An integrative literature review of educational strategies that promote the clinical judgement ability PDF
Preview An integrative literature review of educational strategies that promote the clinical judgement ability
AN INTEGRATIVE REVIEW OF EDUCATIONAL STRATEGIES THAT PROMOTE THE CLINICAL JUDGEMENT ABILITY OF STUDENTS IN HEALTH CARE Nora Frances Olivier July 2014 x AN INTEGRATIVE REVIEW OF EDUCATIONAL STRATEGIES THAT PROMOTE THE CLINICAL JUDGEMENT ABILITY OF STUDENTS IN HEALTH CARE By Nora Frances Olivier Dissertation submitted in accordance with the requirements for the degree Magister Societatis Scientiae in Nursing in the Faculty of Health Sciences School of Nursing University of the Free State Bloemfontein Supervisor: Prof. Y. Botma July 2014 viii I certify that the dissertation hereby submitted by me for the MSocSc (Nursing) degree at the University of the Free State is my independent effort and had not previously been submitted for a degree at another university/faculty. I furthermore waive copyright of the dissertation in favour of the University of the Free State. ________________________ Nora Frances Olivier July 2014 viii LETTER OF SUBMISSION APPROVAL BY STUDY LEADER viii ACKNOWLEDGEMENTS Nielen, as always. Your continued support, care and friendship served as encouragement to complete the work. Annemarie Joubert, once again, you proved to be the special person you are, thank you for all you time and insight. I am honoured to know you and have you as friend. Anna-Marie Welman, thank you for all the phone calls and help. Annamarie du Preez, without your diligent searches and help in the library the research would not have seen the light, thank you. Cecilna Grobler, there is no adequate manner in which to thank you for all you have done but do accept my heartfelt thanks. Thank you for the formatting of the dissertation. You are a wonderful friend. Thank you to all my colleagues at the School of Nursing, the many times I received encouragement and words of advice. Among you there is a special person receiving special thanks. Magda Mulder, I am glad you also had a part in the work, thank you for the Afrikaans translation. The two people who did the language editing, Ella and Christo, thank you for patching my quilt. Last but never the least, Yvonne Botma. Thank you for accompanying me on this journey as mentor, colleague and friend. Thank you for coping with my demanding habits and being available to provide the necessary help. Finally. Thank You for listening to all my prayers, specifically those sent to You at three o’clock at night! viii SUMMARY The plethora of literature available on the practice-theory gap, learning transfer and the continuous search for better methods of educating healthcare students emphasises the fact that an educational problem exists. The best available evidence informs clinical practice, and educators in healthcare should base educational decisions on the best evidence supporting educational strategies. The purpose of the study is to determine the educational strategies that promote clinical judgement of students in healthcare through an integrative literature review of studies published from January 2000 to October 2013. Multiple databases and search methods were used to identify studies that met the inclusion criteria for an integrative literature review. The search strategies identified 897 records of which seven were identified for critical appraisal according to the inclusion criteria. Three researchers independently critically appraised the articles according to the standardised CASP and QaulSyst, appraisal tools. Four of the seven studies were used for analysis. Although an integrative review allows for qualitative studies, all four articles were randomised control studies. This review was unable to provide conclusive evidence regarding appropriate educational techniques promoting clinical judgement. All four studies differed regarding sample size, duration, type of interventions and the outcome measurement tools. The four trials used high fidelity simulation, case-based learning and web- based learning as educational strategies. Shared educational design factors of the educational strategies were found, such as authenticity, active student engagement, cooperative learning, learner focussed and scaffolding, providing a shared base for educational strategies improving learning transfer and clinical judgement. Two of the studies indicated sequencing of the interventions improved clinical judgement. Due to the paucity of evidence, no conclusion as to which educational strategies promote clinical judgment could be made. However, there is evidence suggesting that high fidelity simulation, case-based learning and web-based learning may promote transfer of learning. x Recommendations for further research include a standardised measurement of clinical judgement and that more educational strategies should be tested for their ability to promote transfer of learning. Keywords Clinical judgement Educational strategies Educational design factors Healthcare Learning transfer Theory-practice gap Integrative literature review Simulation Web-based learning Case-based learning viii OPSOMMING Die oorvloed van beskikbare literatuur wat oor die teorie-praktyk gaping, die oordrag van leer en die deurlopende navorsing vir beter onderrigmetodes van gesondheidsorgstudente handel, beklemtoon die feit dat daar ‘n opvoedkundige probleem bestaan. Die beste beskikbare bewyse rig die kliniese praktyk en opvoedkundiges in gesondheidsorg moet hul besluite baseer op die bewyse wat hul opvoedkundige strategieë ondersteun. Die doel van die studie is om die opvoedkundige strategieë te identifiseer wat studente se kliniese oordeel bevorder deur ‘n volledige literatuuroorsig te doen van studies wat vanaf Januarie 2000 tot Oktober 2003 gepubliseer was. Veelvuldige databasisse en soekmetodes is gebruik om studies te identifiseer wat aan die insluitingskriteria van ‘n volledige literatuuroorsig voldoen. Die soekstrategieë het 897 rekords opgelewer waarvan sewe vir kritiese waardering geïdentifiseer is volgens die vereistes van die insluitingskriteria. Drie navorsers het onafhanklik van mekaar die artikels volgens die gestandaardiseerde CASP en QaulSyst instrumente waardeer. Vier van die sewe studies is vir analise gebruik. Alhoewel ‘n omvattende oorsig vir kwalitatiewe studies voorsiening maak, was al vier studies gerandomiseerde toevallige kontrole studies. Hierdie oorsig was nie daartoe in staat om onweerlegbare bewys te lewer van toepaslike opvoedkundige tegnieke wat kliniese oordeel bevorder nie. Al vier studies het verskil met betrekking tot steekproefgrootte, duur van studie, tipe van tussentrede en die instrumente wat gebruik is om die uitkomste te meet. Die vier studies het simulasie , geval- en webgebaseerde leer as opvoedkundige strategieë gebruik. Die opvoedkundige strategieë het die volgende ontwerpfaktore soos outentisiteit, aktiewe studentbetrokkenheid, samewerkende leer, leerder gesentreerdheid en stellasies van kognitiewe denke bevat. Dit voorsien ‘n gedeelde basis vir opvoedkundige strategieë wat leeroordrag en kliniese oordeel bevorder. Twee van die studies het aangetoon dat die opeenvolging van tussentredes ook kliniese oordeel bevorder het. viii Weens die gebrekkige bewyse kan geen gevolgtrekkings gemaak word oor watter opvoedkundige strategieë kliniese oordeel bevorder nie. Nietemin, daar is bewyse wat voorstel dat hoë getrouheid-simulasie, geval-gebaseerde leer en web- gebaseerde leer die oordrag van leer kan bevorder. Aanbevelings vir verdere navorsing sluit gestandaardiseerde meting van kliniese oordeel in en dat meer opvoedkundige strategieë se vermoë om oordrag van leer te bevorder, getoets moet word. Kliniese oordeel Opvoedkundige strategieë Opvoedkundige ontwerpfaktore Gesondheidsorg Oordrag van leer Teorie-praktykgaping Volledige literatuuroorsig Simulasie Web-gebaseerde leer Geval-gebaseerde leer viii ACRONYMS ACS Acute Coronary Syndrome CASP Critical Appraisal Skills Programme CBL Case-based learning eDerm Web-based learning HPS Human patient simulation OSCE Objective structured Clinical Examination PASW Statistical software version 17.0 PBL Problem-based learning RCT Randomised control trial SIM Simulator based learning SPSS Statistical software version 14.0 QualSyst Critical appraisal tool viii
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