When embarking on the task of identifying scholarly articles for school work, it’s crucial to adopt a systematic approach to ensure the selection of reliable and authoritative sources. One of the primary strategies is to utilize academic databases such as CINAHL, PubMed, or Google Scholar, which house extensive collections of scholarly articles across various disciplines. By inputting specific keywords related to your topic of interest and employing Boolean operators to refine searches, you can narrow down results to find relevant articles. Once you’ve retrieved a list of potential articles, it’s essential to scrutinize them for credibility.
Look for articles published in peer-reviewed journals, as this indicates that the research has undergone rigorous evaluation by experts in the field. Pay attention to the credentials of the authors, affiliations, and previous publications to assess their expertise and authority on the subject matter. Additionally, reviewing abstracts and keywords provides insight into the study’s objectives, methods, and findings. It’s also crucial to consider the publication dates of the articles, as newer research often reflects the most current developments and findings in the field. Furthermore, checking for reviews or citations of the article by other scholars can help gauge its significance and impact within the academic community. Finally, ensure that you have access to the full text of the selected articles and keep track of your sources using citation management tools to facilitate proper referencing and citation in your school work. By following these steps, you can effectively identify scholarly articles that contribute to the quality and credibility of your academic research.
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Evidence-based practice (EBP) is essential for providing high-quality, safe patient care in nursing. To prepare future nurses to engage in EBP, nursing education programs must utilize evidence-based teaching strategies that effectively develop students’ EBP knowledge and skills. This paper examines current evidence on effective teaching approaches for promoting EBP competencies in pre-licensure nursing students.
Interactive Teaching Strategies
Research indicates that interactive, student-centered teaching methods are more effective than traditional lecture-based approaches for developing EBP skills. Several studies have found that problem-based learning, small group work, and flipped classroom models enhance students’ abilities to formulate clinical questions, search for evidence, and critically appraise research (Horntvedt et al., 2018; Culyer et al., 2018). These interactive strategies allow students to actively engage with EBP concepts and apply them to clinical scenarios.
Simulation and clinical integration are also valuable for bridging the gap between EBP theory and practice. Studies show that incorporating EBP activities into simulation experiences and clinical rotations improves students’ confidence in implementing evidence-based interventions (Estalella et al., 2023). Having students present evidence-based recommendations in simulated clinical settings can reinforce EBP skills in a low-stakes environment. Examples of some active learning exercises could include
Think-Pair-Share:
Pose an open-ended question
Give students 1-2 minutes to think and write a response individually
Have students pair up to discuss their responses
Call on pairs to share with the whole class
One Minute Paper:
At the end of class, ask students to write brief response to one question like: “What are the two most important points from today’s session?” “What was the muddiest (least clear) point?”
Collect responses anonymously as students leave
Address key points in the next class
Peer Instruction:
Pose a conceptual question
Have students answer individually (can use clickers)
Have students discuss in pairs and try to convince each other
Have students answer again after discussion
Small Group Activities:
Break class into small groups (3-4 students)
Give groups a problem or question to discuss/solve
Have groups report back to the class
Jigsaw:
Divide a topic into smaller “pieces”
Assign each student/group to become an expert on one piece
Have students teach their piece to others
3-2-1:
Have students write down: 3 things they learned 2 things they found interesting 1 question they still have
Four Corners:
Post a question/statement in each corner of the room
Have students move to the corner that matches their view
Discuss within corner groups
Muddiest Point:
Have students identify the most confusing or unclear point from the lesson
You can follow up to clarify questions
via email
via LMS system announcement
via start of next class
Note-Sharing:
Have students pair up to compare and discuss their notes
Write down confusing questions as they go
via email
via LMS system announcement
via start of next class
Minute Paper:
Give students 1 minute to write on a specific prompt or question
Collect as students leave the room
Technology-Enhanced Learning (TEL)
Online and blended learning approaches show promise for teaching EBP. Asynchronous online modules, virtual simulations, and interactive e-learning tools can effectively deliver EBP content and allow for self-paced learning (Patelarou et al., 2020). These technology-enhanced methods may be particularly useful for teaching information literacy skills like database searching and critical appraisal of research.
TEL refers to the implementation of technology into teaching methods to enhance the learning process. It primarily involves digital technologies, though some analog technologies may be included. Enables self-paced learning by providing greater access to resources (e-books, video tutorials, etc.), allowing for more interactive and engaging content, supporting different learning styles, and facilitating real-time interaction through livestreaming. Some examples of TEL include E-books, digital devices (computers, tablets, smartphones), gamification of learning, livestream learning platforms, video and audio tools, social media for education, virtual and augmented reality, and artificial intelligence in education.
It is important for faculty to use TEL in that is aligned with the students’ technology skill level. TEL prepares students for a technology driven world which can be used in both remote and hybrid learning models. TEL also helps to improve student engagement, especially with students who are more introverted in the class room setting. TEL also provides more resources for teachers and students.
