Is Clinical Decision Making Skills are Developed through Academic Nurturing? A Review Based on Available Literature

Abstract

Introduction: Today’s nurses are having challenges, demanding their ability to the profession. Nursing education should concentrate on educating competent health care providers to handle complex health care technology with fundamental implications for latest generation of patients. This paper aims to identify the various strategies used to enhance the clinical decision making ability among nurses. Methods: A comprehensive systematic review of published literature and journal articles from PubMed and Cinhal databases was done. Search strategy specific to each database was used. During initial search 6808 titles were retrieved and after screening 12 articles were selected for full text screening. Finally 12 research articles were selected based on the inclusion criteria. Results: Out of 12 articles, 7 research studies supported that clinical decision making can be developed using different types of simulation (such as human patient simulators, simulated clinical experiences, simulation to create rubric assessment). Two of those studies propose clinical reasoning abilities can be acquired through Outcome-Present state Test (OPT) model. Individual studies used strategies like concept mapping, educational interventions, analogy guided learning experiences, structured reflection in education and workshops can develop clinical decision making. Computer based and multimedia computer simulation program did not showing any clear outcome. Conclusion: Clinical decision making is an abstract skill which can be developed by using different strategies in different specialities and different situations.  Since situational factors and time constraints are evident in practice, findings were supportive for clinical decision making(CDM) skill. The ideal setting for students to learn CDM skills is real clinical practice environment, especially when facilitated by opportunities for immediate feedback and reflection. CDM is necessary for providing quality patient care and favouring patient satisfaction.

Keywords: Decision making, Nurses, Judgement, Clinical Competence