I recently posted an online survey to get the pulse of nurse educators around the country to see what they needed to promote the learning of nursing students and what I could do to more effectively meet these needs with my clinical reasoning resources and topics to address on my blog.

I received 175 responses that revealed areas that educators are struggling in and what they currently need more information on to meet the relentless demands of preparing students for clinical practice.

I want to thank each of you who took the time to provide this needed feedback! Your responses and themes that I was able to derive will demonstrate to others that their needs and struggles are not unique, but shared by many others.

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The Survey Says…

The top topics that educators want addressed in future blog posts is (in order of responses):

• teaching clinical reasoning.
• how to teach more effectively in the classroom
• how to teach more effectively in the clinical setting
• dealing with student/faculty incivility

Though clinical reasoning is a needed paradigm change in nursing education, it appears that obtaining a deeper understanding and teaching of clinical reasoning as well as how to integrate it effectively in the classroom and clinical settings is still relevant to nurse educators.

These are the topics I will also be addressing throughout the year as I write my weekly blog with an emphasis of practical tools and strategies to integrate clinical reasoning in both class and clinical. I have created numerous new tools that I will be sharing in the weeks ahead so stay tuned!

Clinical Reasoning Webinars

When asked if educators would be interested in webinars related to clinical reasoning and strategies to integrate this in the classroom or clinical settings, 40% said yes, 53% maybe with only 7% saying no.

Though I am excited to present at workshops and conferences around the country, the limitations to being in one place at a time become obvious. Later this year I will be exploring this further with some sort of membership site with 20-30 webinars and other resources to provide this needed instruction.

Just an FYI, but I currently have a YouTube channel “Think like a Nurse” that has over 15 videos on topics related to clinical reasoning. I just  posted one of my best videos that presents a RAPID Reasoning case study on acute MI/HF. I will be posting new videos every couple weeks so subscribe to my channel and be kept in the loop!

Problem-Based Learning Clinical Reasoning Activities

I know from my own experience that educators struggle with having enough class time to incorporate active learning tools in the classroom. My clinical reasoning case studies take 30-45″ to work through in class. This can be a barrier to integration.

When asked if educators would be interested in shorter (10-15″) problem based learning clinical reasoning activities for the classroom or clinical 73% said yes, 27% maybe with no no’s!

In response, I am currently creating several distinct “short & sweet” clinical reasoning activities with salient scenarios that emphasize just one aspect of clinical reasoning such as:

• recognizing what clinical data is RELEVANT?
• what is your PRIORITY?
• recognizing clinical relationships
• who to see FIRST with a multiple patient assignment?
• clinical dilemmas…ethical and practical struggles nurses will experience in practice (angry, depressed/withdrawn patient, sexually inappropriate, etc.)

I am currently working on the clinical dilemma activities and will have several posted in a bundle with a blank student version and faculty answer key as PDF files in the next week or two.

Additional Resources Needed

When faculty were asked what additional resources they needed in the classroom or clinical settings to develop clinical reasoning, the following were the most common:

• more specialty case studies: peds, OB, fundamentals
• more med/surg topics of current case studies
• short activities that develop critical thinking
• practical tools to strengthen pharmacology and A&P content

I have 15 topics currently posted of my clinical reasoning case studies and have several more that I am developing including specialty topics. I have just finalized a chapter on clinical reasoning that I will be contributing to Carol Huston’s nursing textbook “Professional Issues in Nursing” 4th ed. and will now have the time to complete these additional case studies in the near future.

Biggest Barrier to Transforming Nursing Education

This was an open ended question whose results I posted last month on the #1 Barrier to Transformation.

In summary, the following themes were most prevalent from the 175 responses:

• Faculty who resist change
• Students who resist change
• Administrative & departmental concerns
• Incivility
• Too little time

In Closing

KeithRN is not about Keith. It is about working together and partnering to bring needed transformation to nursing education. I am not the sage on the stage who has it all figured out, but a guide on the side who has a lens of current clinical practice that I hope can be used to facilitate change and help bridge the current education-practice gap in academia.

It is also all about our students being prepared for real world clinical practice through an emphasis of clinical reasoning that is deeply understood. This will lead to correct clinical judgments and better outcomes for the patients they care for. Thank you for all that you are doing to be advocates for this radical transformation!

Comment Question:
What strategies or tools have you created that have been effective to guide students to apply and use knowledge and develop clinical reasoning?
Respond below and let the conversation begin!