Kautz Donald D, Kuiper RuthAnne, Pesut Daniel J, Knight-Brown Phyllis, Daneker Darlene
University of North Carolina at Greensboro, USA.
Int J Nurs Educ Scholarsh. 2005;2:Article 1. doi: 10.2202/1548-923x.1052. Epub 2005 Jan 24.
Promoting clinical reasoning in undergraduate nursing students through application of the Outcome Present State Test (OPT) Model of Clinical Reasoning, is a challenge that can be successfully managed through effective teaching-learning strategies. Empirical evidence to support teaching strategies that foster both cognitive and metacognitive skill acquisition is limited. The purpose of this research was to evaluate the development of clinical reasoning skills among nursing students through the application and evaluation of teaching-learning strategies associated with self-regulated learning and the OPT model (Pesut & Herman, 1998; 1999; Pesut, 2004). The model and self-regulated learning prompts were used to structure learning with junior level baccalaureate nursing students during a ten-week, medical-surgical clinical experience in acute care telemetry units. Data analysis revealed students effectively made gains in learning associated with the OPT model. Qualitative analysis of self-regulated learning prompt journal data revealed students made significant gains in self-observation, self-judgment, knowledge work and use of health care personnel resources during clinical experiences. Results indicated the intentional use of guided reflection coupled with structure and learning tools of the OPT model significantly enhanced clinical reasoning skill acquisition, and provided evidence for the effectiveness of structured teaching learning strategies.
通过应用临床推理结果现状测试（OPT）模型来促进本科护理专业学生的临床推理，是一项挑战，而通过有效的教学策略能够成功应对这一挑战。支持培养认知和元认知技能的教学策略的实证证据有限。本研究的目的是通过应用和评估与自我调节学习及OPT模型相关的教学策略（佩苏特和赫尔曼，1998年；1999年；佩苏特，2004年），来评估护理专业学生临床推理技能的发展。在急性护理遥测病房为期十周的内科 - 外科临床实习期间，该模型和自我调节学习提示被用于构建本科低年级护理专业学生的学习。数据分析表明，学生在与OPT模型相关的学习方面有效取得了进步。对自我调节学习提示日志数据的定性分析显示，学生在临床实习期间的自我观察、自我判断、知识运用以及医疗保健人员资源利用方面取得了显著进步。结果表明，有意使用引导性反思并结合OPT模型的结构和学习工具，可显著提高临床推理技能的获得，并为结构化教学策略的有效性提供了证据。
