模拟中使用结构化反思后执业护士学生的诊断推理能力与准确性：一项混合方法实验

Diagnostic Reasoning Competency and Accuracy by Nurse Practitioner Students Following the Use of Structured Reflection in Simulation: A Mixed-Methods Experiment.

作者信息

Griffith Patricia B, Mariani Bette, Kelly Michelle M

机构信息

About the Authors Patricia B. Griffith, PhD, CRNP, ACNP-BC, is advanced senior lecturer, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania. Bette Mariani, PhD, RN, ANEF, FAAN, is vice dean of academic affairs and a professor, Villanova University M. Louise Fitzpatrick College of Nursing, Villanova, Pennsylvania. Michelle M. Kelly, PhD, CRNP, CNE, FAANP, is associate professor, Villanova University M. Louise Fitzpatrick College of Nursing. Dr. Mariani, Research Briefs editor for Nursing Education Perspectives , had no role in the review or selection of this article. This work was supported by the National League for Nursing Education Scholarship and the Pennsylvania Higher Education Nursing Schools Association Nursing Education Research funding. For more information, contact Dr. Griffith at

出版信息

Nurs Educ Perspect. 2023;44(6):E18-E24. doi: 10.1097/01.NEP.0000000000001158. Epub 2023 Jul 4.

DOI:10.1097/01.NEP.0000000000001158

PMID:37404060

Abstract

AIM

The aim of this study was to examine the effect of structured reflection used during a simulated patient's diagnostic workup on diagnostic reasoning competency and accuracy and explore participants' cognitive bias experience and perceived utility of structured reflection.

BACKGROUND

Reasoning flaws may lead to diagnostic errors. Medical learners who used structured reflection demonstrated improved diagnosis accuracy.

METHOD

Embedded mixed-methods experiment examined diagnostic reasoning competency and accuracy of nurse practitioner students who did and did not use structured reflection. Cognitive bias experience and perceptions of structured reflection's utility were explored.

RESULTS

Diagnostic Reasoning Assessment mean competency scores and categories were not changed. Accuracy trended toward improvement with structured reflection. The theme, diagnostic verification, prompted diagnosis change by both structured reflection users and control participants.

CONCLUSION

Despite no changes in quantitative outcomes, explicit users of structured reflection believed that this strategy is helpful to their reasoning, and control participants used the strategy's components with the same noted benefits.

摘要