Nursing diagnosis as clinical problem-solving: Factors that influence performance

Year: 1994

Author: Cholowski, Krystyna, Chan, Lorna

Type of paper: Abstract refereed

Current research into student learning and problem-solving has linked motivational constructs and prior content knowledge with the quality of learning outcomes. In the present study these relationships are examined in the context of a group of second-year nursing students.

This paper reports on an empirical study investigating the relationships between nursing students' motivational orientation, structure and accessibility of their content knowledge, and the quality of their logical reasoning with the accuracy and quality of nursing diagnoses made in a simulated clinical problem-solving task. One hundred and thirty-eight preservice nursing students completed the Study Process Questionnaire (Biggs, 1987) and the Causal Attribution Scale (Chan, 1994) prior to receiving four lectures on "Predisposing and Precipitating Factors in Mental Health". Post-tests of content knowledge and the clinical problem-solving task provided measures of structure and accessibility of content knowledge, quality of logical reasoning, and the quality and accuracy of nursing diagnosis.

Results from the path analysis linked motivational constructs with measures of prior content knowledge and the quality of logical reasoning in predicting the accuracy and quality of nursing diagnoses. A major finding in the study was the important role of the amount and structuring of prior content knowledge, in conjunction with the quality of reasoning, as predictors of success in clinical problem- solving in nursing. Implications of these findings for nursing instruction are discussed.