Cooperative learning : an approach to enhance clinical reasoning of nursing students
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Authors
Neethling, Adele
Issue Date
2021-02-24
Type
Thesis
Language
en
Keywords
Clinical reasoning , Cooperative learning , Cognitive development
Alternative Title
Abstract
Clinical reasoning is an essential competency for nurses to enable them to provide quality
nursing care. The optimal development of this skill will affect the quality of nursing care, and
empower nurses to act as advocates for their patients.
The purpose of this study was to design a cooperative clinical reasoning activity (CCRA) that
could assist in developing final-year nursing students’ clinical reasoning skills in a private
nursing education institution (PNEI).
The theoretical underpinning of this study is constructivism, as it supports the understanding
that students construct their knowledge and understanding from their own personal
experiences.
A multi-method design, using qualitative and quantitative data gathering methods over five
phases, was employed. Phase 1A entailed the development of the CCRA after a thorough
literature review. The draft CCRA was exposed to a two-step pre-test by students and
educators to improve the quality and validity thereof. The draft CCRA was then validated in
Phase 1B, by a group of nursing education experts, through a qualitative e-Delphi technique.
Phases 2 and 4 of the study employed a quantitative, quasi-experimental, non-equivalent pretest–
post-test control group method using an Outcome Present State (OPT) worksheet and
marking rubric. Phase 2 focused on pre-testing the nursing students’ clinical reasoning skills
at the commencement of their second year in the bridging programme. Phase 4 entailed the
post-test of the same sample after administering the developed and validated CCRA to the
experimental group. The CCRA was implemented with the experimental group during Phase
3. After the pre-test (Phase 2), implementation of the CCRA (Phase 3) and post-test (Phase
4), the CCRA was refined and adapted (Phase 5) through the use of a qualitative e-Delphi
technique administered to the fieldworkers who coordinated the CCRA’s administration during
Phase 3.
The research findings revealed that poor clinical reasoning skills existed at the
commencement of students’ second year in the bridging programme (Phase 2). After group
participation in four CCRA opportunities (Phase 3), there was clear evidence to indicate the
CCRA assisted in the development of nurses’ clinical reasoning skills. The post-test clinical
reasoning (Phase 4) scores were significantly higher than the control group’s clinical reasoning
scores. Observations and findings during the CCRA’s implementation (Phase 3) led to
recommendations from the panellist in Phase 5 to adapt and refine the CCRA.
The recommendations for implementing the developed CCRA should be followed in the private
nursing education where the study was conducted, and the CCRA can be adapted for
implementation in diverse settings.