DOI QR코드

DOI QR Code

간호교육에서의 비판적 사고, 임상적 추론, 임상적 판단 개념의 고찰

A Review for Concept Clarification of Critical Thinking, Clinical Reasoning, and Clinical Judgment in Nursing Education

  • 이동숙 (강원대학교 간호대학) ;
  • 박지연 (강원대학교 간호대학 대학원)
  • Lee, Dongsuk (College of Nursing, Kangwon National University) ;
  • Park, Jiyeon (College of Nursing, Kangwon National University)
  • 투고 : 2019.07.19
  • 심사 : 2019.08.07
  • 발행 : 2019.08.31

초록

Purpose: This article is a comprehensive review for concept clarification of critical thinking, clinical reasoning, and clinical judgment, which still lack a consensus and are of mixed use. Methods: Norris's method of concept clarification was used to review concepts that have no clear definition or conceptualization yet. Results: This review summarized literature from various disciplines, classified each concept based on similarities and differences, and provided hypothetic conceptual schema. Conclusion: Clinical reasoning and clinical judgment are clinical situation specific concepts, while critical thinking is a concept applied in general situations. Critical thinking is a broader concept and serves as a foundation for clinical reasoning and clinical judgment. Clinical reasoning precedes clinical judgment. Clinical judgement implies the end point or conclusion of clinical reasoning. Each of critical thinking, clinical reasoning, and clinical judgment is a cognitive and affective process not a psychomotor process. The concept of clinical competency involves action taken after the cognitive processes of clinical reasoning and clinical judgment.

