• 동서간호학연구지
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• 제26권2호
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• pp.176-184
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• 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.

• 대한간호학회지
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• 제53권1호
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• pp.87-100
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• 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.

• 근관절건강학회지
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• 제27권3호
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• pp.307-315
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• 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.

• 문화기술의 융합
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• 제10권2호
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• pp.373-382
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• 2024

본 연구는 간호대학생에게 에니어그램 힘의중심에 따른 간호역량, 임상추론역량 및 공감능력의 관계를 파악하고자 시도되었다. 연구의 대상자는 일 지역에 소재하는 2개 대학의 간호학과에 재학중인 학생으로 218명이었으며, 자료수집은 2023년 10월 16일부터 10월 27일까지 실시되었다. 자료분석은 SPSS/WIN version 26.0 프로그램을 활용하여 기술통계, 차이검증은 t-test, ANOVA, pearson's correlation coefficient으로 분석하였다. 연구결과, 본 연구대상자의 에니어그램 성격유형은 9번 유형이 가장 많았다. 그리고 에니어그램 힘의중심에서는 본능중심형이 간호역량이 가장 높았고, 사고중심형은 임상추론역량이 가장 높았으며, 감정중심형은 공감능력이 가장 높았다. 또한 간호역량과 임상추론역량은 유의한 양의 상관관계를 보였고, 임상추론역량과 공감능력도 유의한 양의 상관관계가 있는 것으로 나타났다. 따라서 간호대학생에게 성격유형검사를 반영한 개인에게 맞는 역량강화프로그램을 지속적으로 개발하여 적용하는 것이 중요할 것으로 생각된다. 그리고 공감능력이 높을수록 임상추론역량이 높아 간호역량과 임상추론역량을 향상시킬 수 있는 표준화된 교육과정을 개발하고 그 효과를 검증하는 것이 필요할 것으로 생각된다.

• 성인간호학회지
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• 제23권1호
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• pp.1-9
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• 2011

Purpose: To evaluate undergraduate nursing students' ability in clinical competence, critical thinking, and problem solving following enrollment in a clinical reasoning course. Methods: A clinical reasoning course utilizing a human patient simulator and scenarios was offered to 22 senior students at a College of Nursing in Seoul. Students' clinical competence was measured with a checklist of 15 items by analyzing students' performance recorded on video tapes for eight scenarios. Critical thinking disposition and problem solving were measured by a self-administered questionnaire before and after the course. Data were analyzed using descriptive statistics and Wilcoxon signed-rank test. Results: The high scored items of clinical competence were: 'obtain relevant subjective/objective data', 'interpret vital signs', 'communicate with healthcare providers', and 'utilize standard precautions including handwashing.' Students' critical thinking and problem solving scores following the course were increased with statistical significance. Conclusion: A clinical reasoning course utilizing a human patient simulator creates a realistic clinical environment for nursing students and provides the opportunity to obtain clinical competence, critical thinking, and problem solving skills.

• 한국산학기술학회논문지
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• 제18권4호
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• pp.304-310
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• 2017

본 연구는 간호사의 임상적 추론 역량을 강화하기 위한 기초자료로 Liou와 그의 동료들이 개발한 NCRC (Nurse Clinical Reasoning Competence) 도구를 한국어로 번역하고 번역된 항목들에 대해서는 문장구조와 의미의 유사성을 검토하는 절차를 거쳐 도구의 타당도와 신뢰도를 검증하는 방법론적 연구이다. 본 연구는 서울과 부산 소재의 4개의 상급병원에서 근무하는 간호사 166명을 대상으로 하여 타당도 및 신뢰도 검증을 실시하였다. 전문가들을 통한 내용타당도 검증은 전체문항이 모두 CVI 0.8이상으로 확인되었고, 탐색적 요인 분석과 확인적 요인 분석을 통해 최종적으로 1요인으로 구성된 총 15개 문항으로 분석되었다. 또한 동시타당도 검증을 위해 간호사의 비판적 사고성향과 임상 의사결정 능력 측정도구를 활용하여 본 연구의 한국어판 간호사 임상적 추론 척도와의 상관관계를 확인한 결과, 측정도구간의 상관계수는 .55-.64(p<.001)로 나타났고, 도구의 신뢰도는 Cronbach's ${\alpha}=.93$으로 나타났다. 따라서 한국판 NCRC 도구는 한국 간호사들의 임상적 추론 역량을 객관적으로 평가하기에 유용한 도구라고 할 수 있으며, 국내 간호사들의 임상적 추론 역량 사정 및 증진전략 개발에 기초자료를 제공했다는데 의의가 있다. 그러나 한국의 간호 환경과 문화를 고려한 임상적 추론 역량 문항들이 있는지에 대한 추가적인 연구가 필요하다고 생각한다.

