2025 Theses Doctoral

The Impact of Concept Based Inquiry on Clinical Reasoning

McGuane, Arlene

Clinical reasoning (CR) is an essential skill for nursing and is necessary for safe and effective nursing practice. This skill is critical in how well nurses make clinical decisions and take action to assist their patients. However, this skill is significantly lacking in new nurses, and an academic-practice gap is thought to be the reason. This study investigated the impact of a new concept-based inquiry teaching approach on nursing students’ CR and its relationship with demographics, retention, critical thinking (CT), and metacognition. A quasi-experimental pretest and posttest study design using a non-equivalent comparison group was conducted with undergraduate students enrolled in a baccalaureate pre-licensure program using a concept-based curriculum.

The concept-based inquiry (CBI) approach was introduced to students in the intervention group, while the control group participated in a flipped classroom teaching approach. Both groups engaged in content related to the concept of gas exchange. Clinical reasoning was measured using an NCLEX Next Generation (NGN) style exam created by the author, the clinical reasoning exam (CRE). Test analysis on the exam revealed challenges in writing and using these types of exams to assess CR and were discussed. The relationships of CBI to demographics, critical thinking, and metacognition were also evaluated. A demographic survey assessed age, gender, race/ethnicity, learning disabilities, work experience, military experience, and education level. The Health Sciences Reasoning Test assessed CT, and the Metacognitive Awareness Inventory assessed metacognition.

The results of the study revealed no significant difference in CR between the CBI intervention group and the Flipped Classroom comparison group after the gas exchange class. No significant relationships to demographics or knowledge retention were noted. However, the study revealed that the CBI significantly affected CT and metacognition, critical elements of the CR process. This study demonstrates that the CBI approach may be a promising new teaching method that should be investigated further to determine if using it for a more extended time period would have a greater impact on CR.