Faculty do need to be aware of several strategies when implementing TEL so that deployment goes smoothly. Faculty may want to use digital course materials, textbook, applications, and resources. It is important to optimize all content for mobile access such as cell phones or tablets. Design activities that prioritize interaction and clinical judgment over just content delivery. Overall, TEL is seen as increasingly essential in modern education, offering numerous benefits when implemented thoughtfully and effectively.
Applications that I have found to be particularly effective in either the classroom setting or in an online format. Remember that new applications are being created all of the time.
Kritik – create individual or group assignments, ensure peer reviewing occurs in an appropriate manner, this application grades student work for you and uploads to many LMS system.
Padlet – Digital canvases for whiteboards, lessons, and activities.
Packback – Engage curiosity, increase motivation, build community, and support writing practice with our award-winning student discussion platform with built-in AI coaching that helps students develop better questions and responses. Packback also improves student writing skills and confidence on written assignments through instant AI-powered coaching. Streamline the grading of writing assignments through an AI grading assistant that is tied to your specific rubric.
Nearpod – There’s a reason why Nearpod is so popular; it works. I’ve never met a teacher who didn’t like using it because it takes what you already have (Google Slides, Powerpoint, YouTube Video) and makes it interactive. From polls to game-based quizzes, virtual reality, and simulations, there are so many ways to bring your students from passive recipients to active learners.
Kahoot – Quizzing and fun activities to promote learning
GoNoodle – Get up and move activities. Some of these may be for younger than college age students, but there are many that will still work this this age group too.
Prezi – Presentations are a core part of the curriculum, but let’s face it, PowerPoint isn’t terribly engaging. Prezi allows students to create presentations that are more creative and exciting than what PP has to offer. Not only will this make the presentation creation process more interesting for students, but it will also make watching presentations more interesting. Prezi presentations are published publicly on students’ accounts, so their classmates can access them later to check their notes.
Factile – A Jeopardy platform that is fun to play.
Gimkit – Gameshow platform for learning and fun activities.
Flip – Flip (formerly Flipgrid) is a social media–style video discussion platform great for generating class discussion around topics, videos, or links posted to the class grid. Students can video-record their responses to share with the teacher or class. It’s a great tool for supporting your students to make their thinking visible.
Mentimeter – Mentimeter lets you add polls, word clouds, Q&As, and more to presentations and create an interactive experience for students, who can vote on/respond to questions and engage with the presentation in real time. This made our list because there’s so much variety in the types of formative assessments you can give in real time.
Jamboard – Jamboard is a digital whiteboard that is compatible with Google Workspace (formerly G Suite) services. It’s a game changer for emphasizing the process of learning over the product. Math teachers love how students solve and explain their solution. If you don’t use Google, Padlet is our runner-up.
Reflective Practice
Reflective practice is a systematic approach to continuous learning and professional development that involves critically examining one’s own experiences, actions, and decisions. It is the ability to reflect on one’s actions to engage in a process of ongoing learning and improvement. This concept, popularized by Donald Schön in the 1980s, has become integral to many professional fields, including education, healthcare, social work, and business.
At its core, reflective practice involves thoughtfully considering one’s experiences, analyzing them, and using the insights gained to inform future actions. It goes beyond simply thinking about past events; it requires a deliberate and structured approach to examining one’s thoughts, feelings, and behaviors in various situations. This process allows practitioners to identify areas for improvement, challenge their assumptions, and develop new strategies for handling similar situations in the future.
Reflective practice can take many forms, including reflection-in-action (thinking on your feet during an experience) and reflection-on-action (analyzing an experience after it has occurred). It often involves asking critical questions about one’s practice, such as “What worked well?”, “What could I have done differently?”, and “How does this experience align with my theoretical knowledge?” Practitioners may use various tools to facilitate reflection, such as journaling, peer discussions, mentoring sessions, or structured frameworks like Gibbs’ Reflective Cycle.
The benefits of reflective practice are numerous. It can lead to improved self-awareness, enhanced problem-solving skills, and a deeper understanding of one’s professional role and responsibilities. It also promotes continuous learning and adaptation, helping professionals stay current in their field and respond effectively to new challenges. In educational settings, reflective practice can improve teaching methods and student outcomes. In healthcare, it can lead to better patient care and safety.
However, effective reflective practice requires certain skills and attitudes. These include open-mindedness, self-awareness, critical thinking, and a willingness to question one’s own assumptions and practices. It also requires time and commitment, as meaningful reflection often involves deep thinking and analysis that cannot be rushed.
Scaffolded Approach
A scaffolded approach to teaching involves providing temporary, structured support to students as they learn new concepts or skills, gradually removing that support as students gain mastery. To implement scaffolding effectively, start by assessing students’ current knowledge and skills to determine their starting point. Then, break down complex tasks or concepts into smaller, more manageable steps. Begin by modeling the task or concept for students, clearly demonstrating each step and explaining your thought process. Next, guide students through the process together as a class, encouraging participation and providing immediate feedback. As students become more comfortable, transition to having them work in small groups or pairs, offering support as needed. Finally, allow students to work independently, stepping in only when necessary.
