This study is a one-group pre-post experimental design that investigates the effects of a practice-based learning program with multiple components on the clinical competence of nursing students, and clinical decision-making. From May 4 to 29, 2020, a total of 60 third-year nursing students with no clinical practice experience were divided into two teams and participated in multi-component practice-based education for two weeks each, and the data of the final 51 students were included in the analysis. Following the practicum, there was a significant increase in clinical competence (t=-4.74, p<.001) and self-confidence in clinical decision-making (t=-8.41, p<.001), and a decrease in anxiety related to clinical decision-making (t=2.54, p=.014). The findings suggest that a multi-component, practice-based learning approach for nursing students can enhance their clinical competence, reduce preclincal anxiety and increase confidence in clinical decision-making in patient care.
Purpose: This study aimed to understand the mechanisms of decision regret and stress of family surrogates' end-of-life decision making using an exploratory path model. In particular, the research identified the direct effects of perceptions of uncertainty and effective decisions on decision regret and stress, and examined the indirect effects of being informed, having clear values, and being supported for decision regret and the stress of end-of-life decision making through the mediating variables of perceptions of uncertainty and effective decisions. Methods: Data were collected from 102 family surrogates who had participated in end-of-life decision making for patients with terminal cancer in a tertiary hospital. Results: Perception of effective decisions was a significant direct predictor of decision regret, and uncertainty was a significant predictor of stress among the participants. Being informed, having clear values, and being supported had a significant indirect influence on decision regret through the perception of effective decisions among family surrogates. However, only having clear values had a significant indirect influence on stress through the perception of uncertainty. The model explained 63.0% of decision regret and 20.0% of stress among the participants and showed a good fit with the data, ${\chi}^2=12.40$ (df=8, p=.134), TLI=.97, and RMSEA=.07. Conclusion: Nurses can support family surrogates in end-of-life decision-making processes to decrease their decision regret by providing information about end-of-life care choices, clarifying personal values, and supporting the decision-making process, and to relieve their stress by facilitating the clarification of personal values.
Purpose: The purpose of this descriptive survey study was to characterize the relationship between clinical decision-making and job satisfaction among pediatric nurses and to elucidate the mediating effects of the nurse-parent partnership on that relationship. Methods: The subjects of the study were 174 nurses who had worked in a pediatric ward in a university hospital, general hospital, or children's hospital. Data were collected from June 20, 2016 to August 10, 2016 and analysed using descriptive statistics, the t-test, analysis of variance, the Pearson correlation coefficient, and three-step mediated regression analysis in SPSS version 22.0 for Windows. Results: The nurse-parent partnership had significant effects on clinical decision-making and job satisfaction, with an explanatory power of 19% and 26%, respectively. The nurse-parent partnership had a partial mediating effect on the relationship between clinical decision-making and job satisfaction (Sobel test: Z=4.31, p<.001). Conclusion: The nurse-parent partnership had a partial mediating effect on the relationship between clinical decision-making and job satisfaction among pediatric nurses. Therefore, in order to improve the job satisfaction of pediatric nurses, it is necessary to develop effective educational programs and strategies to address their clinical decision-making and their experiences of the nurse-parent partnership.
Journal of Korean Academy of Nursing Administration
/
v.17
no.4
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pp.443-450
/
2011
Purpose: This study was a descriptive correlation study to increase understanding of, and relationships among critical thinking disposition, clinical decision making and job satisfaction of cancer center nurses. Method: The participants in this study were 150 nurses working in one cancer center located in Gyeonggi Province. The statistic program, SPSS WIN17.0 was used for data analysis and data were analyzed using t-test, ANOVA, and Pearson correlation. Results: The critical thinking disposition of the participants showed statistically significant differences according to areas of practice (F=4.426, p=.005), and current position (F=9.346, p=.000). For clinical decision making of the participants, statistically significant differences were found according to current position (F=10.667, p=.000). Furthermore, for job satisfaction, there were statistically significant differences according to income (F=6.779, p=.002), length of career (F=2.701, p=.033) and current position (F=5.423, p=.005). There were significant positive correlations for critical thinking disposition with clinical decision making, and with job satisfaction. Conclusions: The results of the study indicate that to improve clinical decision making and job satisfaction of cancer center nurses, it is necessary to increase critical thinking disposition. To make this change, appropriate programs are needed to increase critical thinking and clinical decision making of general cancer center nurses.