• 한국산학기술학회논문지
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• 제21권8호
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• pp.107-114
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• 2020

본 연구는 시뮬레이션 기반 교육이 간호학생들의 임상추론역량과 임상수행능력 및 시뮬레이션 교육만족도에 미치는 효과를 알아보고자 수행되었다. 본 연구 설계는 단일군 전후 설계이다. 대상자는 G시 C대학교의 89명 3학년 간호학생으로, 8월부터 10월까지 8주간의 시뮬레이션 교육을 참여하였다. 학습한 시나리오 주제는 전 고관절대치술 후 수혈 부작용 환자 간호, 당뇨 환자의 저혈당증 환자 간호, 간경화증 환자의 고칼륨혈증 환자 간호이다. 자료는 SPSS 23.0 프로그램을 이용하였고, 평균과 표준편차, 대응표본 t검정으로 분석하였다. 간호학생들은 시뮬레이션 교육을 적용한 후 임상추론역량(t=-17.082, p<.001)과 임상수행능력(t=-18.40, p<.001)이 통계적으로 유의하게 향상되었고, 시뮬레이션 교육만족도는 5점 만점에 4.65점으로 높은 점수를 나타내었다. 이러한 결과로 볼 때, 본 시뮬레이션 기반 교육은 간호학생에게 임상상황과 유사한 환경에서 질적이고 안전한 간호를 경험할 수 있도록 하였다. 따라서 간호학생들의 임상추론역량과 임상수행능력을 향상시키기 위해서는 임상현장에서 접할 수 있는 다양한 사례의 시나리오 개발 및 간호교육과정에서 시뮬레이션 기반 교과목들의 적용이 더 필요하다.

• 한국융합학회논문지
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• 제11권10호
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• pp.181-186
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• 2020

본 연구에서는 간호대학생을 대상으로 임상적 추론 역량에 대하여 조사하고 이에 영향을 미치는 요인을 파악하고자 시도되었다. 본 연구는 G^⁎Power 3.1.9.4를 이용하여 간호대학생 3, 4학년 297명을 대상으로 간호핵심역량과 관련된 학습능력을 파악하고자 임상적 추론, 문제해결능력, 비판적 사고성향, 임상적 의사결정, 자기주도학습, 임상수행능력을 측정하고 임상적 추론 역량에 영향을 미치는 변수를 검정하는 서술연구이다. 연구결과를 살펴보면, 학년별로 임상적 추론역량을 비교한 결과 유의한 차이를 보였으며(p=0.001), 또한 임상적 추론역량에 대한 영향변수를 확인한 결과 문제해결능력, 임상적 의사결정 능력, 임상수행능력, 임상실습경험(학년)이 유의한 변수로 나타났다.(p,.001). 본 연구결과는 간호대학생의 임상적 추론 역량을 높이기 위한 다양한 교육과정개발의 근거로 활용될 수 있을 것으로 보이며, 향후 임상적 추론 역량을 높일 수 있는 교육 개발을 위한 연구가 필요할 것으로 사료된다.

• 중환자간호학회지
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• 제17권2호
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• pp.83-95
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• 2024

Purpose : This study aimed to investigate the impact of clinical reasoning competence, positive psychological capital, and nursing work environment on nursing performance of intensive care unit (ICU) nurses in tertiary general hospitals. Methods : Data were collected from 169 ICU nurses in tertiary general hospitals in Busan, South Korea, from July 27 to August 15, 2023, using a self-report questionnaire. After excluding 12 questionnaires with insufficient responses, 157 responses were analyzed. Descriptive statistics, independent t-test, one-way ANOVA, Pearson's correlation coefficient, and stepwise multiple regression analysis were employed. Results : Factors influencing nursing performance included clinical reasoning competence (β=.51, p <.001), hope as a subfactor of positive psychological capital (β=.31, p <.001), and the nursing foundations for quality of care in the nursing work environment (β=.21, p <.001). The explanatory power of the regression model was 62% (F=87.41, p <.001). Conclusion : The study underscores the importance of improving clinical reasoning competence among ICU nurses to enhance nursing performance and foster a hopeful attitude through reflective practices and personal growth. Organizational interventions, such as educational and psychological support programs, along with creating a supportive nursing environment, are crucial for improving nursing performance among intensive care unit nurses.

• 성인간호학회지
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• 제25권5호
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• pp.574-584
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• 2013

Purpose: The purpose of this study was to evaluate the effects of a simulation based clinical reasoning practice program on clinical competence in nursing students. The program was based on the theoretical frameworks of simulation models and experiential learning theory. Methods: The program consisted of eight scenarios which includes three main symptoms (abdominal pain, changes in mental status, dyspnea), for improvement of clinical competencies in nursing students. A nonequivalent control group pretest-posttest design was used for evaluation of the effects of the program. Fifty-two junior nursing students in Y University participated in the experimental group (n=25) or control group (n=27). Critical thinking was measured using a self-administered questionnaire. Clinical judgment and clinical performance were measured by a rater using the Rubric. Descriptive analysis, t-test, Mann-Whitney U, Wilcoxon signed rank test was used for data analyses. Results: Clinical judgment and clinical performance increased in the experimental group, but there were no significant differences in critical thinking. Conclusion: Results indicate that the program developed in this study is a useful strategy to enhance clinical judgment and clinical performance in nursing students. However, the program did not significantly enhance critical thinking disposition, and further study is needed to measure integrated clinical competence including critical thinking skills.