Throughout this process, use various scaffolding techniques such as visual aids, graphic organizers, or think-alouds to support learning. Provide clear instructions and expectations, using rubrics or checklists to help students understand the goals. Offer frequent opportunities for practice and feedback, gradually increasing the complexity of tasks as students progress. Be prepared to adjust the level of support based on individual student needs, providing more assistance to struggling students and challenging advanced learners with extension activities.
As students demonstrate proficiency, begin to remove scaffolds gradually, encouraging them to take more responsibility for their learning. This might involve reducing the amount of guidance provided, asking students to explain their thought processes, or having them teach concepts to peers. Remember that scaffolding is a flexible process, and you may need to reintroduce support if students encounter difficulties with new applications of the skill or concept. By using a scaffolded approach, you can help students build confidence, develop independence, and achieve higher levels of understanding and performance.
Interprofessional Collaboration
Interprofessional collaboration significantly enhances the educational experience by fostering a comprehensive and integrated approach to learning. This collaborative model brings together students and professionals from various healthcare disciplines, creating an environment that mirrors real-world healthcare settings. By learning alongside peers from different fields, students gain a deeper understanding of the roles, responsibilities, and expertise of other healthcare professionals. This exposure helps break down silos between disciplines and promotes a team-based approach to patient care.The collaborative learning environment encourages students to develop crucial skills such as effective communication, conflict resolution, and shared decision-making. Through interprofessional education activities like case studies, simulations, and group projects, students learn to articulate their professional perspectives while also valuing and incorporating insights from other disciplines. This process enhances critical thinking and problem-solving skills as students tackle complex healthcare scenarios from multiple angles.
Moreover, interprofessional collaboration in education prepares students for the realities of modern healthcare delivery. It helps them understand the importance of coordinated care plans and how different professionals contribute to holistic patient assessment and treatment. Students also develop a broader perspective on healthcare challenges and solutions, fostering adaptability and lifelong learning attitudes essential in the ever-evolving healthcare landscape.
The benefits extend beyond skill development. Interprofessional education cultivates mutual respect and appreciation for diverse expertise among future healthcare professionals. It builds professional relationships across disciplines, creating networks that can be valuable throughout their careers. This collaborative approach also aligns with the growing emphasis on patient-centered care, teaching students to work together towards common goals that prioritize patient outcomes.
By participating in interprofessional education, students are better prepared to enter the workforce as effective team members. They develop a more comprehensive understanding of healthcare systems and how different professionals can work together to improve patient safety, reduce errors, and enhance overall care quality. This experience not only enriches their educational journey but also equips them with the collaborative skills and mindset necessary for success in modern healthcare environments.
Faculty Development
Lifelong learning and faculty development are crucial components in teaching nursing using evidence-based practice (EBP) guidelines. As healthcare continues to evolve rapidly, nursing educators must stay current with the latest research, best practices, and technological advancements to provide the highest quality education to their students. Engaging in lifelong learning allows faculty to continually update their knowledge base, refine their teaching strategies, and model the importance of ongoing professional development for their students. This commitment to continuous learning ensures that nursing education remains relevant, effective, and aligned with the ever-changing healthcare landscape.Faculty development programs play a vital role in supporting educators in their lifelong learning journey and in implementing EBP guidelines effectively in their teaching. These programs provide opportunities for nursing faculty to enhance their pedagogical skills, learn new teaching methodologies, and stay informed about the latest developments in nursing research and practice. Through workshops, seminars, and collaborative learning experiences, faculty can develop expertise in integrating EBP into their curriculum, fostering critical thinking skills in students, and utilizing innovative teaching technologies. Additionally, faculty development initiatives often focus on enhancing skills in research methodology, grant writing, and scholarly publication, which are essential for advancing the field of nursing education and contributing to the body of evidence that informs EBP guidelines.
The integration of EBP guidelines in nursing education requires faculty to not only understand the guidelines themselves but also to develop effective strategies for teaching students how to apply these guidelines in clinical practice. This necessitates a deep understanding of both the content and the pedagogical approaches that best facilitate learning and application of EBP. Through ongoing learning and development, faculty can refine their ability to bridge the gap between theoretical knowledge and practical application, ensuring that students are well-prepared to deliver evidence-based care in their future nursing careers.
Moreover, lifelong learning and faculty development foster a culture of inquiry and innovation within nursing education programs. This culture encourages educators to critically evaluate their teaching practices, seek out new evidence to inform their instruction, and collaborate with colleagues to develop and implement best practices in nursing education. By embracing lifelong learning and participating in faculty development initiatives, nursing educators demonstrate to their students the importance of continuous professional growth and the value of evidence-based practice in delivering high-quality patient care.
Conclusion
Implementing evidence-based teaching strategies is crucial for developing strong EBP competencies in pre-licensure nursing students. Interactive, technology-enhanced, and reflective approaches show the most promise based on current research. A scaffolded curriculum that progressively builds EBP skills and incorporates interprofessional experiences can effectively prepare students for evidence-based nursing practice. Ongoing research is needed to continue refining optimal teaching methods as both nursing practice and educational technologies evolve.
References
Culyer, L. M., Jatulis, L., Cannistraci, P., & Brownell, C. A. (2018). Evidenced-based teaching strategies that facilitate transfer of knowledge between theory and practice: What are nursing faculty using?. Teaching and Learning in Nursing, 13(3), 174-179.