Journal of Korean Academy of Nursing Administration
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v.20
no.2
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pp.227-236
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2014
Purpose: This study was designed to develop and evaluate the a web-based simulation program on patient rights education using integrated decision making model into values clarification for nurse students. Methods: The program was designed based on the Aless & Trollip model and Ford, Trygstad-Durland & Nelms's decision model. Focus groups interviews, surveys on learning needs for patient rights, and specialist interviews were used to develop for simulation scenarios and decision making modules. The simulation program was evaluated between May, 2011 and April, 2012 by 30 student nurses using an application of the web-based program evaluation tools by Chung. Results: Simulation content was composed of two scenarios on patient rights: the rights of patients with HIV and the rights of psychiatric patients. It was composed of two decision making modules which were established for value clarifications, behavioral objective formations, problems identifications, option generations, alternatives analysis, and decision evaluations. The simulation program was composed of screens for teacher and learner. The program was positively evaluated with a mean score of $3.14{\pm}0.33$. Conclusion: These study results make an important contribution to the application of educational simulation programs for nurse students' behavior and their decision making ability in protecting the patient rights.
Journal of Korean Academy of Nursing Administration
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v.6
no.1
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pp.19-29
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2000
The purpose of this study was to analyze the relationship and the importance of relevant variables among structure, process, and outcome dimensions of nursing department in hospitals. The subject for this study was the registered nurses(N=400) working in medical, intensive care, and surgical units at 5 general hospitals with more than 500beds in Chungnam and Chungbuk. The research design was cross-sectional correlation among the variables based on their self description. The survey instrument was based on eleven structured questionnaires. The data were collected from April 26 to May 26, 1999. The SPSS/PC+ program and LISREL 8.12a program were used to analyze the data. Based on the data collected, the following results were obtained. The relationship among structural, procedural, and outcome dimensions 1. Structural dimension had a relationship with procedural dimension relating to decision-making of caregiving and working conditions, in particular, participation of the problem identification. 2. The extent of participation in decision-making had a relationship with organizational commitment and group effectiveness through the selection process among the total decision-making processes. 3. The structural dimension had a large direct effect rather than indirect effect through decision making processes on organizational commitment and group effectiveness. The relationship of structure, process, outcome dimensions was partially supported by this study. The information obtained from surveys in the field form the basis for the following recommendations for improving organizational effectiveness with in the nursing department in an hospitals. 1) Establishment of decentralized structure, environment, and culture in organizational settings would be desirable so that their members may actively participate in decision-making process. 2) Continuous education and training of nurses with theoretical Knowledge and skill of decision making, practical knowledge, and upright role perception should be highly emphasized for persons in nursing schools and in on-the-job training.
Journal of the Korea Academia-Industrial cooperation Society
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v.17
no.2
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pp.436-445
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2016
This study examined the effects of ego-resilience, critical thinking disposition, and self leadership on the career decision-making self-efficacy among nursing students. Undergraduate nursing students (N=341) were sampled randomly from nursing departments in two cities. Data collection was conducted from May 11 to June 5, 2015. The participants completed a questionnaire assessing the ego-resilience, critical thinking disposition, self leadership, and career decision-making self-efficacy. The data were analyzed with descriptive statistics, t-tests, ANOVAs, Pearson's correlations, and multiple regression. Career decision-making self-efficacy was varied by application motivation, satisfaction with one's major, personality traits, and interpersonal relationship; Self leadership was the most influential factor predicting the career decision-making self-efficacy, followed by critical thinking disposition, and satisfaction with one's major and personality traits. Therefore, these results highlight the need to devise an appropriate program to improve self-leadership and critical thinking, which will contribute to the career-related behaviors of nursing students.
