Clinical reasoning in nursing students

Nursing students are expected to learn an enormous amount of information, implement interventions and evaluate patient outcomes in their few years of nursing school. Nursing students have limited experiences in the clinical setting to refine their clinical reasoning skills. In the clinical setting, patients leave the hospital sooner due to limited reimbursements while others are so sick that the student might not get a chance to learn from the experience due to the acuity and fast pace of the assignment. Simulation can provide students with a very similar experience to the real patient setting, thus allowing them time to consider and apply their knowledge. This study looked at whether simulation experience assisted the nursing student in recognizing the salient features of a patient scenario as evidenced by a focused assessment tracked by the Clinialedonline.com© computer program using a septic patient case study. The post-test scores would suggest that this research question was supported by the pass rates. The computer program allowed the nursing students to be evaluated on their understanding of assessment and implementation of appropriate interventions for the septic patient. Through the use of the interactive program, the participants were required to evaluate lab data, clinical presentation and current orders before choosing from a number of different treatment options such as fluid, antibiotics, vasopressors and steroids. This process showed that the nursing students improved their ability to evaluate and implement the nursing process which requires clinical reasoning skills. Clinical reasoning develops with mental models that incorporate experience from patients; simulation provided a model of ideal care of the septic patient for the nursing students to correctly assess and treat patients using the sepsis bundle of treatment elements.