Estalella, I., Román, Ó., Reichenberger, T. N., Larrea, I., Garate-Echenique, L., & Juvé-Udina, M. E. (2023). Impact of a teaching strategy to promote evidence-based practice on nursing students’ knowledge and confidence in simulated clinical intervention choices. BMC nursing, 22(1), 1-11.
Horntvedt, M. E. T., Nordsteien, A., Fermann, T., & Severinsson, E. (2018). Strategies for teaching evidence-based practice in nursing education: a thematic literature review. BMC medical education, 18(1), 1-11.
Patelarou, A. E., Mechili, E. A., Ruzafa-Martinez, M., Dolezel, J., Gotlib, J., Skela-Savič, B., … & Patelarou, E. (2020). Educational interventions for teaching evidence-based practice to undergraduate nursing students: A scoping review. International journal of environmental research and public health, 17(17), 6351.
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The Site may contain (or you may be sent through the Site) links to other websites or content belonging to or originating from third parties or links to websites and features in banners or other advertising. Such external links are not investigated, monitored, or checked for accuracy, adequacy, validity, reliability, availability, or completeness by us. WE DO NOT WARRANT, ENDORSE, GUARANTEE, OR ASSUME RESPONSIBILITY FOR THE ACCURACY OR RELIABILITY OF ANY INFORMATION OFFERED BY THIRD-PARTY WEBSITES LINKED THROUGH THE SITE OR ANY WEBSITE OR FEATURE LINKED IN ANY BANNER OR OTHER ADVERTISING. WE WILL NOT BE A PARTY TO OR IN ANY WAY BE RESPONSIBLE FOR MONITORING ANY TRANSACTION BETWEEN YOU AND THIRD-PARTY PROVIDERS OF PRODUCTS OR SERVICES.
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The Site cannot and does not contain medical/health advice. The medical/health information is provided for general informational and educational purposes only and is not a substitute for professional advice. Accordingly, before taking any actions based upon such information, we encourage you to consult with the appropriate professionals. We do not provide any kind of medical/health advice. THE USE OR RELIANCE OF ANY INFORMATION CONTAINED ON THE SITE IS SOLELY AT YOUR OWN RISK.
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The Site may contain links to affiliate websites, and we receive an affiliate commission for any purchases made by you on the affiliate website using such links.
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Clinical reasoning is a fundamental process used by healthcare professionals, including doctors, nurses, and other medical practitioners, to analyze patient information, make diagnoses, and develop treatment plans. It involves critical thinking, problem-solving, and the application of medical knowledge to provide the best possible care to patients. Here are the basics of clinical reasoning:
Data Gathering: The first step in clinical reasoning is gathering relevant information about the patient’s medical history, symptoms, physical examination findings, and any diagnostic test results. This process involves active listening, effective communication with the patient, and using appropriate questioning techniques.
Recognizing Patterns: Healthcare professionals must recognize patterns and identify potential relationships between the patient’s signs and symptoms. This involves comparing the patient’s presentation to known medical conditions and recognizing typical and atypical presentations.
"Clinical reasoning is the cognitive processing and decision-making surrounding healthcare practice" Thiani & Mershen (2023)
Generate Hypotheses: Based on the gathered data and pattern recognition, clinicians generate possible diagnoses or hypotheses. These hypotheses guide further investigation and are essential for the diagnostic process.
Differential Diagnosis: Healthcare professionals consider a list of potential diagnoses, known as a differential diagnosis. This list ranks possible explanations for the patient’s condition from most to least likely based on available evidence.
Prioritization: After generating a differential diagnosis, clinicians prioritize the potential conditions based on their severity, urgency, and impact on the patient’s health. This helps in identifying the most critical issues that need immediate attention.
Further Testing: To confirm or rule out the hypotheses, additional diagnostic tests or examinations may be ordered. These tests could include laboratory tests, imaging studies, or consultations with other specialists.
Evaluation: The results of the tests are evaluated, and clinicians compare them to the expected findings for each potential diagnosis. This evaluation helps in refining the differential diagnosis and narrowing down the possible conditions.
Diagnosis: Using all available information, including the patient’s history, examination findings, test results, and clinical expertise, the healthcare professional arrives at a final diagnosis. This is the identification of the underlying medical condition responsible for the patient’s symptoms.
Treatment Plan: Once the diagnosis is established, a treatment plan is developed. This may include medications, procedures, lifestyle changes, or referrals to specialists for further management.
Monitoring and Reevaluation: Healthcare professionals continuously monitor the patient’s response to treatment and adjust the management plan as needed. Reevaluation is crucial if the patient’s condition changes or if new information becomes available.
Reflection and Learning: Clinical reasoning is an ongoing process, and healthcare professionals reflect on their decisions and outcomes to learn and improve their skills continuously.
Clinical reasoning requires a balance between theoretical medical knowledge, practical experience, and critical thinking skills. It is an essential aspect of providing high-quality and patient-centered care in the medical field.
