عوامل موثر در توسعه قضاوت بالینی در دانشجویان پرستاری: یک مروری سیستماتیک | ||
| نوید نو | ||
| دوره 28، شماره 96، اسفند 1404، صفحه 88-103 اصل مقاله (1.49 M) | ||
| نوع مقاله: مقاله مروری | ||
| شناسه دیجیتال (DOI): 10.22038/nnj.2025.91926.1521 | ||
| نویسندگان | ||
| عاطفه دهنوعلیان1؛ حسین کریمی مونقی* 2 | ||
| 1کمیته تحقیقات دانشجویی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران | ||
| 2استاد، مرکز تحقیقات مراقبت پرستاری و مامایی، و مرکز تحقیقات آموزش علوم پزشکی دانشگاه علوم پزشکی مشهد، مشهد، ایران | ||
| چکیده | ||
| مقدمه و هدف: قضاوت بالینی صحیح مهارتی ضروری برای پرستاران محسوب میشود که آنها را قادر میسازد تا مراقبت ایمن و مؤثر از بیمار ارائه دهند. این مطالعه با هدف شناسایی عوامل مؤثر در قضاوت بالینی در دانشجویان پرستاری انجام شد. مواد و روشها: این مرور سیستماتیک مطابق با دستورالعملهای PRISMA انجام شد. جستجو در پایگاههای اطلاعاتی PUBMED، Web of Science و Scopus برای مطالعات منتشر شده بین سالهای ۲۰۱۵ تا ۲۰۲۵ صورت گرفت. معیارهای ورود شامل مطالعات مقطعی و تحلیلی روی دانشجویان پرستاری که عوامل مؤثر در قضاوت بالینی را بررسی کرده بودند. کیفیت مقالات با استفاده از ابزار STROBE ارزیابی شد. یافته ها: از ۱۳۲ مقاله اولیه، تعداد ۱۴ مطالعه وارد تحلیل نهایی شدند. عوامل مؤثر بر قضاوت بالینی در سه محور اصلی دستهبندی شدند: ۱) ویژگیهای فردی دانشجو شامل تفکر انتقادی، مهارت حل مسئله، تنظیم فراشناختی، هوش هیجانی و ویژگیهای شخصیتی؛ ۲) عوامل محیطی/موقعیتی شامل کیفیت محیط یادگیری بالینی، پیچیدگی وظایف، فشار زمانی و بارکاری؛ ۳) عوامل آموزشی/سازمانی شامل برنامه درسی، روشهای تدریس، شبیهسازی و حمایت حرفهای. نتیجه گیری: توسعه قضاوت بالینی نیازمند رویکردی جامع است که همزمان ویژگیهای فردی، زمینه محیطی و سیاستهای آموزشی را پوشش دهد. بازنگری در برنامههای آموزشی پرستاری و افزایش استفاده از آموزش مبتنی بر شبیهسازی ضروری است | ||
| کلیدواژهها | ||
| قضاوت بالینی؛ دانشجویان پرستاری؛ استدلال بالینی | ||
| مراجع | ||
|
[1] Lasater K. Clinical judgment: The last frontier for evaluation. Nurse Education in Practice. 2011;11(2):86-92. [2] Samuels JG, Leveille DM. Senior nursing students' clinical judgments in pain management. Nurse educator. 2010;35(5):220-4. [3] Phaneuf M. Clinical Judgement–An Essential Tool in the Nursing Profession, Medical Psychologi Journal. 2008. [4] Benner P, Tanner C, Chesla C. Expertise in nursing practice: Caring, clinical judgment, and ethics: Springer Publishing Company; 2009. [5] Dowding D, Thompson C. Measuring the quality of judgement and decision‐making in nursing. Journal of advanced nursing. 2003;44(1):49-57. [6] Tanner CA. Thinking like a nurse: a research-based model of clinical judgment in nursing. J Nurs Educ. 2006;45(6):204-11. [7] Wiles LL, Simko LC, Schoessler M. What do I do now?: clinical decision making by new graduates. Journal for nurses in professional development. 2013;29(4):167-72. [8] Bayoumy HMM, Albeladi GA. Clinical judgment skills among junior-level nursing students enrolled in adult health nursing courses: Errors and risk level classification. Nurse education in Practice. 2020;48:102888. [9] Høegh-Larsen AM, Gonzalez MT, Reierson IÅ, Husebø SIE, Hofoss D, Ravik M. Nursing students’ clinical judgment skills in simulation and clinical placement: a comparison of student self-assessment and evaluator assessment. BMC nursing. 2023;22(1):64. [10] Parodis I, Andersson L, Durning SJ, Hege I, Knez J, Kononowicz AA, et al. Clinical reasoning needs to be explicitly addressed in health professions curricula: recommendations from a European consortium. International journal of environmental research and public health. 