• The Journal of Korean Academic Society of Nursing Education
• /
• v.25 no.3
• /
• pp.378-387
• /
• 2019

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.

• CELLMED
• /
• v.14 no.2
• /
• pp.4.1-4.4
• /
• 2024

The development of clinical reasoning, which is the basis of medical education, is of great importance in medical universities. One of the founders of modern structural clinical reasoning, based on the knowledge of pathological physiology, is the inventor of the stethoscope Rene Laennec (1781-1826). He described the pioneering experience of clinical reasoning in the pages of his treatise A Treatise on the Diseases of the Chest and on Mediate Auscultation, which is of lasting value, since every rookie physicians in his professional development goes through the path of Laennec. Laennec's practice is of great importance for novice physicians since Laennec's treatise contains a diagnostic analysis of the most common clinical cases. Each such analysis demonstrates the algorithm of clinical reasoning. The purpose of this study was to analyze the approaches of clinical reasoning by René Laennec, which made it possible to identify two basic principles. Laennec's diagnostic reasoning involved two principles: pathogenetic analysis of clinical manifestations and a syndrome-based approach to differential diagnosis. These principles help distinguish between diseases with similar symptoms and physical findings are used to demonstrate the practical application of syndrome-based differential diagnosis. These principles can be easily mastered by understanding the pathogenesis of clinical manifestations. Thanks to the pathogenetic basis, the principles of clinical reasoning of Rene Laennec are universal and applicable to the analysis of any signs of the disease: not only physical but also laboratory and instrumental.

• The Journal of Korean Physical Therapy
• /
• v.24 no.5
• /
• pp.370-376
• /
• 2012

Purpose: This study examined whether there are differences in cognitive styles between orthopedic and neurological physical therapists, and whether these differences change with clinical experience in clinical reasoning. Methods: A survey study was conducted on 88 orthopedic and neurologic physical therapists working in South Korea. The survey items used by May and Dennis (1991) were translated, and only those items related to data-gathering and information-processing were used. Results: The cognitive style was similar in the orthopedic and neurologic physical therapists, but the clinical experience affected the cognitive styles of clinical reasoning. Physical therapists with more than 60 months clinical experience responded most positively to the preceptive and systematic styles in clinical reasoning. Conclusion: These results suggest that physical therapy education should provide physical therapy students with a clinical reasoning process related specifically to a particular clinical field.

• Journal of East-West Nursing Research
• /
• v.26 no.2
• /
• pp.176-184
• /
• 2020

Purpose: The purpose of this study was to investigate the influence of nursing students' self-reflection and insight, and academic selfefficacy on their clinical reasoning competence. Methods: Data were collected from 147 third- and fourth-year nursing students who had more than 6 months of clinical training experience. Clinical reasoning competence, self-reflection and insight, and academic self-efficacy were measured using self-reported questionnaires. Data analysis was conducted with IBM SPSS 25.0 using one-way ANOVA, independent t-test, Pearson correlation coefficient, and multiple regression analysis. Results: Clinical reasoning competence was positively correlated with self-reflection and insight (r=.24, p=.003) and academic self-efficacy (r=.30, p<.001). Academic self-efficacy (β=.23, p=.011), dissatisfaction with major (β=-.17, p=.034), and 5~8 case studies (β=-.39, p=.027) were identified as factors influencing clinical reasoning competence (adjusted R²=.15). Conclusion: To improve the clinical reasoning competence of nursing students, it is necessary to develop the academic self-efficacy of complex cases and provide critical inquiries, debriefing tailored to clinical reasoning, and sufficient reflection during clinical and simulation practice.

• PNF and Movement
• /
• v.17 no.1
• /
• pp.145-156
• /
• 2019

Purpose: This study suggests clinical reasoning strategies for therapists with little experience in clinical reasoning for the evaluation and treatment of patients with neurological disorders. Methods: The suggested method was the mnemonic PT STRESS whose initials represent the body structure and functions that can affect the activity limits and the items that can cause problems at the functional level in patients with neurological disorders. Results: PT STRESS stands for pain (P), ability of the trunk (T), sensation (S), tone (T), range of motion (R), emotion and endurance (E), muscular strength (strength), and stability (S). It tests and measures problems in the body structure and functions. Conclusion: This study suggests easy clinical reasoning strategies that can be used by therapists who have insufficient experience in the evaluation or treatment of patients with neurological disorders. However, more factors need to be considered in the future with regard to clinical reasoning of the diverse problems of patients with neurological disorders.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.16 no.3
• /
• pp.1874-1883
• /
• 2015

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.

