Impacting Nursing Students' Clinical Reasoning Through an Innovative Series of Obstetric Simulations
Abstract
Purpose: Most maternal deaths in the United States are attributed to avoidable medical causes. Clinical reasoning has been indicated as an essential competency for nurses to successfully manage patient care (Liou et al., 2015; Tyo & McCurry, 2019). New graduate nurses are often considered inadequately prepared for practice, lacking clinical reasoning skills to make critical decisions (Liou et al., 2015). Nursing students must develop clinical reasoning in high-risk obstetric care to reduce maternal mortality. Simulation provides an evidence-based approach to develop clinical reasoning using higher-order cognitive skills (Theobald et al., 2021; Tyo & McCurry, 2019).
The purpose of this quantitative descriptive study was to determine if a series of high-risk obstetric simulations affected student’s clinical reasoning. The research question asked: What is the effect of high-risk obstetric simulations on pre-licensure nursing students' clinical reasoning?
Methods: The study was conducted at a Health Sciences Center School of Nursing in the southeastern United States. Junior-level nursing students in a traditional BSN program were recruited for the study via email. Participants completed an online demographic survey prior to the simulations and the Nurses Clinical Reasoning Scale prior to and following the simulations. The simulation topics were pre-eclampsia, shoulder dystocia, and post-partum hemorrhage. The study received approval from the Institutional Review Board.
Results: A total of 98 students participated, 80 (81.63%) female and 18 (18.37%) male. Most students were non-Hispanic (95.92%) and Caucasian (72.45%). Participant ages ranged from 20 to 44 with mean=23, SD=4.5.
Total scores for the Nurses Clinical Reasoning Scale increased significantly from pre (M=53.95, SD=8.38) to post (M=59.44, SD=8.74) with p<.0001. No statistically significant relationships were observed between post minus pre-test differences in Nurses Clinical Reasoning Scale scores and age, gender, or race.
Conclusion: This study explored the effect of a series of high-risk obstetric simulations on clinical reasoning in undergraduate nursing students. This study's results indicated that students had a significant increase in clinical reasoning following participation in a single-site simulation experience consisting of three high-risk obstetric simulations. These findings highlight the value of integrating simulation in nursing curricula to improve clinical reasoning.
Notes
References: Gunja, M.Z., & Zephyrin, L.C. (2022). Health and health care for women of reproductive age. The Commonwealth Fund. https://www.commonwealthfund.org/publications/issue-briefs/2022/apr/health-and-health-care-women-reproductive-age
Liou, S., Liu, H., Tsai, H., Tsai, Y., Lin, Y., Chang, C., & Cheng, C. (2016). The development and psychometric testing of a theory based instrument to evaluate nurses’ perception of clinical reasoning competence. Journal of Advanced Nursing, 72(3), 707–717. https://doi.org/10.1111/jan.12831
Reinhardt, A., León, T. G., DeBlieck, C., & Amatya, A. (2019). Using simulations to advance clinical reasoning. Applied Nursing Research, 47, 63–70. https://doi.org/10.1016/j.apnr.2019.05.005
Theobald, K., Tutticci, N., Ramsbotham, J., & Johnston, S. (2021). Effectiveness of using simulation in the development of clinical reasoning in undergraduate nursing students: A systematic review. Nurse Education in Practice, 57, 103220. https://doi.org/10.1016/j.nepr.2021.103220
Tyo, M. B., & McCurry, M. K. (2019). An Integrative Review of Clinical Reasoning Teaching Strategies and Outcome Evaluation in Nursing Education. Nursing Education Perspectives, 40(1), 11–17. https://doi.org/10.1097/01.nep.0000000000000375
Sigma Membership
Epsilon Nu at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Descriptive/Correlational
Research Approach
Quantitative Research
Keywords:
Simulation, Teaching and Learning Strategies, Competence, Maternal Health, Maternal Deaths, New Graduate Nurses, Novice Nurses
Recommended Citation
Davis, Alison H. and Giarratano, Gloria, "Impacting Nursing Students' Clinical Reasoning Through an Innovative Series of Obstetric Simulations" (2025). International Nursing Research Congress (INRC). 153.
https://www.sigmarepository.org/inrc/2025/presentations_2025/153
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Impacting Nursing Students' Clinical Reasoning Through an Innovative Series of Obstetric Simulations
Seattle, Washington, USA
Purpose: Most maternal deaths in the United States are attributed to avoidable medical causes. Clinical reasoning has been indicated as an essential competency for nurses to successfully manage patient care (Liou et al., 2015; Tyo & McCurry, 2019). New graduate nurses are often considered inadequately prepared for practice, lacking clinical reasoning skills to make critical decisions (Liou et al., 2015). Nursing students must develop clinical reasoning in high-risk obstetric care to reduce maternal mortality. Simulation provides an evidence-based approach to develop clinical reasoning using higher-order cognitive skills (Theobald et al., 2021; Tyo & McCurry, 2019).
The purpose of this quantitative descriptive study was to determine if a series of high-risk obstetric simulations affected student’s clinical reasoning. The research question asked: What is the effect of high-risk obstetric simulations on pre-licensure nursing students' clinical reasoning?
Methods: The study was conducted at a Health Sciences Center School of Nursing in the southeastern United States. Junior-level nursing students in a traditional BSN program were recruited for the study via email. Participants completed an online demographic survey prior to the simulations and the Nurses Clinical Reasoning Scale prior to and following the simulations. The simulation topics were pre-eclampsia, shoulder dystocia, and post-partum hemorrhage. The study received approval from the Institutional Review Board.
Results: A total of 98 students participated, 80 (81.63%) female and 18 (18.37%) male. Most students were non-Hispanic (95.92%) and Caucasian (72.45%). Participant ages ranged from 20 to 44 with mean=23, SD=4.5.
Total scores for the Nurses Clinical Reasoning Scale increased significantly from pre (M=53.95, SD=8.38) to post (M=59.44, SD=8.74) with p<.0001. No statistically significant relationships were observed between post minus pre-test differences in Nurses Clinical Reasoning Scale scores and age, gender, or race.
Conclusion: This study explored the effect of a series of high-risk obstetric simulations on clinical reasoning in undergraduate nursing students. This study's results indicated that students had a significant increase in clinical reasoning following participation in a single-site simulation experience consisting of three high-risk obstetric simulations. These findings highlight the value of integrating simulation in nursing curricula to improve clinical reasoning.
Description
Nurses need education in managing pregnancy complications to reduce maternal mortality rates. Multiple ways of thinking allow nurses to manage their role in the healthcare team and provide safe patient care. Clinical reasoning has been indicated as an essential feature for successful management of patient care. Simulation provides an approach to develop and practice clinical reasoning.