2021;18(21):11202. [11] Simmons B. Clinical reasoning: concept analysis. Journal of advanced nursing. 2010;66(5):1151-8. [12] Levett-Jones T, Hoffman K, Dempsey J, Jeong SY-S, Noble D, Norton CA, et al. The ‘five rights’ of clinical reasoning: An educational model to enhance nursing students’ ability to identify and manage clinically ‘at risk’patients. Nurse education today. 2010;30(6):515-20. [13] Lavoie P, Pepin J, Boyer L. Reflective debriefing to promote novice nurses' clinical judgment after high-fidelity clinical simulation: a pilot test. Dynamics (Pembroke, Ont). 2013;24(4):36-41. [14] Abu Arra AY, Ayed A, Toqan D, Albashtawy M, Salameh B, Sarhan AL, Batran A. The factors influencing nurses’ clinical decision-making in emergency department. INQUIRY: The Journal of Health Care Organization, Provision, and Financing. 2023;60:00469580231152080. [15] Arkan B, Yılmaz D, Çinar HG, Uzun R. Clinical decision-making levels of nursing students and affecting factors. Cyprus Journal of Medical Sciences. 2023. [16] Garrett B. Student nurses' perceptions of clinical decision-making in the final year of adult nursing studies. Nurse education in practice. 2005;5(1):30-9. [17] Jahanpour F, Sharif F, Salsali M, Kaveh MH, Williams LM. Clinical decision‐making in senior nursing students in Iran. International journal of nursing practice. 2010;16(6):595-602. [18] Özden D, Özveren H, Gülnar E. Nurse students’ clinical decision-making abilities level and the factors that affect abilities. E-Journal of Dokuz Eylul University Nursing Faculty. 2018;11(1):41-7. [19] Reeves S, Fletcher S, Barr H, Birch I, Boet S, Davies N, et al. A BEME systematic review of the effects of interprofessional education: BEME Guide No. 39. Medical teacher. 2016;38(7):656-68. [20] Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. The lancet. 2007;370(9596):1453-7. [21] Wang F, Liu D, Zhang M. Metacognitive processes, situational factors, and clinical decision-making in nursing education: a quantitative longitudinal study. BMC Medical Education. 2024;24(1):1530. [22] Xu Q, Li D, Dong Y, Wu Y, Cao H, Zhang F, et al. The relationship between personality traits and clinical decision-making, anxiety and stress among intern nursing students during COVID-19: a cross-sectional study. Psychology Research and Behavior Management. 2023:57-69. [23] Candan Dönmez Y, Sahin Koze B, Durmaz Edeer A, Ciğerci Y, Yilmaz E, Gök F, et al. Evaluation of clinical decision-making perception of nursing students: the Aegean region case. BMC nursing. 2025;24(1):486. [24] Darvishi Alamouti H, Nikravan Mofrad M, Borzabadi Farahani Z, Amini AR. Clinical Reasoning in Nursing Students. Advances in Nursing & Midwifery. 2021;29(4):24-30. [25] Nunes JGP, Amendoeira JJP, Cruz DdALMd, Lasater K, Morais SCRV, Carvalho ECd. Clinical judgment and diagnostic reasoning of nursing students in clinical simulation. Revista brasileira de enfermagem. 2020;73(6):e20180878. [26] Canto VBd, Silva TGd, Santos GAd, Carvalho ECd, Morais SCRV, Frazão CMFdQ. Clinical judgment performance of undergraduate Nursing students. Revista Latino-Americana de Enfermagem. 2021;29:e3452. [27] Quach TBY, Nguyen TPL, Huynh TPH. The clinical decision-making of Vietnamese nursing students and related factors: A cross-sectional survey. Belitung Nursing Journal. 