A conceptual framework to facilitate clinical judgement in nursing: A methodological perspective

Abstract

The South African health care and education systems are challenged to provide independent, critical thinking nurses who can cope with diversity in a creative way and define their role in a complex, uncertain, rapidly changing health care environment. Quality clinical judgement is an imperative characteristic that newly qualified professional nurses should possess. To accommodate these needs, SANC in line with the SAQA Act, advocated the development of teaching and learning strategies to balance theory and practice opportunities together with an outcome-based, studentcentred approach and appropriate clinical supervision. This resulted in a positive outcome to facilitate the integration/fusion of theory and practice. The purpose of this study was to synthesise a teachingelearning strategy for creating an enabling learning environment to facilitate clinical judgement in South African undergraduate nursing students. The proposed teachingelearning strategy is grounded in modern-day constructivist approach of learning. The conceptual or theoretical framework of this study aimed to link the central concepts that were identified from the conclusions of four (4) strategic objectives of the two preceding phases of the study into a new structure of meaning that served as a basis for the proposed strategy. The implementation of the proposed action plan to achieve the stated strategic objectives should empower the relevant role players to facilitate clinical judgement in undergraduate nursing students and thereby promote autonomous and accountable nursing care.

Perceptions of senior nursing students regarding clinical decision-making

“…The results of the present study support the idea that theoretical knowledge, complemented by clinical knowledge, contributes to substantiated, personalized, and responsible decision-making, guided by a reflective attitude on and about actions, supported by dialogue that facilitates personal and professional growth, aspects that were stressed by Graan and Williams (41) and Mahmoud and Mohamed (34) . Consequently, the results suggested that students can make clinical judgments by applying a complex process and using domains of knowledge and the decision-making process (6) .…”

Newly qualified midwives’ perceptions of their level of midwifery clinical competence during community service in KwaZulu-Natal, South Africa

“…In lower-middle-income countries (LMICs), including South Africa, the midwife’s workload demands are increased by the fluid healthcare system (Baloyi & Mtshali 2018 ). Furthermore, the healthcare systems in LMIC are characterised by complicated and complex maternity cases, the high risk profile of pregnant women, and MMR’s high burden (Baloyi & Mtshali 2018 ; Van Graan & Williams 2017 ; WHO 2019 ). The complexity of the maternity cases in LMICs requires higher-order thinking skills, facilitating an ability to think critically and problem-solving by applying clinical reasoning skills, thereby enabling informed clinical decisions (Baloyi & Mtshali 2018 ; Levett-Jones et al 2012; Van Graan & Williams 2017 ).…”

“…Furthermore, the healthcare systems in LMIC are characterised by complicated and complex maternity cases, the high risk profile of pregnant women, and MMR’s high burden (Baloyi & Mtshali 2018 ; Van Graan & Williams 2017 ; WHO 2019 ). The complexity of the maternity cases in LMICs requires higher-order thinking skills, facilitating an ability to think critically and problem-solving by applying clinical reasoning skills, thereby enabling informed clinical decisions (Baloyi & Mtshali 2018 ; Levett-Jones et al 2012; Van Graan & Williams 2017 ). Newly qualified midwives who are job-ready need to demonstrate capability in providing evidence-based care, practice independently and be accountable for their actions (Netshisaulu & Maputle 2018 ).…”

Patient Perceptions on Primary Health Care (PHC) Nurses and Its Impact on Services Delivery at County Level, Machakos, Kenya

“…To achieve effectively the nursing role, they have to combine theoretical knowledge, skills, values, beliefs and attitudes which form the foundation upon which nursing art is based on [18]. According to clients in the FGDs, the right nursing care practice is synonymous to the quality of care and quality of care is derived from quality of the theory learned, practical experience and mentorship which enhance professional competence [19]. The combination of theory and practice has an important role in the education of nursing students and influence the quality of care, competence and professional practice.…”