Journal Article

Pathophysiology-medical History-signs and symptoms-Health assessment-Investigation-Treatment (PHsHIT): A mnemonic framework for development of clinical reasoning in nursing students: A quasi-experimental design

Chan, Alice M.L.

2025

Overview

To investigate how implementing the PHsHIT framework within a mind map concept and instructional approach could enhance learning experience, leading to enhanced self-perceived clinical reasoning abilities, self-confidence, and clinical decision-making skills among nursing students, while also reducing their levels of anxiety. Nursing graduates face challenges in applying clinical reasoning proficiently within their initial year of practice. This study employed a quasi-experimental pretest-posttest design. Purposive sampling involving a total of 125 nursing students. The intervention group (n = 67) attended a 2-hour tutorial class using the PHsHIT framework, whereas the control group (n = 58) attended a standard tutorial class using conventional methods. Descriptive statistics, chi-square test, parametric between-participants and within-participants analyses of variance were conducted to compare the self-perceived clinical-reasoning ability, self-confidence and anxiety levels, and clinical decision-making ability of the two groups. At the post-training time point, a significant difference was observed between the two groups in terms of their clinical decision-making ability (MD = 1.18, SE = 0.35, p = 0.001), which suggested that the PHsHIT framework had a short-term training effect. The PHsHIT framework exhibited short-term benefits for improving students’ clinical decision-making ability, and participants welcomed the method. •Nursing students lack clinical reasoning.•Nursing students lack effective learning strategies.•Nursing students are not able to apply knowledge into clinical practice.•Using learning in teaching exhibited short-term benefits for improving clinical decision-making.•Mnemonic PHsHIT can be used in classroom and clinical learning to develop clinical reasoning.

• Publisher: Elsevier Ltd,Elsevier Limited
• Subject: Ability / Adult / Anxiety / Associative processes / Attrition (Research Studies) / Case Studies / Chi-square test / Clinical assessment / Clinical Competence - standards / Clinical Decision-Making / Clinical nursing / Clinical Reasoning / Clinical skills / College students / Confidence / Control Groups / Coronaviruses / COVID-19 / Data Analysis / Decision making / Decision Making Skills / Education, Nursing, Baccalaureate - methods / Educational Assessment / Educational Strategies / Female / Frame analysis / Groups / Humans / Information storage / Learning framework / Learning strategies / Likert scale / Likert Scales / Male / Medical decision making / Medical Evaluation / Medical history / Medical History Taking - methods / Medical treatment / Mnemonic / Mnemonics / Multiple choice / Nurse education / Nurses / Nursing / Nursing education / Nursing Students / Outcomes of Education / Pandemics / Pathophysiology / Patients / Practicums / Pretesting / Quasi-experimental methods / Quasiexperimental Design / Questionnaires / Reasoning / Research design / Researchers / Sample Size / Sampling / Self concept / Self Esteem / Short term / Statistical Data / Statistics / Students / Students, Nursing - psychology / Students, Nursing - statistics & numerical data / Teaching methods / Training