The association between nursing students’ perceptions of their clinical reasoning ability and their background of clinical experience: A cross-sectional correlation study

Abstract

Background and objective: Nursing students tend to show poor clinical reasoning skills and incompetence in clinical performance. This study aimed to explore nursing students’ perceptions of their clinical reasoning ability in relation to their different background of academic program and clinical experience.

Methods: A cross-sectional correlation study was conducted in a private tertiary professional training institute. Nursing students (n = 508) were surveyed with demographic details and a self-reported Nurse Clinical Reasoning Scale (NCRS) questionnaire about their perceptions of clinical reasoning in relation with their clinical experience.

Results: Descriptive statistic, parametric analyses of variance, and Pearson’s correlation coefficients were used to determine the relationships between variables. The mean NCRS score was lower for paid student nurse externs (49.22 ± 9.2) than for participants who were not paid student nurse externs. The mean NCRS scores differed significantly between the different clinical placements that nursing students last experienced (F = 5.41, p ≤ .001), as well as between students of various academic programs (F = 11.88, p ≤ .001), with students of the sub-baccalaureate level nursing program showing the highest score (53.04 ± 10.48), followed by those of the accelerated baccalaureate level nursing program (52.93 ± 7.67) and those of the baccalaureate level nursing program (48.82 ± 10.11). The mean NCRS score showed a weakly positive, but significant, correlation with the attendance of pre-clinical training, r(506) = .12, p = .009. The free-text surveys provided rich information concerning nursing students’ preferences for future pre-clinical training.

Conclusions: Different academic backgrounds and clinical experiences influence nursing students’ clinical reasoning competence. Strategies are needed to motivate earlier clinical preparedness and caring attitudes which are essential attributes of a nursing student before their exposure to real patients.