Pathophysiology-medical History-signs and symptoms-Health assessment-Investigation-Treatment (PHsHIT): A mnemonic framework for development of clinical reasoning in nursing students: A quasi-experimental design

Aims

To investigate how implementing the PHsHIT framework within a mind map concept and instructional approach could enhance learning experience, leading to enhanced self-perceived clinical reasoning abilities, self-confidence, and clinical decision-making skills among nursing students, while also reducing their levels of anxiety.

Background

Nursing graduates face challenges in applying clinical reasoning proficiently within their initial year of practice.

Methods

This study employed a quasi-experimental pretest-posttest design. Purposive sampling involving a total of 125 nursing students. The intervention group (n = 67) attended a 2-hour tutorial class using the PHsHIT framework, whereas the control group (n = 58) attended a standard tutorial class using conventional methods. Descriptive statistics, chi-square test, parametric between-participants and within-participants analyses of variance were conducted to compare the self-perceived clinical-reasoning ability, self-confidence and anxiety levels, and clinical decision-making ability of the two groups.

Results

At the post-training time point, a significant difference was observed between the two groups in terms of their clinical decision-making ability (MD = 1.18, SE = 0.35, p = 0.001), which suggested that the PHsHIT framework had a short-term training effect.

Conclusion

The PHsHIT framework exhibited short-term benefits for improving students’ clinical decision-making ability, and participants welcomed the method.