关键词: 教育,护理, 临床决策, 成人护理学, 课程

Abstract:

To enhance students’ clinical reasoning and decision-making skills,our research team previously developed a clinical nursing reasoning and decision-making model—the GUIDANCE model. This model comprises eight distinct stages:gather cues,use cues to hypothesize,investigate further,diagnose the problems,analyze and determine the nature of the problems,nursing care planning,carry out interventions,and evaluate outcomes. In this study,the model was integrated into the teaching practice of the Adult Nursing curriculum. By systematically embedding the model into instructional components such as classroom lectures,problem-based learning,scenario simulations,virtual simulations,and clinical clerkships,we guided students to perform information gathering,problem analysis,and nursing decision-making in accordance with structured steps. Comprehensive analysis of students’ classroom performance,formative assessments,and teaching feedback over long-term practice indicates that the GUIDANCE model effectively enhances the systematicity and organization of students’ clinical reasoning and decision-making. It facilitates a transition from superficial,fragmented judgments to systematic,structured decision-making,thus providing practical experience and a reference for the cultivating of clinical reasoning and decision-making skills in nursing curricula.

Key words: Education,Nursing, Clinical Decision-Making, Adult Nursing, Curriculum