References
Pillay, T., & Pillay, M. (2023). The power struggle: exploring the reality of clinical reasoning. Health: An Interdisciplinary Journal for the Social Study of Health, Illness & Medicine, 27(4), 559–587. https://doi-org.proxy.mul.missouri.edu/10.1177/13634593211054008
Trinidad, D. R., & Wung, S.-F. (2023). Excellence via Strategic Experiential Learning (ExSEL): A Continuous Improvement Project for Developing Clinical Reasoning and Management. Clinical Simulation in Nursing, 81, N.PAG. https://doi-org.proxy.mul.missouri.edu/10.1016/j.ecns.2023.05.003
van Sassen, C. G. M., van den Berg, P. J., Mamede, S., Knol, L., Eikens-Jansen, M. P., van den Broek, W. W., Bindels, P. J. E., & Zwaan, L. (2023). Identifying and prioritizing educational content from a malpractice claims database for clinical reasoning education in the vocational training of general practitioners. Advances in Health Sciences Education, 28(3), 893–910. https://doi-org.proxy.mul.missouri.edu/10.1007/s10459-022-10194-8
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Nursing is a highly sought-after career choice today. Nurses are in very high demand and the nursing shortage makes that demand even higher. Students, practicing nurses, and educators may find the following resources useful. Check them out.
The Health Resources and Services Administration, or HRSA, is working to ensure that everyone has access to a broad spectrum of public health services. HRSA programs provide equitable health care to people who are geographically isolated and economically or medically vulnerable. This includes programs that deliver health services to people with HIV, pregnant people, mothers, and their families, those with low incomes, residents of rural areas, American Indians, Alaska Natives, and those otherwise unable to access high-quality health care. HRSA programs also support health infrastructure, including training health professionals and distributing them to areas where they are needed most, providing financial support to health care providers, and advancing telehealth. In addition, HRSA oversees programs for providing discounts on prescription drugs to safety net providers, facilitating organ, bone marrow, and cord blood transplantation, compensating individuals injured by a vaccination, and maintaining data on healthcare malpractice payments.
Nurse Tim is an online platform for nursing educators. Nurse Tim offers webinars, conferences, consultations, and a blog for answering common questions. Nurse Tim has created NurseThink which provides resources for testing, simulations, and NextGen NCLEX writing, among other resources. Educational resources on teaching clinical judgment and reasoning are of high priority. Many institutions use Nurse Tim’s resources to help them frame their courses.
The Learning Nurse Resources Network is an online professional development center for nurses. This is a great website that provides independent, safe, free resources. To maintain and continue education for nurses, the website is divided into three main sections: an assessment section, an e-learning section, and a library.
The assessment portion of the website is filled with apps, quizzes, and nursing games for students. Helping students to locate the gaps in their knowledge allows them to study more effectively.
The Educational Resource Center of the American Nurses Association (ANA) is a portal focused on providing continuing nursing learning resources. This organization provides numerous fact sheets and tips covering topics relevant to the nursing profession. The ANA is working to make the Education Resource Center a go-to repository for information regarding nursing education.
This website provides links to a multitude of resources for nurses including lists of e-books, other nursing websites, dissertations, anatomy resources, and much more. The site itself is a great jumping-off point for nurses looking to build up online nursing resources. Furthermore, the Nursing and Allied Health Resources section has links to style and plagiarism guides, powerful tools for those that have not written papers.
The anatomy resources page provides connections to online activities and nursing games, compiling some of the most interesting videos and studies from a wide range of universities and higher education institutions. There is also a compilation of medical databases.
The Nurse.com website includes educational and professional advice and career resources. Nurse.com is consistently an innovative space for nurses to develop professionally, learn field-relevant skills and read compelling news.
Resources include several financial aid links and resources. The student news section allows you to hear from students, their experiences, and best practices. For anyone who is currently working as a nurse, or for those who are looking to go back to school and continue their nursing education, these online professional resources can be extremely important to help you continue your learning and growth opportunities.
Keith, a Ph.D.-prepared nursing educator, is driven by a passion to help educators and students in learning clinical judgment. He has developed a series of textbooks, and case studies to help develop these clinical reasoning skills. Keith offers resources in both free and paid versions. These case studies and other materials are key to advancing the clinical judgment of our students.
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The Site may contain (or you may be sent through the Site) links to other websites or content belonging to or originating from third parties or links to websites and features in banners or other advertising. Such external links are not investigated, monitored, or checked for accuracy, adequacy, validity, reliability, availability, or completeness by us. WE DO NOT WARRANT, ENDORSE, GUARANTEE, OR ASSUME RESPONSIBILITY FOR THE ACCURACY OR RELIABILITY OF ANY INFORMATION OFFERED BY THIRD-PARTY WEBSITES LINKED THROUGH THE SITE OR ANY WEBSITE OR FEATURE LINKED IN ANY BANNER OR OTHER ADVERTISING. WE WILL NOT BE A PARTY TO OR IN ANY WAY BE RESPONSIBLE FOR MONITORING ANY TRANSACTION BETWEEN YOU AND THIRD-PARTY PROVIDERS OF PRODUCTS OR SERVICES.