2025;11(2):126. [28] Khan A HF. Factors that affect the clinical reasoning competencies among undergraduate nursing students: a cross-sectional study. J Nurs Educ Pract. 2023;13(4):45-52. [29] Rehman AU UN, Rahim A, Khan S, Ali S, Sultan A, Siddique U. Assessment of clinical reasoning competencies among undergraduate nursing students. Kurdish Studies. 2024;12(5):429-33. [30] Hallin K, Häggström M, Bäckström B, Kristiansen LP. Correlations between clinical judgement and learning style preferences of nursing students in the simulation room. Global journal of health science. 2015;8(6):1. [31] Farčić N, Barać I, Lovrić R, Pačarić S, Gvozdanović Z, Ilakovac V. The influence of self-concept on clinical decision-making in nurses and nursing students: a cross-sectional study. International journal of environmental research and public health. 2020;17(9):3059. [32] Hong S, Lee J, Jang Y, Lee Y. A cross-sectional study: What contributes to nursing students’ clinical reasoning competence? International Journal of Environmental Research and Public Health. 2021;18(13):6833. [33] Mohammed RF, Omar AAA. Knowledge about elderly care and its relation to ageism attitude among undergraduate nursing students. American Journal of Nursing Research. 2019;7(1):73-8. [34] Shin S, Park JH, Kim JH. Effectiveness of patient simulation in nursing education: meta-analysis. Nurse Educ Today. 2015;35(1):176-82. [35] Benner P. Educating nurses: a call for radical transformation-how far have we come? J Nurs Educ. 2012;51(4):183-4. [36] Nielsen A. Concept-based learning activities using the clinical judgment model as a foundation for clinical learning. Journal of Nursing Education. 2009;48(6):350-4. [37] Fedko AS, Dreifuerst KT. Examining the relationship between clinical judgment and nursing actions in prelicensure students. Nurse Educator. 2017;42(1):47-50. [38] Seidi J, Alhani F, Salsali M. Nurses’ clinical judgment development: a qualitative research in Iran. Iranian Red Crescent Medical Journal. 2015;17(9):e20596. [39] Pouralizadeh M, Khankeh H, Ebadi A, Dalvandi A. Factors influencing nursing students’ clinical judgment: A qualitative directed content analysis in an Iranian context. Journal of clinical and diagnostic research: JCDR. 2017;11(5):JC01. [40] Smith T, editor Guided reflective writing as a teaching strategy to develop nursing student clinical judgment. Nursing Forum; 2021: Wiley Online Library. [41] Klenke-Borgmann L, Cantrell MA, Mariani B. Nurse educators’ guide to clinical judgment: A review of conceptualization, measurement, and development. Nursing Education Perspectives. 2020;41(4):215-21. [42] Agbedia C, Ofi B, Ibeagha J. Causal model of clinical judgment of practising nurses, in selected hospitals in Delta State, Nigeria. West African Journal of Nursing. 2008;19(2). [43] Menezes SSCd, Corrêa CG, Silva RdCGe, Cruz DdAMLd. Clinical reasoning in undergraduate nursing education: a scoping review. Revista da Escola de Enfermagem da USP. 2015;49(6):1032-9. [44] Ironside PM, McNelis AM, Ebright P. Clinical education in nursing: Rethinking learning in practice settings. Nursing outlook. 2014;62(3):185-91. [45] Delany C, Golding C. Teaching clinical reasoning by making thinking visible: an action research project with allied health clinical educators. BMC medical education. 2014;14(1):20. | ||
|
آمار تعداد مشاهده مقاله: 44 تعداد دریافت فایل اصل مقاله: 49 |
||
