Clinical reasoning education: evaluating the effect of script strategy and reflective practice on nursing students' reasoning development.

Abstract

Objective: The script strategy is a multistage, adaptive method designed for integration with established clinical reasoning frameworks to enhance educational outcomes for clinical students. This study evaluated the effect of these pedagogical interventions on nursing students' learning, satisfaction levels, and learning experience. This quasi-experimental study was conducted at Tehran University of Medical Science, involving nursing students enrolled in the clerkship course (n = 58). The intervention group was trained using the script strategy method combined with structured reflection within a workplace-based education setting. A hypothesis formation test and a 10-item questionnaire were used to evaluate the students' clinical reasoning skills. In addition, the experiences of the nursing students were explored through conventional content analysis.

Results: The students' scores in reasoning skills were 18.54 ± 11.33 (out of 20), which was significantly above the cutoff value of 10.8. The students' satisfaction score was 74.37 ± 16.31 on a 100-point scale. The students' experiences were explored under the theme "a learner as a director in the learning process." The integration of script strategy enhances the reasoning abilities of nursing students. This approach fosters a sense of responsibility for their learning and cultivates critical thinking skills essential for professional nurses in dynamic healthcare environments.