Jessee Mary Ann
J Nurs Educ. 2018 Jan 1;57(1):7-13. doi: 10.3928/01484834-20180102-03.
The link between clinical education and development of clinical reasoning is not well supported by one theoretical perspective. Learning to reason during clinical education may be best achieved in a supportive sociocultural context of nursing practice that maximizes reasoning opportunities and facilitates discourse and meaningful feedback. Prelicensure clinical education seldom incorporates these critical components and thus may fail to directly promote clinical reasoning skill.
Theoretical frameworks supporting the development of clinical reasoning during clinical education were evaluated. Analysis of strengths and gaps in each framework's support of clinical reasoning development was conducted. Commensurability of philosophical underpinnings was confirmed, and complex relationships among key concepts were elucidated.
Six key concepts and three tenets comprise an explanatory predictive theory-the integrated clinical education theory (ICET).
ICET provides critical theoretical support for inquiry and action to promote clinical education that improves development of clinical reasoning skill. [J Nurs Educ. 2018;57(1):7-13.].
临床教育与临床推理发展之间的联系在单一理论视角下缺乏有力支持。在临床教育过程中学习推理，或许在支持性的护理实践社会文化环境中能够最好地实现，这种环境能最大化推理机会并促进交流和有意义的反馈。执照前临床教育很少纳入这些关键要素，因此可能无法直接促进临床推理技能。
对支持临床教育中临床推理发展的理论框架进行评估。分析每个框架在支持临床推理发展方面的优势与不足。确认了哲学基础的可通约性，并阐明了关键概念之间的复杂关系。
六个关键概念和三个原则构成了一种解释性预测理论——综合临床教育理论（ICET）。
ICET为促进临床教育的探究和行动提供了关键的理论支持，而这种临床教育能够改善临床推理技能的发展。[《护理教育杂志》2018年；57(1):7 - 13。]
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