A clinical reasoning skills development plan for coronary care nurse: an action research

Abstract Background Clinical reasoning (CR) skills are among the most important nursing competencies for providing safe and effective care in critical care units. Development of CR skills in nursing needs a well-designed interactive process for change to effectively support clinical competence promo...

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Main Authors: Touba Hossein Zadeh, Kian Norouzi Tabrizi, Masoud Fallahi-Khoshknab, HamidReza Khankeh, Forozan Shokooh
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Nursing
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Online Access:https://doi.org/10.1186/s12912-025-03106-9
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author Touba Hossein Zadeh
Kian Norouzi Tabrizi
Masoud Fallahi-Khoshknab
HamidReza Khankeh
Forozan Shokooh
author_facet Touba Hossein Zadeh
Kian Norouzi Tabrizi
Masoud Fallahi-Khoshknab
HamidReza Khankeh
Forozan Shokooh
author_sort Touba Hossein Zadeh
collection DOAJ
description Abstract Background Clinical reasoning (CR) skills are among the most important nursing competencies for providing safe and effective care in critical care units. Development of CR skills in nursing needs a well-designed interactive process for change to effectively support clinical competence promotion. The aim of this study was to develop CR skills among coronary care nurses through an action plan. Methods This participatory action research study was conducted in 2021 based on the framework of Hart and Bond (1995). Study setting was the coronary care unit of a leading heart center in Rasht, Iran. An action plan was designed and implemented with three main components, namely efficiency of nursing education, effective nursing management, and personal professional development. The results of the plan were provided to participants and strategies for improving the plan were determined. Quantitative outcome assessment was performed using the Nurses’ Clinical Reasoning Skills Checklist and the Nurses’ Clinical Reasoning Scale and data were analyzed through the Wilcoxon’s test. Qualitative outcome assessment was performed through focus group discussions and data were analyzed through conventional content analysis. Results The mean scores of CR skills significantly increased after the action plan and participants were satisfied with the plan. The four main categories of the outcomes of the plan were improvement of the thinking process, improvement of professional commitment, improvement of professional competence, and improvement of interprofessional communications. The challenges of the plan were limited efficiency of educational courses on the nursing process, incoherence in nursing documentation, mentors’ inadequate supervision and instructions, and mentors’ role pressure. Conclusions The CR skills action plan can improve coronary care nurses’ CR skills and their competency in making sound clinical decisions and providing safe and quality care services.
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spelling doaj-art-627d4790812e4df8a53512880e586ab52025-08-20T02:10:49ZengBMCBMC Nursing1472-69552025-05-0124111210.1186/s12912-025-03106-9A clinical reasoning skills development plan for coronary care nurse: an action researchTouba Hossein Zadeh0Kian Norouzi Tabrizi1Masoud Fallahi-Khoshknab2HamidReza Khankeh3Forozan Shokooh4School of Nursing and Midwifery, Guilan University of Medical Science (GUMS)Social Determinants of Health Research Center, Department of Nursing, University of Social Welfare and Rehabilitation SciencesDepartment of Nursing, University of Social Welfare and Rehabilitation SciencesDepartment of Health in Disasters & Emergencies, University of Social Welfare and Rehabilitation SciencesDepartment of Basic Sciences, University of Social Welfare and Rehabilitation SciencesAbstract Background Clinical reasoning (CR) skills are among the most important nursing competencies for providing safe and effective care in critical care units. Development of CR skills in nursing needs a well-designed interactive process for change to effectively support clinical competence promotion. The aim of this study was to develop CR skills among coronary care nurses through an action plan. Methods This participatory action research study was conducted in 2021 based on the framework of Hart and Bond (1995). Study setting was the coronary care unit of a leading heart center in Rasht, Iran. An action plan was designed and implemented with three main components, namely efficiency of nursing education, effective nursing management, and personal professional development. The results of the plan were provided to participants and strategies for improving the plan were determined. Quantitative outcome assessment was performed using the Nurses’ Clinical Reasoning Skills Checklist and the Nurses’ Clinical Reasoning Scale and data were analyzed through the Wilcoxon’s test. Qualitative outcome assessment was performed through focus group discussions and data were analyzed through conventional content analysis. Results The mean scores of CR skills significantly increased after the action plan and participants were satisfied with the plan. The four main categories of the outcomes of the plan were improvement of the thinking process, improvement of professional commitment, improvement of professional competence, and improvement of interprofessional communications. The challenges of the plan were limited efficiency of educational courses on the nursing process, incoherence in nursing documentation, mentors’ inadequate supervision and instructions, and mentors’ role pressure. Conclusions The CR skills action plan can improve coronary care nurses’ CR skills and their competency in making sound clinical decisions and providing safe and quality care services.https://doi.org/10.1186/s12912-025-03106-9Clinical reasoningNurseCoronary care unitAction research
spellingShingle Touba Hossein Zadeh
Kian Norouzi Tabrizi
Masoud Fallahi-Khoshknab
HamidReza Khankeh
Forozan Shokooh
A clinical reasoning skills development plan for coronary care nurse: an action research
BMC Nursing
Clinical reasoning
Nurse
Coronary care unit
Action research
title A clinical reasoning skills development plan for coronary care nurse: an action research
title_full A clinical reasoning skills development plan for coronary care nurse: an action research
title_fullStr A clinical reasoning skills development plan for coronary care nurse: an action research
title_full_unstemmed A clinical reasoning skills development plan for coronary care nurse: an action research
title_short A clinical reasoning skills development plan for coronary care nurse: an action research
title_sort clinical reasoning skills development plan for coronary care nurse an action research
topic Clinical reasoning
Nurse
Coronary care unit
Action research
url https://doi.org/10.1186/s12912-025-03106-9
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