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As a nursing instructor, using effective questioning techniques can significantly enhance students’ clinical judgment skills. Thoughtful and strategic questioning encourages critical thinking, reflection, and the application of theoretical knowledge to real-world patient care scenarios. Here are some strategies to use questioning effectively in nursing education to improve students’ clinical judgment:
Open-Ended Questions: Encourage students to think deeply and critically by asking open-ended questions. These questions do not have a single right answer and require students to explore different perspectives and possibilities. For example, instead of asking, “What is the correct nursing intervention for this patient?” ask, “How would you approach this patient’s care, considering their current condition and medical history?”
Case-Based Questions: Present students with real or hypothetical patient cases and ask them to analyze the situation and propose appropriate nursing interventions. Discuss the rationale behind their choices and encourage them to consider potential outcomes and complications.
Socratic Questioning: Use the Socratic method to guide students through a series of thought-provoking questions that lead them to arrive at conclusions independently. This approach helps students develop their critical thinking abilities and enhances their clinical judgment skills.
Why-How-What Approach: When discussing patient care plans or clinical decisions, follow the “why-how-what” approach. Start by asking why a specific intervention is chosen, then explore how it will be implemented, and finally, discuss what outcomes are expected. This method encourages students to consider the rationale behind their actions and the impact on patient care.
Predicting and Evaluating Outcomes: Encourage students to predict potential patient outcomes based on their proposed interventions. Ask follow-up questions to explore the possible positive and negative consequences of their decisions. This exercise helps students connect their actions to patient well-being and safety.
Reflective Questions: After clinical experiences, simulations, or case studies, use reflective questions to help students assess their performance and clinical judgment. Ask them to identify what went well, what challenges they faced, and how they could improve their decision-making in similar situations.
Ethical Dilemmas: Present students with ethical dilemmas commonly encountered in nursing practice. Engage them in discussions about how their clinical judgment and decision-making process may be influenced by ethical considerations.
Group Discussions and Peer Learning: Encourage group discussions where students can share their perspectives and learn from each other. Peer learning fosters collaboration and exposes students to diverse viewpoints, enriching their clinical judgment abilities.
Real-Time Decision-Making: During clinical rotations, challenge students to think on their feet by asking questions about patient care in real-time. This exercise simulates the fast-paced nature of nursing practice and helps students develop quick and effective clinical judgment.
Feedback and Follow-up: Provide constructive feedback on students’ responses to questions and track their progress over time. Follow up on previous discussions to reinforce learning and allow students to demonstrate how they have integrated feedback into their clinical judgment process.
Examples of Questions you can Ask to Help Students with Clinical Judgment
“How would you prioritize the nursing interventions for this patient, considering their current condition and medical history?”
“What are some potential factors that could be contributing to this patient’s symptoms, and how would you go about further assessing them?”
“Describe your thought process when determining whether to escalate care for a patient who is showing signs of deterioration.”
“In this patient scenario, what are some alternative approaches you could consider for pain management, and how would you decide which one to implement?”
“Imagine you encounter a patient whose cultural beliefs differ significantly from your own. How would you approach providing patient-centered care while respecting their cultural preferences?”
“When dealing with a complex wound, how do you decide on the most appropriate dressing and wound care regimen for the patient?”
“Describe the steps you would take to ensure medication safety when administering high-risk medications to multiple patients simultaneously.”
“In a situation where a patient’s values and preferences conflict with the treatment plan, how would you handle the ethical dilemma?”
“What information would you seek from the patient and their family to better understand their psychosocial needs and support systems?”
“Discuss your approach to gathering evidence-based practice resources when facing a new and unfamiliar patient condition.”
“How would you adapt your communication style when providing education to a patient with limited health literacy?”
“When preparing for a patient handoff, what critical information would you include to ensure continuity of care?”
“In a rapidly changing clinical situation, how do you maintain situational awareness and make swift but informed decisions?”
“When encountering a potential medication error, what immediate actions would you take, and how would you prevent similar incidents in the future?”
“Explain how you would assess the effectiveness of a patient’s treatment plan and modify it based on their progress.”
If you implement this specific nursing intervention for the patient, what are the potential short-term and long-term outcomes you would expect to see?”
“What are some of the potential complications that could arise from the medication regimen you’ve suggested, and how would you monitor the patient for these adverse effects?”
“Based on the patient’s current condition and response to treatment, what do you anticipate will be the next steps in their care plan?”
“Imagine the patient’s family has concerns about the proposed surgical procedure. How would you address their fears and help them understand the potential benefits and risks involved?”
“Considering the patient’s comorbidities and medications, what potential drug interactions should you be vigilant about when adding a new medication to their regimen?”
“If you choose not to intervene in this particular patient case, what are the potential implications for the patient’s health and well-being?”
“You’ve administered a potent pain medication to a post-operative patient. How would you evaluate its effectiveness, and what alternative pain management strategies might you consider if the patient’s pain persists?”
“The patient is refusing a crucial diagnostic test. What are the possible outcomes of this decision, and how would you approach this situation to ensure the patient receives appropriate care?”
