Effectiveness of combined reflective learning strategy on perceived clinical reasoning among nursing students Tanzania: A quasi- experimental study

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Abstract Background Patient safety is seriously threatened by the lack of fundamental clinical reasoning abilities. Competent nurses play a significant role in maintaining safety and effective healthcare services by integrating knowledge, abilities and attitudes that enable them to adapt to a changing health environment. Nursing clinical competence is the synthesis of knowledge, skills, clinical reasoning, values, beliefs and attitudes. Objective The purpose of this study was to compare the three teaching and learning methods (conversational, journaling and combined conversational and journaling reflective learning strategy in determine its effect on perceived self-directed learning and clinical reasoning in nursing education. Methods The study was conducted using a prospective quasi-experimental with pre- and post-evaluation. Participants received brief training on reflective practices and started to collect their clinical experiences based on the current clinical rotation department, write reflective journals, and conduct reflective conversations guided with Gibbs’s model of reflection. Data collection was performed before and after the intervention on their perceived clinical reasoning using the Nurses Clinical Reasoning Descriptive analysis and inferential statistics such as DID model were used. Results The study included 143 participants with mean age of 24.10 ± 2.12 where 74.8% of them were male. There was a statistically significant mean score change on perceived clinical reasoning among participants over time. The mean score performance of the participants ranged from 2.98 ± 0.94 to 4.43 ± 0.50. The overall effect size of the intervention on perceived clinical reasoning among participants accounted for β = 1.7091 to 2.2217. which is a huge effect size as compared to when they had no exposed on a combined reflective practice. Conclusion The findings revealed that integrated conversational and journaling reflective learning strategy has significant academic potentials of empowering the nursing students clinical reasoning skills before the provision of care to patients. Thus, combined reflective learning strategy can be used as a clinical teaching and learning strategy in nursing education.

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