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A Study on Clinical Reasoning Ability and Academic Achievements in Nursing Students

간호대학생의 임상추론 능력과 학업성취도

  • Received : 2014.10.10
  • Accepted : 2015.03.12
  • Published : 2015.03.31

Abstract

The purpose of this study was to verify clinical reasoning of nursing students as well as clarify the relevance between clinical reasoning and academic achievement. 87 students broke into 30 groups of two or three. The students performed post operative care for adult patients in the simulation practicum course of their final semester. Data were collected by evaluating the video-recorded nursing practicum using the clinical reasoning rubric. Clinical reasoning of 61(70.1%) students was limited to the beginning level and that of 6(6.9%) students of the highest scoring was at the third level among the four levels of ability. There was no significant correlation between clinical reasoning and the final cumulative GPA, while there was low level of significant correlation between clinical reasoning and GPA of adult health nursing course or adult health nursing practicum course. Therefore, it is necessary to improve the nursing curriculum to enhance nursing students' clinical reasoning.

본 연구는 간호대학생의 임상추론 능력을 확인하고 학업성취도와의 관련성을 파악하고자 시도되었다. 졸업반 4학년 학생 87명을 30팀으로 나누어 2-3명이 한 조가 되어 시뮬레이션을 활용하여 수행한 성인 환자의 수술 후 간호를 녹화하여 분석하였다. 연구자 2명이 개발한 임상추론 루브릭을 사용하여 평가 및 분석한 대학생의 임상추론 능력은 가장 낮은 초보자 수준이 70.1%(61명), 그 다음 양호한 수준이 23%(20명), 우수한 수준이 6.9%(6명)이었으며, 가장 높은 탁월한 수준에 해당하는 학생은 없었다. 또한 간호대학생들의 임상추론 능력은 학업성취도인 총평점평균과 유의한 상관관계가 없었으며, 성인간호학 및 성인간호학 실습 교과목의 평점과는 낮은 유의한 상관관계가 있었다. 따라서 4학년 졸업반 간호대학생들은 졸업 후 신규 간호사가 갖추어야 할 임상추론 능력이 매우 부족하고, 임상추론 능력과 학업성취도 간에 상관성이 확인되지 않았으므로 교육과정 개선이 시급한 것으로 판단된다.

