This scoping review describes the responsibilities of facilitators, especially clinical teachers, in facilitating clinical reasoning and factors affecting the implementation of the strategies. This review was conducted by collecting and identifying original data in peer-reviewed full English journals published between 2004 and 2021. It followed Arksey and O’Malley’s framework and adhered to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. The process included formulating review questions, developing a comprehensive search strategy, selecting relevant studies, extracting data, and presenting findings. Initial searches were conducted on PubMed, EBSCO, Scopus, and EMBASE, with a research librarian ensuring the efficiency and comprehensiveness of the search. The search based on the PCC approach (population, concept, context approach) encompassed “clinical reasoning,” “facilitation,” and “clinical teachers.” Out of the initial 2,004 records retrieved from the four databases, a thorough screening process led to the 30 studies included in the review, revealing three primary themes and multiple strategies related to clinical reasoning facilitation in clinical settings. These themes involved the responsibilities of clinical teachers, strategies utilized, and factors influencing clinical reasoning learning in clinical settings. In the clinical settings, clinical teachers have crucial responsibilities in facilitating clinical reasoning learning, including creating a safe environment, demonstrating effective practices, using appropriate strategies, and assessing students’ abilities. While this review has explored the responsibilities of clinical teachers, specific strategies that enhance clinical reasoning abilities need further investigation. Additionally, the impacts of identified factors on strengthening clinical reasoning abilities require more analysis.
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Clinical reasoning is considered a crucial concept in reaching medical decisions. This paper reviews the reasoning processes involved in clinical reasoning from the perspective of cognitive psychology. To properly use clinical reasoning, one requires not only domain knowledge but also structural knowledge, such as critical thinking skills. In this paper, two types of reasoning process required for critical thinking are discussed: inductive and deductive. Inductive and deductive reasoning processes have different features and are generally appropriate for different types of tasks. Numerous studies have suggested that experts tend to use inductive reasoning while novices tend to use deductive reasoning. However, even experts sometimes use deductive reasoning when facing challenging and unfamiliar problems. In clinical reasoning, expert physicians generally use inductive reasoning with a holistic viewpoint based on a full understanding of content knowledge in most cases. Such a problem-solving process appears as a type of recognition-primed decision making only in experienced physicians’ clinical reasoning. However, they also use deductive reasoning when distinct patterns of illness are not recognized. Therefore, medical schools should pursue problem-based learning by providing students with various opportunities to develop the critical thinking skills required for problem solving in a holistic manner.
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Purpose Premedical education is one stage in which various educational approaches are used to promote critical thinking. Given that critical thinking ability could be regarded as one of the intended outcomes of social science and humanities education, this study explored the effectiveness of a course to promote critical thinking in a premedical curriculum using both literature and film.
Methods Fifty-one 2nd year premedical students enrolled in a ‘Critical Thinking for Premeds’ course. Students were required to read or watch a selected material, submit group discussion agendas, attend five group discussion sessions, and write critical essays. Five tutors facilitated the group discussions, observed and assessed the students’ performance and critical essay. Students’ critical thinking disposition and opinion on assigned reading materials were examined before and after the course. A program evaluation survey was conducted to investigate the students’ reaction after the course.
Results On average, students appreciated 78.6% of the total assigned materials. The students indicated that group discussions and the narrative comments of facilitators contributed the most to develop critical thinking. After the course, the students’ tendency preferring cheaper price books, as well as medicine-related books decreased significantly. Students who had critical essay scores greater than or equal to the median demonstrated a significant improvement in critical thinking disposition scores.
Conclusion The course was well-accepted by premedical students and had several positive outcomes. A more effective use of the course could be anticipated with a clearer explanation of the purpose, the consideration of previous reading experience, and use of complementary learning activities.
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PURPOSE The purpose of this study was to evaluate the relationships among critical thinking disposition, general self-efficacy, leadership and clinical competence, and identify the factors influencing clinical competence in nursing students.
METHODS In this descriptive study, 153 nursing students (from 2nd to 4th school year) of a university in South Korea were enrolled in December 2010. The instruments for this study were the Korean versions of the Critical Thinking Disposition Scale, General Self-Efficacy Scale, Leadership Inventory, and Clinical Competence Scale. Data were analyzed by descriptive statistics, t-test, MANOVA, Pearson correlation, and multiple linear regression with PASW 18.0 software.
RESULTS The mean scores (ranging from 1 to 5) in nursing students for critical thinking disposition, general self-efficacy, leadership, and clinical competence were 3.44, 3.51, 3.55, and 3.42, respectively. Positive correlations were found for clinical competence with critical thinking disposition, general self-efficacy, and leadership. The strongest predictor of clinical competence was leadership. In addition, leadership, nursing school year, and subjective academic achievement accounted for 34.5% of variance in clinical competence.
CONCLUSION This study revealed that developing leadership, critical thinking disposition, and self-efficacy in undergraduate nursing education is important to improve clinical competence of nursing students.
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