Arefeh Davoodi, Akram Ghahramanian, Hassan Rezazadeh, Faranak Jabbarzadeh Tabrizi,
Volume 31, Issue 2 (7-2025)
Abstract
Background & Aim: Current clinical education programs in nursing often demonstrate moderate quality; despite a solid theoretical foundation, students frequently lack essential cognitive skills necessary for effective clinical decision-making. This study aimed to evaluate the impact of an integrated educational program using case study method and the nursing process on the clinical decision-making capabilities of nursing students.
Methods & Materials: This study employed a quantitative, quasi-experimental design with a pretest-posttest approach, conducted in 2019 among final-year undergraduate nursing students at the Faculty of Nursing and Midwifery in Tabriz. A census sampling method was utilized, resulting in a total sample size of 106 students. The intervention group received an integrated educational program incorporating case studies and the nursing process, whereas the control group received conventional training based on a standard logbook. Data collection occurred pre- and post-intervention using the Jenkins Clinical Decision-Making Scale. Data were analyzed using SPSS version 16 through independent t-tests, paired t-tests, and analysis of covariance (ANCOVA).
Results: Paired t-test comparisons within the control group revealed no significant change in overall clinical decision-making scores. Conversely, the intervention group exhibited a statistically significant improvement post-intervention. Between-group analyses indicated that both the total clinical decision-making scores and their four dimensions experienced significant increases after the intervention (P<0.001). ANCOVA, controlling for pretest scores and GPA (Grade Point Average) as covariates, confirmed that the differences in clinical decision-making between the two groups remained statistically significant (P=0.004), with an effect size of 0.08.
Conclusion: The integrated educational method significantly enhances clinical decision-making skills among nursing students. Therefore, nursing educators can enhance students' cognitive skills by using this method in clinical training.
Avishan Gholamiyan, Somayeh Gheysari, Zinat Mohebbi,
Volume 31, Issue 4 (1-2026)
Abstract
Background & Aim: Clinical competence is crucial for enhancing the quality of patient care and increasing patient satisfaction with nurses. Critical thinking is a key factor that influences the clinical competence of nurses. Therefore, this study aimed to explore the relationship between critical thinking and clinical competence among nurses working in intensive care units.
Methods & Materials: This descriptive-correlational study involved 240 nurses working in intensive care units at hospitals affiliated with Shiraz University of Medical Sciences in 2021. Participants were selected using stratified random sampling. Data collection included demographic questionnaires, the California Critical Thinking Form B, and assessments of nurses' clinical competence. Data analysis was conducted using descriptive statistics and the Spearman correlation coefficient in SPSS software version 23.
Results: The mean total score of nurses' clinical competence was 143.53 with a standard deviation of 26.62, indicating an average level of clinical competence based on the instrument's scoring. The total score for nurses' critical thinking was 17.51 with a standard deviation of 13.41, showing a relatively high level of critical thinking among the nurses in the study. A positive and significant correlation was found between the total score of clinical competence and critical thinking (r=0.147, P=0.023).
Conclusion: The results suggest that nurses with stronger critical thinking skills also demonstrate higher levels of clinical competence. Therefore, incorporating strategies to enhance critical thinking in nursing education programs can enhance students' clinical competence, better preparing them for effective clinical judgment and decision-making in complex care scenarios.