“Considering the patient’s age and underlying health conditions, how might their recovery differ from a younger patient with a similar diagnosis?”
“The patient’s lab results show abnormalities in their liver function. What implications might this have for their medication management and overall treatment plan?”
“You suspect the patient is experiencing a medication side effect not previously documented. How would you further investigate this, and what steps would you take to prevent further complications?”
“You’re planning to discharge the patient with a chronic condition. How would you assess their readiness for self-care management, and what could happen if they struggle to adhere to their treatment plan?”
“If you decide to use an alternative communication approach with a non-responsive patient, how would you evaluate the effectiveness of this intervention?”
“The patient’s vital signs indicate a subtle decline in their condition. What actions would you take immediately, and what outcomes are you hoping to achieve by intervening promptly?”
“You suspect the patient may be experiencing a psychological response to their diagnosis. How might addressing their emotional well-being impact their overall recovery and treatment outcomes?”
Remember that the goal of questioning in nursing education is not just to test students’ knowledge but to guide them in developing their clinical judgment skills. Creating a supportive and inquisitive learning environment empowers students to think critically and make sound decisions that positively impact patient outcomes.
References
Craig, J. L., & Page, G. (1981). The questioning skills of nursing instructors. Journal of Nursing Education, 20(5), 18-23.
Merisier, S., Larue, C., & Boyer, L. (2018). How does questioning influence nursing students’ clinical reasoning in problem-based learning? A scoping review. Nurse education today, 65, 108-115.
Nicholl, H. M., & Tracey, C. A. (2007). Questioning: a tool in the nurse educator’s kit. Nurse education in practice, 7(5), 285-292.
Saeed, T., Khan, S., Ahmed, A., Gul, R., Cassum, S. H., & Parpio, Y. (2012). Development of students’ critical thinking: the educators’ ability to use questioning skills in the baccalaureate programmes in nursing in Pakistan. JPMA. The Journal of the Pakistan Medical Association, 62(3), 200.
Problem-Based Learning (PBL) is an instructional approach that focuses on engaging students in solving real-world problems or complex scenarios. It is a student-centered, active learning methodology that promotes critical thinking, problem-solving skills, collaboration, and self-directed learning. Here are the key features and benefits of Problem-Based Learning:
Key Features of Problem-Based Learning:
Real-world problems: PBL presents students with authentic, open-ended, and complex problems that reflect real-world situations. These problems are often multidisciplinary and require students to integrate knowledge from various subjects to find solutions.
Student-centered approach: PBL places students at the center of the learning process. Instead of passive recipients of information, students become active participants who drive their learning by identifying knowledge gaps, conducting research, and seeking solutions.
Collaboration and teamwork: PBL encourages collaborative learning and teamwork. Students work in small groups, sharing ideas, perspectives, and expertise to analyze problems, develop strategies, and reach consensus on potential solutions. Collaboration enhances communication, interpersonal skills, and the ability to work effectively in a team.
Problem-solving skills: PBL emphasizes the development of critical thinking and problem-solving skills. Students learn to analyze complex problems, break them down into manageable components, identify relevant information, and propose solutions based on logical reasoning and evidence.
Self-directed learning: PBL fosters self-directed learning skills. Students take responsibility for their learning process, set learning goals, conduct independent research, and explore resources to acquire the necessary knowledge and skills to address the problem at hand.
Facilitator role of the teacher: In PBL, the teacher takes on the role of a facilitator or a guide rather than a lecturer. The teacher provides support, guidance, and resources to help students navigate the problem-solving process, clarify concepts, and develop critical thinking abilities.
Benefits of Problem-Based Learning:
Active engagement: PBL promotes active engagement and deep learning. Students are actively involved in problem analysis, research, information synthesis, and the application of knowledge to propose solutions. This hands-on approach increases student motivation and interest in the subject matter.
Application of knowledge: PBL allows students to apply theoretical concepts to real-world situations, making the learning experience more meaningful and relevant. It helps students bridge the gap between theory and practice, enhancing their understanding and retention of knowledge.
Critical thinking and problem-solving skills: PBL cultivates critical thinking skills, such as analyzing, evaluating, and synthesizing information, as well as problem-solving skills, including generating creative solutions and making informed decisions. These skills are transferable and valuable beyond the classroom.
Collaboration and communication skills: PBL encourages collaboration, effective communication, and teamwork. Students learn to work cooperatively, respect diverse perspectives, and effectively communicate their ideas, fostering interpersonal skills essential for future professional and personal contexts.
Self-directed and lifelong learning: PBL nurtures self-directed learning skills, including research, information literacy, and the ability to set and achieve learning goals. These skills prepare students for lifelong learning, enabling them to adapt to new challenges and acquire knowledge independently.
Higher-order thinking: PBL promotes higher-order thinking skills, such as analysis, synthesis, evaluation, and application. Students engage in complex problem-solving, requiring them to think critically, make connections across disciplines, and demonstrate a deeper understanding of the subject matter.
Long-term retention: Due to the active and contextual nature of PBL, students often retain knowledge and skills acquired through problem-solving experiences for longer periods. The meaningful application of knowledge in solving real-world problems enhances memory consolidation and retrieval.
