimize the level of utilization of the results of the studies by nurses and subsequently could improve the delivery of evidence-based nursing services; Prioritization will also help in directing resources to the essential research needs.

Background: Clinical Reasoning (CR) is a main professional competency for nurses which have significant contribution to sound clinical performance in critical clinical conditions. Nonetheless, evidence shows that nurses do not have the necessary competencies and thinking skills for managing complex conditions in critical care units. This study aimed at exploring the barriers to the development of CR skills among coronary care nurses. Materials and Methods: Using conventional content analysis, this qualitative study was conducted in 2020 in the Coronary Care Unit (CCU) of Heshmat Subspecialty Heart Center in Rasht, Iran. Participants were 15 nurses, head nurses, nursing supervisors, nursing managers, and nursing instructors. Data were collected using semi-structured interviews and were analyzed using conventional content analysis. Results: The four main categories of the barriers to CR skill development among nurses were limited professional development, inefficient educational program, ineffective professional interactions, and limited professional self-efficacy. Conclusion: There are different personal, educational, professional, and interprofessional barriers to the development of CR skills among CCU nurses. Study findings can be used to develop effective strategies for supporting and developing nurses' CR skills.