Exploring Clinical Reasoning and Judgement Processes Among New Graduate Nurses

Abstract

Introduction: The notion of a seamless transition from the academic to the clinical practice environment for newly graduated nurses (NGNs) remains an ideal. Practice challenges stemming from an under-developed cognitive reasoning ability is associated with new graduate nurses entering the workplace. To date, this remains a concern for practice safety and readiness for the professional nurse role. Given an increasingly complex and fast-paced work environment that is characterized by high acuity levels, in-depth insights to the various aspects and processes that influence the development of clinical reasoning of nurses during transition remains an under-researched area. An understanding of factors that shape NGNs' ability to recognize and reason through clinical scenarios effectively is vital in order to leverage workplace transition and inform learning programs that support transition in the workplace. This doctoral research examined newly graduated nurses' clinical reasoning processes and decision-making abilities to provide guidance in the creation of comprehensive transition programs and explore the influences of contextual factors on clinical reasoning in order to support NGNs entering the workforce. Methods: Mixed methods methodology was utilized to answer the research question and consisted of data collection with the NGNs' at 3-4 months and at 11-12 months of practice experience in their first year. Results: Four main themes were identified; findings suggest several factors influence clinical reasoning and decision-making ability in the new grad ability as they go through different aspects of transition shock in the first year of practice. Conclusion: NGNs' clinical reasoning and judgment ability require time for their development with emphasis not only on content accuracy but also inclusive of process accuracy in reasoning.