Keywords

References

  1. Korean Accreditation Board of Nursing Education (KABON). Nursing core competencies. Retrieved December 20, 2012, from http://www.kabon.or.kr
  2. J. K. Ko, M. S. Chung, M. A. Choe, Y. I. Park, K. S. Bang, J. A. Kim, M. S. Yoo, H. Y. Jang, "Modeling of nursing competencies for competency-based curriculum development." The Journal of Korean Academic Society of Nursing Education. 19(1) pp.87-96. 2013. DOI: http://dx.doi.org/10.5977/jkasne.2013.19.1.87
  3. International Council of Nursing. "An implementation models for the ICN framework of competencies for the generalist nurse." Standards and Competencies series(2nd ed.) Geneva; ICN. pp1-30, 2003.
  4. G. E. Armstrong, T. S. Spencer, & C. B. Lenburg, "Using quality and safety education for nurses to enhance competency outcome performance assessment: A synergistic approach that promotes patient safety and quality outcomes." Journal of Nursing Education. 48(12), pp. 686-693, 2009. DOI: http://dx.doi.org/10.3928/01484834-20091113-02
  5. P. McLagan, "Great ideas revisited: Job competency models." Training & Development. 50(1), pp.40-47, 1996.
  6. S. J. Im, "Strategies for effective teaching in clinical clerkship." Hanyang Medcial Reviews. 32(1), pp.51-58. 2012. DOI: http://dx.doi.org/10.7599/hmr.2012.32.1.51
  7. C. A. Tanner, "Thinking like a nurse: A research-based model of clinical judgment in nursing." Journal of Nursing Education.. 45(6), pp.204-211, 2006.
  8. H M. Jenkins, "A research tool for measuring perceptions of clinical decision making." of Professional Nursing. 1(4), pp.221-229, 1985. DOI: http://dx.doi.org/10.1016/S8755-7223(85)80159-9
  9. B. Simmons, D. Lanuza, M. Fonteyn, F. Hicks, K. Holm, "Clinical reasoning in experienced nurses." Western Journal of Nursing Research. 25(6), pp.701-724, 2003. DOI: http://dx.doi.org/10.1177/0193945903253092
  10. K. Lasater, "Clinical judgment development: Using simulation to create an assessment rubric." Journal of Nursing Education. 46, p.496-503, 2007.
  11. S. Lauri, S. Salantera, "Decision making models in different field of nursing." Research in nursing & Health. 21, pp.443-452, 1998. DOI: http://dx.doi.org/10.1002/(SICI)1098-240X(199810) 21:5<443::AID-NUR7>3.0.CO;2-N
  12. H. J. Choi, "Public health nurses' decision making models and their knowledge structure." Journal of Korean Academy of Nursing. 31(2). pp.328-339. 2000.
  13. K. J. Kang, E. M. Kim, S. A. Ryu, "Factors Influencing Clinical Competence for General Hospital Nurses." The Korea Contents Society. 11(1), pp.284-293, 2011. DOI: http://dx.doi.org/10.5392/JKCA.2011.11.1.284
  14. Y. Lee, M. Gang, M. S. Jung, "Impact of professional autonomy and nursing work environment on clinical decision making of clinical nurses." Korean Journal of Occupational Health Nursing. 22(4) pp.285-294. 2013. DOI: http://dx.doi.org/10.5807/kjohn.2013.22.4.285
  15. I. K. Kwon, S. M. Park. "Effects of critical reflective inquiry on new graduate nurses' clinical decision-making." Journal of Korean Clinical Nursing Research. 13(2), pp.39-50, 2007.
  16. H. K. Hur, Y. S. Roh. "Effects of a simulation based clinical reasoning practice program on clinical competence in nursing students." Korean Journal of Adult Nursing. 25(5), pp.574-584. 2013. DOI: http://dx.doi.org/10.7475/kjan.2013.25.5.574
  17. H. Goodrich, "Understanding rubrics." Educational Leadership. 54(4), p.14-17, 1996.
  18. J. K. Ko, The principle and practices in health education. Seoul: Bomungak. 2005. pp1-230.
  19. S. H. Bum, J. H. Chae, "Rubric Development for Performance Evaluation of Middle School Home Economics -Focusing on Experiment and Practice Methods." Korean Home Economics Education Association. 20(3), pp.85-105, 2008.
  20. A. K. Yang, H. J. Cho, "An analysis on the influence of self-regulated learning upon academic achievement." The Journal of Korean Educational Forum. 8(3), pp.61-82, 2010.
  21. D. M. Zimmaro, Developing Grading Rubrics. Last Retrived January 13, 2004 from http://slo.sbcc.edu/wp-content/uploads/developing_grading_rubrics.pdf
  22. W. K. Noh, "A studdy for the development and effects of learning strategy rubrics: Focused on college students's learning strategy educational program." Journal of Educational Technology. 24(4), pp.259-294. 2008. https://doi.org/10.17232/KSET.24.4.259
  23. K. A. Adamson, P. Gubrud, S. Sideras, K. Lasater, "Assessing the reliability, validity, and use of the Lasater clinical judgment rubric: Three approaches." Journal of Nursing education. 51: pp.66-73, 2012. DOI: http://dx.doi.org/10.3928/01484834-20111130-03
  24. R. D. Wimmer, J. R. Dominick, Mass Media Research: An Introduction, 9th ed. Yoo J. C, Kim D. K translator. Belmont, CA: Wadsworth Cengage Learning. pp105-180, 2010.
  25. K. K. Shim, Judgement rubric in Korean nursing students[thesis]. Seoul: Kyung Hee University. pp.1-64. 2012.
  26. B. Mariani, M. A. Cantrell, C. Meakim, P. Prieto, K. T. Dreifuerst, "Structured debriefing and students' clinical judgment abilities in simulation." Clinical Simulation in Nursing 9(5), pp.147-155, 2013. DOI: http://dx.doi.org/10.1016/j.ecns.2011.11.009
  27. H. Shin, C. G. Park, K. Shim, "The Korean version of the Lasater clinical judgment rubric: A validation study." Nurse Education Today. 2014. Forthcoming.
  28. H. J. Jang, Y. K. Kwag, "Affecting factors on clinical competence of nursing students." Journal of the Korea Academia-Industrial Cooperation Society. 14(9), pp.4380-4387, 2013. DOI: http://dx.doi.org/10.5762/KAIS.2013.14.9.4380
  29. H. S. Shin, Educational needs assessment and perceptions of core nursing competencies[thesis]. Suwon: Aju University. pp.1-68, 2010.
  30. P. Boxter, G. Norman, "Self-assessment or self deception? A lack of association between nursing students' self-assessment and performance." Journal of Advanced Nursing. 67(11), pp.2406-2413. (22 ref). 2011. DOI: http://dx.doi.org/10.1111/j.1365-2648.2011.05658.x