The ‘five rights’ of clinical reasoning: An educational model to enhance nursing students’ ability to identify and manage clinically ‘at risk’ patients

Levett‐Jones, Tracy; Hoffman, Kerry; Dempsey, Jennifer; Jeong, Sarah Yeun‐Sim; Noble, Danielle; Norton, Carol; Roche, Janiece; Hickey, Noelene

doi:10.1016/j.nedt.2009.10.020

Cited by 345 publications

(316 citation statements)

References 32 publications

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“…In healthcare professional competence has been defined by Epstein and Hundert (2002) as a common, sound judgment and a skillful way to communicate. It presupposes knowledge in the field (Epstein & Hundert, 2002;Holm, 2003Holm, , 2009, moral development (Epstein & Hundert, 2002;Holm 2003Holm , 2009), empathy and affective sensitivity (Holm, 2003(Holm, , 2009Levett-Jones et al, 2010) practical skills, and ability of clinical reasoning (Epstein & Hundert, 2002;Levett-Jones et al, 2010;Tanner, 2006). All health care professionals should comprise a competence to work in interprofessional teams (Barr, Koppel, Reeves, Hammerick & Freeth, 2005;Wilhelmsson et al, 2012).…”

Section: Theoretical Frameworkmentioning

confidence: 99%

“…All health care professionals should comprise a competence to work in interprofessional teams (Barr, Koppel, Reeves, Hammerick & Freeth, 2005;Wilhelmsson et al, 2012). Levett-Jones et al (2010) also emphasize the professionals' ability of, and competence in, complex thinking and reflection from a meta-cognitive perspective. Competence can also be viewed as a desired outcome in education, something that can be assessed and evaluated.…”

Section: Theoretical Frameworkmentioning

confidence: 99%

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Becoming a Specialist Nurse in Psychiatric Mental Health Care

Södergren¹,

Benjaminsson

Mattsson

2016

IJHE

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BackgroundSpecialist nurse students are upon graduation certified to have increased their professional competence to an advanced level. But how do specialist nurse students themselves experience and understand their professional competence and its development upon graduation? This is what this study aims at describing. MethodThis study has a phenomenographic approach. Data consists of student written narratives. ResultsThe participants understood their professional competence developed in various degrees as a transformation in me and a transition in my encounter with the patient. Being able to integrate theory in practice was crucial for this competence to develop. ConclusionThe specialist programme needs to support students in developing an alliance with the patient and promote patients' self-management, self-efficacy and promote students' possibility to integrate theoretical knowledge into practice. The result becomes an important input in the formulation of the assessment criteria for professional competence.

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Section: Theoretical Frameworkmentioning

confidence: 99%

Section: Theoretical Frameworkmentioning

confidence: 99%

Becoming a Specialist Nurse in Psychiatric Mental Health Care

Södergren¹,

Benjaminsson

Mattsson

2016

IJHE

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“…The concept of remote simulation as a teaching strategy in nursing education, while not an entirely new concept, has experienced renewed interest in relation to its ability to improve clinical reasoning skills in student cohorts [17][18][19]. The interest may relate to the advent of high fidelity patient simulators (HFPS) which can interact with the learner to represent changes in physiological parameters consistent with learner intervention.…”

Section: B Nursing and Ralmentioning

confidence: 99%

“…The standout concept stemming from all of the literature on remote robotics in health care [25,28,29] is that the technology has great potential in improving the clinical reasoning skills of health-care professionals allowing the clinician to practice a task and skill in a risk free environment, developing confidence and building competence [17,30,31].…”

Section: B Nursing and Ralmentioning

confidence: 99%

Enhancing Nursing Education with Remote Access Laboratories

Bowtell¹,

Moloney²,

Kist³

et al. 2012

Int. J. Onl. Eng.

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Abstract-Given the vast coverage area and dispersed population centres in which nursing professionals practice in Australia, Remote Access Laboratory (RAL) based learning activities would seem to be an ideal match. However while they are commonplace in engineering faculties; in other disciplines such activities are not widely used. This may well be due to the intricacies of these practicals not being as straightforward and readily reproducible as typical physics or science experiments.In our chosen case, the safe practice of intravenous pump driver operations and related clinical reasoning skills are important components for the training of both registered nurses and nursing students. The aim of this research project is to develop and trial remote access technologies that enable nursing students to test their knowledge, skills, and clinical reasoning with intravenous infusion pump drivers. This has been possible by extending the concept of RAL from a physical and tangible experiment, to more conceptual experimentation in any form conducted remotely. In such a context clinical reasoning becomes possible. This paper discusses a prototype system that has been built with collaborative input from the Faculty of Engineering and Surveying and the Department of Nursing and Midwifery. An initial evaluation with a group of nursing students has been completed to assess if such activities can assist with the training of student nurses. Previous work has identified the need to scaffold learning activities that rely on RAL technology; the key conclusion in this paper is that in the context of nursing this has to be taken a step further. RAL activities here require contextualisation to become an effective learning tool.

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“…A gap in clinical reasoning because of inadequate training during initial education can lead to the risk of errors and consequently affects the quality and safety of the care provided to patients. [2,3] In this context, it is therefore necessary to reassess the quality of the pedagogical support provided and to adapt, among other elements, educational activities by bridging the gap between education and practice with regard to clinical reasoning in nursing. [1] Clinical reasoning, a competency at the heart of nursing practice, is characterised by recursive metacognitive and cognitive processes mobilised by nurses.…”

Section: Introductionmentioning

confidence: 99%

Addressing the development of both knowledge and clinical reasoning in nursing through the perspective of script concordance: An integrative literature review

Deschênes

Goudreau

2017

JNEP

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Background: In clinical practice settings, where situations of uncertainty exist, clinical reasoning is situated or contextualized. It calls upon honed knowledge, wherein nurses rely on highly-developed and organized knowledge networks known as "mental scripts". Methods: The aim of this integrative literature review was to address ways to develop knowledge and clinical reasoning in nursing through the use of mental scripts, and to tackle these pedagogical considerations. The literature search was performed using the following data sources: CINHAL, MEDLINE Google Scholar, PubMed, ProQuest, PsycINFO, Scopus and Web of Science. Results: Script concordance, which optimises situated clinical reasoning, ties in with the socio-cognitive perspective of cognitive apprenticeship, using role models to guide the development of knowledge and clinical reasoning in nursing. Moreover, this perspective proposes implementing new teaching strategies, which focus on situational awareness, reflective acuity, and cognitive dialogue. Conclusions: The perspective of script concordance allows a foreseeable innovative formulation of practices favourable to the development of clinical reasoning in nursing.

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The ‘five rights’ of clinical reasoning: An educational model to enhance nursing students’ ability to identify and manage clinically ‘at risk’ patients

Cited by 345 publications

References 32 publications

Becoming a Specialist Nurse in Psychiatric Mental Health Care

Becoming a Specialist Nurse in Psychiatric Mental Health Care

Enhancing Nursing Education with Remote Access Laboratories

Addressing the development of both knowledge and clinical reasoning in nursing through the perspective of script concordance: An integrative literature review

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