Effect of a guide for clinical reasoning on Nursing students’ diagnostic accuracy: A clinical trial
DOI:
https://doi.org/10.1590/1518-8345.5452.3515%20Keywords:
Critical Thinking; Clinical Decision-Making; Nursing Students; Randomized Controlled Trial; Teaching; Nursing.Abstract
Objective: to evaluate the effect of the Self-Instructional Guide
for Clinical Reasoning on the diagnostic accuracy of undergraduate
Nursing students. Method: a randomized, parallel and double-blind
(researchers and outcome evaluators) clinical trial, carried out with
undergraduate Nursing students. Validated case studies were applied
in two phases to identify the patient’s Nursing diagnosis/problem,
etiology and clues, using the Guide with the intervention group in the
second phase. The outcomes - diagnostic and etiological accuracy
and number of clues - were evaluated using validated rubrics.
Descriptive statistics were used to analyze demographic data;
Fisher’s exact test for similarities in prior education and confidence;
Mann-Whitney’s test for age; and non-parametric ANOVA test in
the evaluation of the hypothesis of differences in performance.
Results: final sample composed of 24 students in the control group
and 27 in the intervention group; no difference as to gender, age
and schooling. There was a difference in diagnostic (p=0.041) and
etiological (p=0.0351) accuracy in the intervention group, showing
a negative effect of using the Guide. Conclusion: the one-time selfinstruction
was not effective in impacting the diagnostic accuracy of
students solving case studies. Repeated application of the Guide as
a teaching tool can be effective in improving such outcome. REBEC:
RBR-4bhr78.
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