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Clinical reasoning, a key component of knowledgedevelopment for new nurses, is a practice-based, situated form ofreasoning that requires general case knowledge, basic scientificand evidence-based knowledge of patient care. Within Benner’sNovice to Expert framework, a quasi-experimental study with amatched pairs, pre-and post-test design, was conducted using acommercially available web-based instrument validated for measuringclinical reasoning in health care providers (Insight Assessment’sHealth Science Reasoning Test-Numeracy). The study evaluated thenurse resident’s clinical reasoning skills in an establishedacademic medical center’s nurse residency program. This followedthe pilot of a four-session resident facilitation model usingSocratic questioning, case studies, peer-discussion andself-reflection compared with the standard lecture model. Nostatistical significance between the intervention and controlcohort was found on the overall clinical reasoning score (t=-.661df (43), p=0.512> 0.05). However a statistically significantdifference was noted on the sublevel category of explanation forthe control group which could not be explained by this project(t=-2.043, df (43), p=0.047<0.05). This suggests the need forfurther studies to better understand the expected levels ofclinical reasoning and impact of education delivery models within anurse residency program curriculum.

Improving Clinical Reasoning in Nurse Residents: Evaluation of a Resident Facilitator Model in a Nurse Residency Program