Baxter Pamela, Rideout Elizabeth
McMaster University, School of Nursing, Hamilton, Ontario, Canada.
J Nurs Educ. 2006 Apr;45(4):121-7. doi: 10.3928/01484834-20060401-05.
This qualitative, intrinsic case study explored the decision-making activities of baccalaureate nursing students in the second year of a 4-year program. It sought to discover how second-year students determine the need to make a clinical decision, how they respond to a pending clinical decision, the types of decisions made in the clinical setting, and the factors that enhance or impede decision making. The study involved 12 students, all of whom were enrolled in their first clinical rotation on an inpatient unit and completed journals and interviews. Inductive analysis revealed three key encounters that demonstrated students' decision making: encounters with the patient, nursing staff, and clinical tutor. Each encounter revealed an emotion-based and knowledge-based response to various clinical situations. Decisions were evident within each of the three encounters. Implications for curriculum development and clinical tutors are described.
这项质性的、内在案例研究探讨了四年制护理学本科项目二年级学生的决策活动。该研究旨在发现二年级学生如何确定做出临床决策的必要性,他们如何应对即将做出的临床决策,在临床环境中做出的决策类型,以及促进或阻碍决策的因素。该研究涉及12名学生,他们都参加了住院部的首次临床轮转,并完成了日志记录和访谈。归纳分析揭示了三个关键事件,展示了学生的决策过程:与患者、护理人员和临床导师的接触。每次接触都揭示了对各种临床情况基于情感和基于知识的反应。在这三个事件中的每一个中都能明显看到决策。文中还描述了对课程开发和临床导师的启示。