The Journal of the Convergence on Culture Technology
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v.9
no.5
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pp.885-896
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2023
This study attempted to identify the relationship between nursing students' adjustment to college life, stress, and major satisfaction, and to identify the factors that affect career decision-making self-efficacy. The study included 298 nursing students from two universities in the region, and data collection was conducted from April 24 to May 9, 2023. Results, It showed a significant negative correlation between college adjustment and stress, and it was found that there was a significant positive correlation between major satisfaction and career decision-making self-efficacy. Major satisfaction was the predictor variable that had the greatest impact on career decision-making self-efficacy, and the explanatory power was found to be 44.8%. This shows that nursing students with high self-efficacy are satisfied with their majors and adapt well to university life if they choose nursing studies. Therefore, there is a need to develop various career exploration and career education programs to enhance career decision-making self-efficacy.
The Journal of Korean Academic Society of Nursing Education
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v.8
no.1
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pp.51-60
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2002
The purpose of this study was to identify the relationship between self-esteem, self- efficacy and clinical practice performance, academic achievement, decision making of major field in clinical practice . The study subjects consisted with 244 students from G. junior nursing college that will adapt a new majoring program of clinical nursing practice funded by Ministry of human and resources development. Data were analyzed using descriptive statistics, and t-test, Pearson correlation, and multiple regression. The results of this study were summarized as follows: 1. The students were relatively performed well in clinical practice setting (total M :3.78). The item of student's personal relationship between patients, patient's family, and professional staff showed high score (M=3.96). However students did not feel comfortable to communicate with patients, patient's family and professional staffs in clinical setting(mean=3.56). 2. Students who had experiences of temporal absence from school showed significant difference in the variable of academic achievement and decision making of major field in clinical practice Students who entered to nursing school with self-motive revealed statistically significant difference in the variable of clinical practice performance, academic achievement, self-esteem, self-efficacy, and decision making of major field in clinical practice. 3. There was a significant correlation between self-esteem and clinical practice performance, (r=.512, p<.000). And the relation between self-esteem and decision making of major field in clinical practice was significantly correlated(r=.377, p<.000). Self-efficacy and clinical practice performance(r=.567, p<.000), and decision making of major field in clinical practice (r=.441, p<.000) showed significant correlations. Also relation between academic achievement and self-esteem reveled a significant correlation(r=.129, p<.05) but correlation between self-efficacy and academic achievement was not significant. 4. Correlation between clinical practice performance and decision making of major field in clinical practice also identified a significant relation(r=.498, p<.000). 5. Self-esteem and self-efficacy variables predicted clinical practice performance and explained 37.7% of clinical practice performance. 6. Aptitude and personal interests(m=4.07) reveled important factor affecting to select majoring area in clinical practice, and advice from parents reflected low percentage on selecting places(m=2.42). In conclusion, the variables of self-esteem and self-efficacy showed significant correlations with the variables of student's clinical practice performance, academic achievement, and decision making of major field in clinical practice. Thus it is recommended that student's affective domain of self-esteem and self-efficacy should be developed by nursing intervention before clinical nursing education.
Journal of Korean Academy of Nursing Administration
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v.7
no.2
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pp.301-314
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2001
The main purpose of this research is to describe comprehensively the processes of clinical decision making in novice critical care nurses through clinical experience. This research was an exploratory, longitudinal study using a fieldwork approach incorporating "think-aloud" method and in-depth interviews with the study participants. The study participants consisted of 5 novice nurses assigned to critical care units at a tertiary medical center located in Seoul, among a group of 27 novice nurses who started at the same period at this hospital. The data were collected from March 1999 to April 2000. The major findings of the study is that the novice nurses followed the analytic linear model of clinical decision making in the beginning, but were changed increasingly to follow the comprehensive, integrated model of clinical decision making. Through repeated experience that resulted in increasing repertoire of clinical schema and familiarity of task environments of clinical practice the novice nurses expanded their ability to arrive at comprehensive integration of information and to arrive at accurate and time-efficient decisions. Both the analytic, linear model mostly used at the beginning period and the comprehensive, integrated model that seems to be the mode significantly dependent upon experience seem to have strengths and weaknesses as decision making processes in clinical situations. Hence, it is imperative to develop an effective orientation and training program for novice nurses through the use of clinical preceptors. In addition, students should be exposed to the process of clinical decision making early in their nursing education through an appropriate clinical experiences and clinical assignments.
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