키워드

참고문헌

  1. Alfaro-LeFevre, R. (2014). Applying nursing process: The foundation for clinical reasoning (8th ed.). Philadelphia, PA: Wolters Kluwer Health.
  2. Banning, M. (2008). Clinical reasoning and its application to nursing: Concepts and research studies. Nurse Education in Practice, 8, 177-183. https://doi.org/10.1016/j.nepr.2007.06.004
  3. Barrett, C., & Myrick, F. (1998). Job satisfaction in preceptorship and its effect on the clinical performance of the preceptee. Journal of Advanced Nursing, 27(2), 364-371. https://doi.org/10.1046/j.1365-2648.1998.00511.x
  4. Berman, A., Snyder, S., & Frandsen, G. (2016). Kozier & Erb's fundamentals of nursing: Concepts, process, and practice (11th ed.). Edinburgh-Gate, England: Pearson.
  5. D'Zurilla, T. J., & Nezu, A. M. (1990). Development and preliminary evaluation of the social problem-solving inventory Psychological Assessment. A Journal of Consulting and Clinical Psychology, 2(2), 156-163.
  6. Education Research Institute Seoul National University (Ed.). (1995). Encyclopedia of education. Seoul: Howdongseol.
  7. Facione, P. A. (1990). American Philosophical Association delphi research report (ED 315 423) - Critical thinking: A statement of expert consensus for purposes of educational assessment and instruction. Millbrae, CA: The California Academic Press.
  8. Fonteyn, M. E., & Ritter, B. J. (2008). Clinical reasoning in nursing. In J. Higgs, M. Jones, S. Loftus, & N. Christensen (Ed.). Clinical reasoning for health professionals (pp. 235-244). Boston: Elsevier.
  9. Hawkins, D., Elder, L., & Paul, R. (2013). The thinker's guide to clinical reasoning. CA: Foundation for Critical Thinking Press.
  10. Hur, H. K., & Roh, Y. S. (2013). Effects of simulation based clinical reasoning practice program on clinical competence in nursing students. Korean Journal of Adult Nursing, 25(5), 574-584. https://doi.org/10.7475/kjan.2013.25.5.574
  11. Joung, J. W., & Han, J. W. (2017). Validity and reliability of a Korean version of nurse clinical reasoning competence scale. Journal of the Korea Academia-Industrial Cooperation Society, 18(4), 304-310. https://doi.org/10.5762/KAIS.2017.18.4.304
  12. Kim, J. A., & Ko, J. K. (2015). A study on clinical reasoning ability and academic achievements in nursing students. Journal of the Korea Academia-Industrial Cooperation Society, 16(3), 1874-1883. https://doi.org/10.5762/KAIS.2015.16.3.1874
  13. Korean Accreditation Board of Nursing Education. (2019, July 01). Accreditation of nursing education. Retreived from: http://www.kabone.or.kr/kabon02/index.php
  14. Kuiper, R. A., & Pesut, D. J. (2004). Promoting cognitive and metacognitive reflective reasoning skills in nursing practice: self-regulated learning theory. Journal of Advanced Nursing, 45(4), 381-391. https://doi.org/10.1046/j.1365-2648.2003.02921.x
  15. Lackey, R. N. (2000). Concept clarification: Using the Norris method in clinical research. In B. L. Rogers & K. A. Knafl (Ed.), Concept development in nursing (pp. 193-208). Philadelphia, PA: W. B. Saunders Company.
  16. Lasater, K. (2007). Clinical judgment development: Using simulation to create an assessment rubric. Journal of Nursing Education, 46(11), 496-503. https://doi.org/10.3928/01484834-20071101-04
  17. Lee, J. H., & Choi, M. (2011). Evaluation of effects of a clinical reasoning course among undergraduate nursing students. Korean Journal of Adult Nursing, 23(1), 1-9.
  18. Liou, S. R., Liu, H. C., Tsai, H. M., Tsai, Y. H., Lin, Y. C., Chang, C. H., et al. (2016). The development and psychometric testing of a theory-based instrument to evaluate nurses' perception of clinical reasoning competence. Journal of Advanced Nursing, 72(3), 707-717. https://doi.org/10.1111/jan.12831
  19. Oh, I., & Kim, J. H. (2016). Impacts of critical thinking disposition and nursing work environment on nurses' clinical decision making abilities. Journal of Korean Academic Society of Nursing Education, 22(3), 304-315. https://doi.org/10.5977/jkasne.2016.22.3.304
  20. Possin, K. (2014). Critique of the Watson-Glaser Critical Thinkng Appraisal Test: The more you know, the lower your score. Informal Logic, 34(4), 393-416. https://doi.org/10.22329/il.v34i4.4141
  21. Rhodes, M. L., & Curran, C. (2005). Use of the human patient simulator to teach clinical judgment skills in a baccalaureate nursing program. CIN: Computers, Informatics, Nursing, 23(5), 256-262. https://doi.org/10.1097/00024665-200509000-00009
  22. Seo, M. G. (2013). A study on class design of clinical critical thinking: Focusing on critical thinking skills for nursing education. Korean Journal of General Education, 7(5), 317-341.
  23. Shin, K. R., Hwang, J. W., & Shin, S. J. (2008). Concept analysis on the clinical critical thinking ability in nursing, Korean Journal of Adult Nursing, 20(5), 707-718.
  24. Simmons, B. (2010). Clinical reasoning: Concept analysis. Journal of Advanced Nursing, March 2010, 1151-1158.
  25. Sommers, C. L. (2018). Measurement of critical thinking, clinical reasoning, and clinical judgment in culturally diverse nursing students - A literature review. Nurse Education in Practice, 30, 91-100. https://doi.org/10.1016/j.nepr.2018.04.002
  26. Tanner, C. A. (2006). Thinking like a nurse: A research based model of clinical judgement in nursing. Journal of Nursing Education, 45(6), 204-211. https://doi.org/10.3928/01484834-20060601-04
  27. Victor-Chmil, J. (2013). Critical thinking versus clinical reasoning versus clinical judgment: Differential diagnosis. Nurse Educator, 38(1), 34-36. https://doi.org/10.1097/NNE.0b013e318276dfbe
  28. Yoon, J. (2004). Development of an instrument for the measurement of critical thinking disposition: In nursing. Unpublished doctoral dissertation, Catholic University, Seoul.
  29. You, S. Y., & Kim, N. C. (2014). Development of critical thinking skill evaluation scale for nursing students. Journal of Korean Academy Nursing, 44(2), 129-138. https://doi.org/10.4040/jkan.2014.44.2.129

피인용 문헌

  1. Promoting civility in nursing practice using systems thinking: Evidence‐based teaching strategies for nurse educators vol.55, pp.4, 2019, https://doi.org/10.1111/nuf.12493
  2. Relationship between Simulation Design Characteristics and Clinical Reasoning Competence: Multiple Additive Moderating Effects of Teaching Effectiveness and Students' Anxiety on Nursing Students vol.33, pp.4, 2019, https://doi.org/10.7475/kjan.2021.33.4.322
  3. Influence of Perceived Helicopter Parenting, Critical Thinking Disposition, Cognitive Ability, and Learning Motivation on Learning Behavior among Nursing Students vol.18, pp.3, 2019, https://doi.org/10.3390/ijerph18031362
  4. Development and Effects of Leukemia Nursing Simulation Based on Clinical Reasoning vol.18, pp.8, 2021, https://doi.org/10.3390/ijerph18084190
  5. 간호대학생의 비판적 사고 교육의 효과 vol.11, pp.8, 2021, https://doi.org/10.22156/cs4smb.2021.11.08.224