Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Research Center in Nursing Clinical Practice, Wan Fang Hospital, Taipei, Taiwan.
University of Illinois at Chicago, 845 S. Damen Ave., Chicago, IL, United States.
Nurse Educ Today. 2025 Jan;144:106401. doi: 10.1016/j.nedt.2024.106401. Epub 2024 Sep 12.
Typically, nurse education curricula are separated into the teaching of theoretical knowledge and practical skills. This separation may hinder nursing students' development of clinical reasoning skills, making it difficult for them to prioritize tasks and make decisions about interventions. Illness scripts have been shown to help medical students improve their clinical reasoning skills; however, they are rarely used in nurse education.
To evaluate the influence of illness script teaching method on post-baccalaureate nursing students' clinical reasoning skills.
The study adopted a single-arm quantitative pre-experimental research design and incorporated qualitative focus group discussions.
SETTINGS/PARTICIPANTS: This study was conducted at a university in northern Taiwan. Participants included 35 post-baccalaureate nursing students who were enrolled in an elective course focused on clinical skills.
To enhance nursing students' clinical reasoning skills, illness scripts for five clinical scenarios were developed and implemented as part of their curriculum. The Nurses Clinical Reasoning Scale was utilized to assess self-rated clinical reasoning abilities, while dual-teacher scoring was used to evaluate clinical reasoning objectively. The VARK learning preference questionnaire was used to examine how learning preferences affect learning outcomes. After the course, semi-structured focus groups were held to collect student feedback on the effectiveness of the teaching methods and the learning outcomes.
This study's quantitative and qualitative results show that illness script-based teaching improves nursing students' clinical reasoning. Quantitative results showed significant objective reasoning score improvements. However, minimal changes in self-rated scores suggest a learning style-influenced gap between perceived and actual abilities. Qualitative findings showed that students valued linking clinical issues to practical applications but struggled with knowledge gaps and engagement.
The illness script teaching method improved students' understanding of clinical scenarios and enhanced their clinical reasoning abilities. Incorporating illness scripts into nurse education was beneficial for nursing students.
通常，护士教育课程分为理论知识教学和实践技能教学。这种分离可能会阻碍护理学生临床推理技能的发展，使他们难以优先处理任务并对干预措施做出决策。疾病脚本已被证明有助于医学生提高临床推理技能；然而，它们在护士教育中很少使用。
评估疾病脚本教学方法对本科后护理学生临床推理技能的影响。
本研究采用单臂定量预实验研究设计，并结合定性焦点小组讨论。
地点/参与者：本研究在台湾北部的一所大学进行。参与者包括 35 名参加临床技能选修课程的本科后护理学生。
为了提高护理学生的临床推理技能，为五个临床场景开发了疾病脚本并将其纳入课程。使用护士临床推理量表评估自我评估的临床推理能力，同时使用双师评分客观评估临床推理。使用 VARK 学习偏好问卷来研究学习偏好如何影响学习成果。课程结束后，举行半结构化焦点小组讨论，收集学生对教学方法和学习成果的反馈。
本研究的定量和定性结果表明，基于疾病脚本的教学可以提高护理学生的临床推理能力。定量结果显示客观推理分数有显著提高。然而，自我评估分数的微小变化表明，学习风格会影响感知能力和实际能力之间的差距。定性研究结果表明，学生重视将临床问题与实际应用联系起来，但在知识差距和参与度方面存在困难。
疾病脚本教学方法提高了学生对临床场景的理解，并增强了他们的临床推理能力。将疾病脚本纳入护士教育对护理学生有益。
