“Learning a Way of Thinking”—World Café on Clinical Reasoning in Nursing and Midwifery Education and Practice across Five European Union Countries

Abstract

Clinical reasoning is a key attribute of nursing and midwifery professionals. As a part of the Erasmus plus project, we designed a study with the aim of exploring the understanding of clinical reasoning as a concept, experiences of teaching clinical reasoning and practices related to using clinical reasoning in nursing and midwifery. A qualitative study was carried out using the World Café method, involving 44 participants from five European countries. The participants represented diverse professional backgrounds, including nurses, midwives and lecturers. Our analytical approach was based on a thematic analysis. We categorized the data into three main categories, namely, “Spiral of thinking”, “The learning and teaching of a way of thinking” and “Clinical reasoning in real life”, all under an overarching theme, “Learning a way of thinking”. This study highlighted areas of learning and teaching which can be improved in current nursing and midwifery education. Furthermore, it identified barriers, facilitators and practices from five European countries which can be used in the further development of nursing and midwifery curricula and courses with the aim of enhancing clinical reasoning competence and ultimately improving patient care.

Teaching and Learning Clinical Reasoning in Nursing Education: A Student Training Course

“…Using the World Café method in the second phase of the STC made it possible to share ideas, explore different perspectives, reflect on concepts and structure, and engage in structured learning [ 4 , 32 ]. The students’ perspectives on clinical reasoning align with the concepts of clinical reasoning described in the literature.…”

“…The choice and combination of teaching methods enhance the development of fundamental clinical reasoning for decisionmaking, self-efficacy, and teamwork [35,36]. Clinical reasoning supports the development of nurses' skills and promotes formal reasoning to 'think like a nurse' [4,[14][15][16]. Considering the aspects mentioned in the literature that can influence the learning of clinical reasoning by nursing and midwifery students [7,8,20,27,28], learning strategies based on reflection that increase problem-solving skills and self-efficacy in learning must be adopted systematically and consistently throughout nurses' training [8,10,35].…”

“…In the second step, we introduced the World Café methodology to encourage reflection on the concept and application of clinical reasoning. The World Café methodology allows a structured learning and knowledge process and can also be used for exploratory qualitative research [ 4 , 32 ].…”

“…Clinical reasoning is essential to nursing competence as it promotes critical, creative, scientific, and formal reasoning to 'think like a nurse' [4,[14][15][16]. In this sense, nursing and midwifery schools should invest in curricula that focus on developing clinical reasoning to prepare students for the nursing care process of acquiring clinical reasoning [11,12,17,18].…”

“…Clinical reasoning is still a developing concept in nursing and midwifery. Recent studies have highlighted an existing challenge of not only understanding clinical reasoning as a concept but also teaching, assessing, and using it in clinical practice [ 1 , 2 , 3 , 4 ]. Furthermore, there is a general lack of literature and research evidence on clinical reasoning in the European Union context—such as understanding the clinical reasoning proficiency of recently graduated students in the European Union (education is harmonized in EU member states by directives)—and on teaching strategies employed within the EU.…”