Enhancing the clinical reasoning of new graduate nurses: An experimental study using pre-test and post-test measures

Abstract

Abstract Background: This study examined the development of clinical reasoning abilities among new graduate nurses in a hospital setting. A blended learning approach incorporating a serious gaming platform, Socratic questioning, self-assessment, and facilitator feedback was used to improve their ability to reason clinically in actual patient cases. Method: This study used a blended learning approach to examine how including a serious gaming platform, Socratic questioning, self-assessment, and facilitator feedback impacted the clinical reasoning abilities of new graduate nurses when evaluating patient cases. We conducted a Paired Sample t-test using a validated rubric to evaluate the potential enhancement of clinical reasoning abilities. Results: The results showed a noticeable disparity in the scores of clinical reasoning from the initial pre-test to the first post-test (M= -6.54 SD = 5.754) (t = -5.334, df = 21, p = 0.000), and from the initial pre-test to the second post-test (M = -9.54 SD = 5.115) (t = -8.752, df = 21, p = 0.000), at a significance level of 0.05, with p value less than 0.05. The study found that the effect size, d, was 0.53 indicating a medium effect size. In addition to quantitative data, nurses' perceptions of the blended learning approach incorporating the serious gaming platform, Socratic questioning, self-written case scenarios, and facilitator feedback were also reported to provide qualitative insights into the approach's effectiveness for nurses. Conclusions: Study findings suggest that integrating a serious gaming platform (thinking aloud), self-assessment, facilitator feedback (using self-written case scenarios), and Socratic questioning effectively enhanced the clinical reasoning skills of nurses. Specifically, nurses were better able to form well-supported reasons and judgments when evaluating patient cases. These findings suggest that using a serious gaming platform with Socratic questions can enhance nurses' clinical reasoning skills through written and oral discussions.