Effects of simulation with problem-based learning (S-PBL) on nursing students' clinical reasoning ability: based on Tanner's clinical judgment model

Abstract

Background: Clinical reasoning ability, a complex cognitive and metacognitive process, is a crucial core competency required in nursing practice. Therefore, undergraduate nursing students should be provided with nursing education to strengthen their clinical reasoning ability based on real-life nursing scenarios.

Methods: This study was conducted using a quasi-experimental single-group pretest-posttest design. Three sessions (lasting three hours each) of Simulation with Problem-Based Learning (S-PBL) using high-risk obstetrics-gynecology scenarios were provided to 71 third-year nursing students of a university. The sessions were conducted from September to December 2022, and they aimed to strengthen their clinical reasoning ability. For data collection, an online survey was conducted using Rubric for Clinical Reasoning and learning satisfaction evaluation tool. Data were analyzed using descriptive statistics and repeated measures analysis of variance in SPSS.

Results: The mean score of clinical reasoning ability significantly increased from 29.42 (standard deviation: 4.62) out of 40 points in the pre-test to 32.28 (4.36), 33.44 (5.35), and 33.80 (5.91) after the first, second, and third S-PBL sessions, respectively (F = 61.668, p < .001). The learning satisfaction score was as high as 107.04 (12.66) out of 120 points.

Conclusion: This S-PBL program is an effective nursing education strategy to strengthen nursing students' clinical reasoning ability. Future studies must examine learner variables and standardize the S-PBL design and operation process by comparison to a traditional teaching approach and a higher range of clincal reasoning ability.

Keywords: Clinical reasoning; Nursing education; Nursing students; Problem-based learning; Simulation.