Evaluation of Reported Level of Clinical Confidence in Student Nurses Using Deliberate Practice
Critical thinking and clinical reasoning, which support confidence in clinical decision-making of nurses, are still being developed during pre-licensure education. Nursing faculty in higher education are tasked with the challenge to increase the level of practice undergraduate nursing students experience during their program. The question guiding this project was what effect does the use of deliberate practice with medication administration have on medical-surgical nursing II students regarding clinical confidence? The purpose of this study was to determine if the use of deliberate practice with nursing students by implementing weekly medication administration simulations would increase the level of clinical confidence in second semester medical-surgical nursing II clinical students. Two campuses of a community college system were used as intervention and control groups. The intervention group participated in weekly medication administration simulations requiring them to review a simulated patient chart and provide rationale for administration of identified medications. Statistical analysis was completed using independent samples t-test to evaluate any potential differences. Statistically significant differences were identified when comparing intervention and control groups (p < .001), however, further evaluation revealed significance between pre-intervention data regarding control vs. intervention groups, but no significance between post-intervention data (p = .336). The intervention group showed a lower level of clinical confidence with the initial survey when compared to the control group, but did improve and surpass the control group, though a statistical difference was not observed. The implementation of deliberate practice did not show significantly greater results for this research project but did appear to support improved clinical confidence with the intervention group. The intervention group started with a lower confidence level compared to the control group, but ended up slightly, yet not significantly, higher level of confidence than the control group. Further research is recommended on this topic, particularly over a longer period (16-week course instead of 8-week course), to allow for more evenly dispersed practice time.
Clinical confidence, Clinical reasoning, Deliberate practice, Pre-licensure nursing student
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