The Effect of Case-Based Education on the Development of Nursing Students' Clinical Reasoning Skills

NCT05504824 | Completed

• 1 other identifier: AU-OBIRGE-001
• Study Type: interventional
• Target: 22
• Locations: 1 country
• Sites: 1

Brief Summary

Aim: This study was conducted to determine the effect of case-based education on the development of clinical reasoning skills of nursing students in critical illnesses. Methods: The study was conducted between January 20 and June 30, 2021 using a pilot randomized controlled trial design. In the study, 22 volunteer students were assigned to the experimental and control groups by simple randomization. The experimental group was given case-based education to improve their clinical reasoning skills, and the control group continued the standard education process. Data were collected using a Student Information Form, the Clinical Reasoning Case Form (CRCF), the Student Satisfaction with Education Questionnaire, and a Form for Views on the Education. In the evaluation of data, frequency values, Fisher exact test, Mann-Whitney U, and Wilcoxon tests, Cohen's d coefficient for effect size, ITT analysis, and covariance analysis were used.

Conditions

Clinical Reasoning; Critical Illness

Outcome Measures

Primary Outcomes (2)

• Student Information Form

  This form consists of 9 questions, including students' nicknames, age, gender, duration of clinical experience, level of school success, and views on the nursing process

  The measurement was collected one week before education.

• Clinical Reasoning Case Form (CRCF)

  There were 10 clinical cases on the CRCF prepared for the objectives of these three steps in students' clinical reasoning process. The cases involved critical illness, and early warning findings that show worsening in critical illness and are used to determine priority nursing diagnosis. Five people, who were experts in the field of medical nursing and had clinical experience, were consulted between February 15 and 28, 2021 to confirm the clinical accuracy and reality of CR cases and their content and comprehensibility. The content validity index of expert opinions evaluated with the Davis technique was determined as 1.

  The first measurement was collected one week before education. The second measurement was collected 3 weeks after education.

Secondary Outcomes (2)

• Student Satisfaction with Education Questionnaire

  The measurement was collected 3 weeks after education.

• Form for Views on the Education

  The measurement was collected 3 weeks after education.

Study Arms (2)

Experimental group

EXPERIMENTAL

Students in both experimental groups were applied the student information form and the pretest of the CRCF between May 18 and 20, 2021 before the education. The schedule of the education intervention was determined according to the convenience of the students in the experimental group. Accordingly, the experimental group was given education between June 8 and 11, 2021. After the education sessions were completed, experimental groups were applied the CRCF as a posttest on June 28, 2021. The students in the experimental group were asked to fill out the "Student Satisfaction with Education Questionnaire" and the "Form for Views on the Education" online.

Other: Case-based education

Control group

NO INTERVENTION

Students in control groups were applied the student information form and the pretest of the CRCF between May 18 and 20, 2021 before the education. The students in the control group continued their current standard education process. After the education sessions were completed, control groups were applied the CRCF as a posttest on June 28, 2021.

Interventions

Case-based education OTHER

The education phase This stage included the explanation of the CR process, the analysis of CR cases, the drafting of new cases suitable for the CR process by students, and the analysis process. The education program was carried out on a web platform (Zoom) consistent with the changes in the COVID-19 pandemic process. The CR cases to be used in case-based education were sent to the students via e-mail before the group interview to make sure students came prepared for the group discussion. In case-based education, after the students read the case, they were asked some questions to determine their decisions and reasoning.

Experimental group

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Having completed the "Medical Nursing" and Surgical Nursing" courses,
• Volunteering to participate in the study,
• Participate in "Case-Based Education"

You may not qualify if:

• Not being willing to participate in the study,
• Abandoning the "Case-Based Education" practice
• Not taking one or two of the "Medical Nursing" and "Surgical Nursing" courses at all, or to have taken them but unsuccessfully

Sponsors & Collaborators

• Ankara University: lead

Study Sites (1)

Ankara University Faculty of Nursing

Ankara, 06230, Turkey (Türkiye)

Location

Related Links

• Altman, M. R., Kantrowitz-Gordon, I., Moise, E., Malcolm, K., Vidakovic, M., Barrington, W., ... \& de Castro, A. B. (2021). Addressing Positionality Within Case-Based Learning to Mitigate Systemic Racism in Health Care. Nurse Educator, 46(5), 284-289.
• Banning, M. (2008). Clinical reasoning and its application to nursing: Concepts and research studies. Nurse education in practice, 8(3), 177-183.
• Dekhtyar, M., Park, Y. S., Kalinyak, J., Chudgar, S. M., Fedoriw, K. B., Johnson, K. J., ... \& Stern, S. (2022). Use of a structured approach and virtual simulation practice to improve diagnostic reasoning. Diagnosis, 9(1), 69-76.
• de Sá Tinôco, J. D., Cossi, M. S., \& de Carvalho Lira, A. L. B. (2021). Effect of educational intervention on clinical reasoning skills in nursing: A quasi-experimental study. Nurse Educat
• Groves, M., Scott, I., \& Alexander, H. (2002). Assessing clinical reasoning: a method to monitor its development in a PBL curriculum. Medical teacher, 24(5), 507-515.
• Hoffman, K. A., Aitken, L. M., \& Duffield, C. (2009). A comparison of novice and expert nurses' cue collection during clinical decision-making: Verbal protocol analysis. International journal of nursing studies, 46(10), 1335-1344.
• Hong, S., Lee, J., Jang, Y., \& Lee, Y. (2021). A Cross-Sectional Study: What Contributes to Nursing Students' Clinical Reasoning Competence?. International Journal of Environmental Research and Public Health, 18(13), 6833.
• Jacques, T., Harrison, G. A., McLaws, M. L., \& Kilborn, G. (2006). Signs of critical conditions and emergency responses (SOCCER): a model for predicting adverse events in the inpatient setting. Resuscitation, 69(2), 175-183.
• Lee, K. C., \& Wessol, J. L. (2022). Clinical Reasoning, Judgment, and Safe Medication Administration Practices in Senior Nursing Students. Nurse Educator, 47(1), 51-55.
• Leijser, J., \& Spek, B. (2021). Level of clinical reasoning in intermediate nursing students explained by education year and days of internships per healthcare branches: A cross-sectional study. Nurse Education Today, 96, 104641.
• Levett-Jones, T.,... \& Hickey, N. (2010). The 'five rights' of clinical reasoning: An educational model to enhance nursing students' ability to identify and manage clinically 'at risk'p
• Ma, C., \& Zhou, W. (2022). Effects of unfolding case-based learning on academic achievement, critical thinking, and self-confidence in undergraduate nursing students learning health assessment skills. Nurse Education in Practice, 103321.
• Rohde, E., \& Domm, E. (2018). Nurses' clinical reasoning practices that support safe medication administration: An integrative review of the literature. Journal of clinical nursing, 27(3-4), e402-e411.
• Tedesco-Schneck, M. (2019). Use of script concordance activity with the think-aloud approach to foster clinical reasoning in nursing students. Nurse educator, 44(5), 275-277.
• Wong, S. H. V., \& Kowitlawakul, Y. (2020). Exploring perceptions and barriers in developing critical thinking and clinical reasoning of nursing students: A qualitative study. Nurse Education Today, 95, 104600.

MeSH Terms

Conditions

Critical Illness

Condition Hierarchy (Ancestors)

Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Study Record Dates

• First Submitted: August 4, 2022
• First Posted: August 17, 2022
• Study Start: May 18, 2021
• Primary Completion: June 28, 2021
• Study Completion: June 30, 2021
• Last Updated: August 17, 2022

Record last verified: 2022-08

Locations

TU (1)