The Status Of Nurses,clinical Reasoning Competence And Its,Correlation With Self-directed Learning Ability In Three-level A-rate Hospitals In Shenyang

Objective: To investigate the current status of clinical reasoning competence and explore factors of clinical reasoning competence,as well as its relationship with self-directed learning ability of nurse,to provide nurses with a theoretical basis of interventional measures in order to improve clinical reasoning competence of nurses,for reforming teaching method of nursing continuing education and providing a new direction to enhance the overall quality of nurses so as to improve the quality of care services.Methods: Multi-stage sampling was used to extract 800 clinical nurses in 4three-level A–rate hospitals in Shenyang for the questionnaire survey.The questionnaire consisted of the General Information Questionnaire,Nurses Clinical Reasoning Scale and Nurses' Self-directed Learning Ability scale.SPSS 20.0was used to analyze the data.Statistical analysis was carried out on the general data of clinical nurses,clinical reasoning competence and nurses' self-directed learning ability of nurses.The single factor analysis and multivariate analysis were used to analyze the influencing factors of nurses 'clinical reasoning competence.The correlation between nurses' clinical reasoning competence and self-directed learning ability was analyzed by Spearman analysis and linear correlation analysis.Results: 1.The results of clinical reasoning competence: The median nurse's clinical reasoning competence was 62 points,25% nurses' score less than 57 points,25% nurses' score higher than 68 points,the rest of the nurses' scored in the range of57 points to 68 points.2.The results of single factor analysis: Nine factors had statistically significant effect on the clinical reasoning competence of nurses(P <0.05).3.The results of multivariate analysis: Working hours,the frequency of reading,departments,with colleagues in the overall health of patients into the multiple regression equation(P <0.05).4.The results of nurse self-directed learning ability survey: Among the four dimensions of nurse self-directed learning ability scale,the scores of "self-motivation and belief" dimensions ranged from 23 to 88,while the "task analysis" dimensionsranged from 8 to 30,the scores of "self-monitoring and adjustment " dimension ranged from 18 to 50,the scores of " self-evaluation " dimension ranged from 4 to 12,and overall score ranged from 72 to 169.75% of nurses' self-directed learning ability ranged from 127~ 151 points.5.Correlation analysis and linear regression between nurses ' clinical reasoning competence and self-learning ability of nurses : there was a positive correlation between clinical reasoning competence of nurses and nurses' self-directed learning ability.The higher of Self-motivation,mission analysis,self-monitoring and adjustment lead to higher score of clinical reasoning competence.Conclusions: 1.The clinical reasoning competence of nurses in Shenyang is at a high level.2.The factors of nurses' clinical reasoning competence are working hours,the frequency of reading,departments,with colleagues on the overall health status of patients.3.The clinical reasoning competence of nurses is significantly related to nurses' self-directed learning ability.Nurses' self-directed learning ability is the influencing factor of nurses' clinical reasoning competence,and a high level of self-learning ability is conducive to enhancing nurses' clinical reasoning competence.