• The Journal of Korean Physical Therapy
• /
• v.24 no.5
• /
• pp.377-382
• /
• 2012

Purpose: The purpose of this qualitative study was to understand the application of clinical reasoning throughout clinical and therapeutic knowledge of clinical pediatric physical therapists under physician prescriptions. Methods: Purposive sampling techniques were used in selection of nine clinical pediatric physical therapists in South Korea. Open and semi structured interviews were conducted, and were thoroughly examined and reviewed, followed by analysis of the clinical reasoning portion. Results: Pediatric physical therapists have been influenced by information gathering, physical function and evaluation of their patients, hypothesis-orientation, and re-evaluation and self-monitoring. Novice physical therapists were more dependent on physician prescriptions and parent's hope than the result of their own evaluation and critical pathway. Middle experienced pediatric physical therapists were more dependent on rapport with children and their parents. Highly experienced pediatric physical therapists were more reliant on hypothesis-orientation and self-monitoring. As reports on clinical experience of pediatric physical therapists have accumulated, clinical reasoning of pediatric physical therapists has been influenced by their experience, such as education, clinical pathology conference, their own clinical experience and rapport with patients and their parents than physicians' prescriptions. Conclusion: The findings of the current study are generally consistent with existing research on clinical reasoning. The results of the current study may be used by educators for enhancement of clinical reasoning abilities and knowledge of students or novices as well as development of a guide for use by suitable novices or students, and could provide important information for use in physical therapy practice and research.

• Korean Journal of Adult Nursing
• /
• v.27 no.5
• /
• pp.604-611
• /
• 2015

Purpose: Knowledge, clinical reasoning, and self-confidence are the basis for undergraduate education, and determine students' level of competence. The purpose of this study was to assess the effects of the addition of a one-time simulation experience to the didactic curriculum on nursing students' knowledge acquisition, clinical reasoning skill, and self-confidence. Methods: Using a quasi-experimental crossover design consisted of intervention and wait-list control groups. Participants were non-randomly assigned to the first intervention group (Group A, n=48) or the wait-list control group (Group B, n=46). Knowledge level was assessed through a multiple choice written test, and clinical reasoning skill was measured using a nursing process model-based rubric. Self-confidence was measured using a self-reported questionnaire. Results: Results indicated that students in the simulation group scored significantly higher on clinical reasoning skill and related knowledge than those in the didactic lecture group; no difference was found for self-confidence. Conclusion: Findings suggest that undergraduate nursing education requires a simulation-based curriculum for clinical reasoning development and knowledge acquisition.

• Journal of muscle and joint health
• /
• v.27 no.3
• /
• pp.307-315
• /
• 2020

Purpose: This study sought to identify the effects of emotional intelligence, self-leadership, and critical thinking disposition on clinical reasoning competence among nursing students. Methods: Data were collected from 149 nursing college students using structured self-reported questionnaires, and analyzed using descriptive statistics, independent t-tests, one-way analysis of variance, Pearson correlation coefficients, and multiple regression analysis via the software SPSS version 25.0. Results: Clinical reasoning competence was positively correlated with emotional intelligence (r=.61, p<.001), self-leadership (r=.50, p<.001), and critical thinking disposition (r=.48, p<.001). Emotional intelligence (β=.46, p<.001), self-leadership (β=.24, p=.002), and age (β=-.15 p=.017) were identified as factors that influence clinical reasoning competence(Adjusted R2=.42). Conclusion: To enhance clinical reasoning competence among nursing students, their emotional intelligence and self-leadership need to be improved, and the age of students should be considered, as the level of clinical reasoning competence tends to decrease in students over 31 years old.

• Journal of Korean Academy of Nursing
• /
• v.53 no.1
• /
• pp.87-100
• /
• 2023

Purpose: This study aimed to develop a nursing simulation learning module for coronavirus disease 2019 (COVID-19) patient-care and examine its effects on clinical reasoning competence, clinical competence, performance confidence, and anxiety in COVID-19 patient care for nursing students. Methods: A non-equivalent control group pre- and post-test design was employed. The study participants included 47 nursing students (23 in the experimental group and 24 in the control group) from G City. A simulation learning module for COVID-19 patient-care was developed based on the Jeffries simulation model. The module consisted of a briefing, simulation practice, and debriefing. The effects of the simulation module were measured using clinical reasoning competence, clinical competence, performance confidence, and anxiety in COVID-19 patient-care. Data were analyzed using χ²-test, Fisher's exact test, t-test, Wilcoxon signed-rank test, and Mann-Whitney U test. Results: The levels of clinical reasoning competence, clinical competence, and performance confidence of the experimental group were significantly higher than that of the control group, and the level of anxiety was significantly low after simulation learning. Conclusion: The nursing simulation learning module for COVID-19 patient-care is more effective than the traditional method in terms of improving students' clinical reasoning competence, clinical competence, and performance confidence, and reducing their anxiety. The module is expected to be useful for educational and clinical environments as an effective teaching and learning strategy to empower nursing competency and contribute to nursing education and clinical changes.