Examples of Problem-Based Learning
Case study: A nursing student is presented with a case study involving a patient with multiple chronic conditions, such as diabetes, hypertension, and obesity. The student is tasked with developing a comprehensive care plan that addresses the patient’s physical health, medication management, lifestyle modifications, and psychological well-being.
Ethical dilemma: A group of healthcare students, including nursing students, is presented with an ethical dilemma, such as the allocation of scarce resources during a pandemic. They must analyze the situation, consider ethical principles, and propose a fair and just approach to resource allocation.
Community health project: Nursing students are assigned to a specific community and asked to identify a prevalent health issue affecting the population. They must conduct a needs assessment, develop an intervention plan, and propose strategies to improve the health outcomes of the community, considering factors such as cultural sensitivity, access to care, and health promotion.
Interprofessional simulation: Nursing students, along with students from other healthcare disciplines, participate in a simulated patient scenario. The scenario involves a complex medical case where each student represents their profession and must collaborate to assess the patient, make clinical decisions, and develop a coordinated care plan.
Quality improvement project: Nursing students are tasked with identifying a quality improvement opportunity within a healthcare setting, such as reducing hospital-acquired infections or medication errors. They must collect and analyze data, identify root causes, and propose evidence-based strategies to improve patient safety and outcomes.
Global health challenge: Nursing students are presented with a global health challenge, such as addressing the high prevalence of a specific disease in a low-resource country. They must research the cultural, social, and economic factors influencing the disease, propose strategies for prevention and treatment, and consider the sustainability of the interventions.
Problem-Based Learning offers a learner-centered approach that develops critical thinking, problem-solving abilities, collaboration, and self-directed learning skills. By immersing students in authentic problem-solving experiences, PBL facilitates a deeper understanding of the subject matter and prepares students for the challenges they may face in their future careers. It promotes active engagement, application of knowledge, and the development of essential skills that are highly valued in the workforce, such as critical thinking, collaboration, and effective communication.
Furthermore, PBL fosters a positive and supportive learning environment where students feel empowered to take ownership of their learning and explore their interests. It encourages curiosity, inquiry, and the exploration of multiple perspectives, leading to a richer and more comprehensive understanding of the problem at hand.
PBL also helps students develop important meta-cognitive skills, such as self-reflection and self-assessment. They learn to evaluate their own progress, identify areas for improvement, and adjust their learning strategies accordingly. This metacognitive awareness enhances their ability to monitor and regulate their own learning, promoting lifelong learning habits.
Moreover, PBL can contribute to the development of transferable skills beyond subject-specific knowledge. Students learn to adapt to new situations, think critically and creatively, work effectively in teams, and communicate their ideas with clarity and confidence. These skills are vital in today’s rapidly changing world, where the ability to adapt, innovate, and collaborate is highly valued.
Overall, Problem-Based Learning offers numerous benefits, including active engagement, application of knowledge, development of critical skills, and preparation for real-world challenges. By immersing students in authentic problem-solving experiences, PBL not only deepens their understanding of the subject matter but also equips them with the skills and mindset necessary for success in their academic, professional, and personal lives.
References
Ghani, A. S. A., Rahim, A. F. A., Yusoff, M. S. B., & Hadie, S. N. H. (2021). Effective learning behavior in problem-based learning: a scoping review. Medical Science Educator, 31(3), 1199-1211.
Malmia, W., Makatita, S. H., Lisaholit, S., Azwan, A., Magfirah, I., Tinggapi, H., & Umanailo, M. C. B. (2019). Problem-based learning as an effort to improve student learning outcomes. Int. J. Sci. Technol. Res, 8(9), 1140-1143.
Moallem, M., Hung, W., & Dabbagh, N. (Eds.). (2019). The Wiley handbook of problem-based learning. John Wiley & Sons.
Trullàs, J. C., Blay, C., Sarri, E., & Pujol, R. (2022). Effectiveness of problem-based learning methodology in undergraduate medical education: a scoping review. BMC medical education, 22(1), 104.
The International Council of Nurses (ICN) has released a new global definition of “nurse” and “nursing“, marking a significant milestone in the profession’s identity and global recognition.
Key Highlights:
Purpose: The new definition aims to clearly articulate the scope, identity, and contribution of nursing to global health. It serves as a “global compass” for the profession.
Core Values: It emphasizes nursing as a science-based, people-centered, and socially just profession, grounded in ethical standards and human connection.
Development Process: The definition was the result of a year-long global initiative, involving an expert panel and a Delphi group of nurses from all ICN regions, ensuring cultural inclusivity and global consensus.
Leadership and Support: ICN leaders, including CEO Howard Catton and Director David Stewart, highlighted the importance of defining nursing to ensure its visibility, value, and leadership in shaping health systems.
Impact: The definition is intended to influence policy, education, regulation, and legal frameworks worldwide. It empowers nurses to fully embrace and lead within their roles.
This initiative is seen not just as a professional update, but as a reaffirmation of nursing’s leadership and identity for current and future generations
Nursing Notes 
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