Wang FangFang, Liu Dandan, Zhang ManHong
Shanxi Provincial People's Hospital, No. 29 Shuangta East Street, Yingze District, Taiyuan City, Shanxi Province, China.
Department of Media and Communication Studies, Faculty of Arts and Social Sciences, Universiti Malaya, Kuala Lumpur, Malaysia.
BMC Med Educ. 2024 Dec 26;24(1):1530. doi: 10.1186/s12909-024-06467-y.
This study examined the longitudinal development of metacognitive skills and clinical decision-making abilities in nursing students, focusing on the interactions between metacognitive processes, situational factors, and individual differences.
A longitudinal, quantitative design was employed, following 185 third-year nursing students from a major university in China over one academic year. Data were collected at six time points using the Metacognitive Awareness Inventory, Nursing Decision-Making Instrument, and custom-designed clinical scenario assessments. Latent Growth Curve Modeling, Multilevel Modeling, and Moderation Analysis were used to analyze the data.
Significant positive growth trajectories were observed for both metacognitive awareness (mean slope = 0.07, p < .001) and decision-making skills (mean slope = 0.08, p < .001). Metacognitive regulation emerged as the strongest predictor of decision-making outcomes (β = 0.188, p < .001 for quality; β = 0.168, p < .001 for efficiency). Task complexity negatively impacted decision-making quality (β = -0.129, p < .001), while time pressure more strongly affected efficiency (β = -0.121, p < .001). Cognitive style and emotional intelligence moderated the relationship between metacognitive processes and decision-making outcomes. The effectiveness of metacognitive strategies in mitigating the negative effects of situational factors varied across individuals and over time.
This study provides robust evidence for the complex interplay between metacognitive processes, situational factors, and individual differences in the development of clinical decision-making skills among nursing students. The findings highlight the importance of tailoring educational interventions to enhance specific metacognitive skills, particularly regulation, while considering the impact of situational factors and individual cognitive styles. These insights can inform the design of more effective, personalized approaches to nursing education, potentially enhancing the preparation of nursing students for the complexities of clinical practice.
本研究考察了护理专业学生元认知技能和临床决策能力的纵向发展情况，重点关注元认知过程、情境因素和个体差异之间的相互作用。
采用纵向定量设计，对中国一所主要大学的185名大三护理专业学生进行了为期一学年的跟踪研究。在六个时间点使用元认知意识量表、护理决策工具和定制的临床情景评估收集数据。采用潜在增长曲线模型、多层次模型和调节分析对数据进行分析。
元认知意识（平均斜率=0.07，p<0.001）和决策技能（平均斜率=0.08，p<0.001）均呈现显著的正向增长轨迹。元认知调节成为决策结果的最强预测因素（质量方面β=0.188，p<0.001；效率方面β=0.168，p<0.001）。任务复杂性对决策质量有负面影响（β=-0.129，p<0.001），而时间压力对效率的影响更大（β=-0.121，p<0.001）。认知风格和情商调节了元认知过程与决策结果之间的关系。元认知策略减轻情境因素负面影响的有效性因个体和时间而异。
本研究为护理专业学生临床决策技能发展过程中元认知过程、情境因素和个体差异之间的复杂相互作用提供了有力证据。研究结果强调了在考虑情境因素和个体认知风格影响的同时，定制教育干预措施以增强特定元认知技能（特别是调节技能）的重要性。这些见解可为设计更有效、个性化的护理教育方法提供参考，有可能提高护理专业学生应对临床实践复杂性的准备程度。
