Student nurses' perceptions of clinical decision-making in the final year of adult nursing studies

This paper focuses upon an exploration of undergraduate students' perceptions of clinical decision-making skills in their final year of a baccalaureate adult nursing programme. A phenomenological study was carried out, with a sample of 21 students undertaking their nursing management module. They produced a consensus concept mapping of clinical decision-making and completed self-assessment questionnaires exploring their personal confidence and understanding of clinical decision-making. Twelve students from this group also participated in a focus group interview to further explore their conceptualisation of clinical decision-making. Although the students demonstrated a complex theoretical conceptualisation of clinical decision-making, they tended to focus on the impact of clinical decision-making, and the value of concrete experience rather than the value of cognitive skills in the process and application of decision-making theory to practice. They linked their level of clinical knowledge and experience with their level of skill in clinical decision-making, rather than their cognitive ability. The students identified the patient as the focus of clinical decision-making, and reflected concerns about the personal impact of clinical decision-making on themselves, and the quality of care as the main factors influencing their decisions.