A comprehensive pedagogical strategy to cultivate clinical reasoning and problem-solving skills in nursing education.

To evaluate the effectiveness of the StepUp Learning tool on problem-solving and clinical reasoning skills among first-year undergraduate nursing students. While various pedagogical strategies aim to foster higher-order cognitive skills such as problem-solving and clinical reasoning, these efforts o...

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Publicado en:Nurse Education in Practice Vol. 92
Autores principales: Wong, Florence Mei Fung, Lau, Leonia Hiu Wan, Cheng, Kelvin Hai Kiu
Formato: clinical trial research Journal Article
Publicado: Elsevier B.V. Mar2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2026
      vid: 92
      pid: 82545
      pub: Elsevier B.V.
      place: Philadelphia, Pennsylvania
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        192906867
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        10.1016/j.nepr.2026.104744
        192906867
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        atl: A comprehensive pedagogical strategy to cultivate clinical reasoning and problem-solving skills in nursing education.
      aug:
        au:
          Wong, Florence Mei Fung
          Lau, Leonia Hiu Wan
          Cheng, Kelvin Hai Kiu
        affil: Tung Wah College, School of Nursing. Room 1605, Tower 2, Kowloon Commerce Centre, 51 Kwai Cheong Road, Kwai Chung, Hong Kong
      sug:
        subj:
          Teaching Methods
          Clinical Reasoning Education
          Problem Solving Education
          Nursing Skills
          Education, Nursing, Baccalaureate
          Students, Nursing, Baccalaureate Psychosocial Factors
          Human
          Male
          Female
          Adult
          Critical Thinking
          Self-Efficacy
          Confidence
          Learning
          Experiential Learning
          Simulations
          Patient Simulation
          Computer-Assisted Instruction
          Quasi-Experimental Studies
          Parametric Statistics
          Nonparametric Statistics
          Self Report
          Feedback
          Scales
          Descriptive Statistics
          Analysis of Variance
          Analysis of Covariance
          Questionnaires
          Clinical Trials
          Adult: 19-44 years
          Male
          Female
      ab: To evaluate the effectiveness of the StepUp Learning tool on problem-solving and clinical reasoning skills among first-year undergraduate nursing students. While various pedagogical strategies aim to foster higher-order cognitive skills such as problem-solving and clinical reasoning, these efforts often lack a cohesive theoretical structure. Controlled, quasi-experimental design. Guided by Kolb's Experiential Learning Theory, 124 first-year students were assigned to intervention (n = 62) or control group (n = 62). Data normality and variance homogeneity were tested; parametric or non-parametric tests were used accordingly. The intervention involved interactive lectures, self-assessments via e-learning and short questions, videos with feedback, and high-fidelity patient simulation (HFPS). Outcomes were assessed at three time points using the self-reported Problem-Solving Inventory and Nurses' Clinical Reasoning Scale. The intervention group showed significant improvements in problem-solving, reflected in the Approach-Avoidance Style (t = 2.88, p = 0.006) and Problem-Solving Confidence (t = 4.24, p < 0.001), and clinical reasoning (t = -6.16, p < 0.001). Repeated measures ANOVA confirmed these gains over time, whereas the control group showed no significant changes. After adjusting for baseline, ANCOVA revealed higher post-HFPS clinical reasoning scores in the intervention group (F(1121) = 9.01, p = 0.003). Within-group analyses showed significant pre- to post-HFPS improvements in problem-solving and clinical reasoning (all p < 0.001) for the intervention group only. The StepUp Learning tool, grounded in Kolb's experiential learning cycle, effectively enhances problem-solving and clinical reasoning skills. The findings support the efficacy of a structured, multimodal educational framework that prepares nursing students for complex clinical practice. • Nursing education develops students' problem-solving and clinical reasoning abilities through various teaching pedagogies. • The StepUp Learning tool enhance these two skills with a structured, multimodal approach. • This tool can improve nursing students' clinical competencies through a stepwise, active learning process. • Findings support multimedia reinforcement and simulation-based learning to better prepare students for clinical challenges.
      pubtype: Academic Journal
      doctype:
        clinical trial
        research
        Journal Article
      ougenre: Article
    language: English
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