Papers by RuthAnne Kuiper
Self-Regulated Learning and the Outcome-Present-State Test Model of Clinical Reasoning Accelerating Critical Thinking Skill Acquisition of Nursing Students
International journal of nursing terminologies and classifications : the official journal of NANDA International
To analyze the degree to which standardized nursing language was used by baccalaureate nursing st... more To analyze the degree to which standardized nursing language was used by baccalaureate nursing students completing Outcome-Present State-Test (OPT) model worksheets in a clinical practicum. METHODS. A scoring instrument was developed and 100 worksheets were retrospectively analyzed. NANDA nursing diagnoses were correctly stated in 92% of the OPT models. Nursing Outcomes Classification (NOC) outcomes were explicitly stated in 22%, and implied in 72%. Interventions matched appropriate Nursing Interventions Classification (NIC) activities in 61%. NANDA, NIC, and NOC (NNN) language was used inconsistently by students in this sample. If NNN language is to advance nursing knowledge, its promotion, representation in curriculum development, and active use is necessary. Educational research is needed on the facilitators and barriers to NNN language use.
PURPOSE. To analyze the degree to which standardized nursing language was used by baccalaureate n... more PURPOSE. To analyze the degree to which standardized nursing language was used by baccalaureate nursing students completing Outcome-Present State-Test (OPT) model worksheets in a clinical practicum. METHODS. A scoring instrument was developed and 100 worksheets were retrospectively analyzed. FINDINGS. NANDA nursing diagnoses were correctly stated in 92% of the OPT models. Nursing Outcomes Classification (NOC) outcomes were explicitly stated in 22%, and implied in 72%. Interventions matched appropriate Nursing Interventions Classification (NIC) activities in 61%. CONCLUSIONS. NANDA, NIC, and NOC (NNN) language was used inconsistently by students in this sample. IMPLICATIONS FOR PRACTICE. If NNN language is to advance nursing knowledge, its promotion, representation in curriculum development, and active use is necessary. Educational research is needed on the facilitators and barriers to NNN language use. Article: This article evaluates students' use of standardized nursing languages with the Outcome-Present State-Test (OPT) model of clinical reasoning. The OPT model has been described as a third-generation nursing process model (Pesut & Herman, 1998). Figures 1 and 2 illustrate the structure of the Clinical Reasoning Web and OPT model worksheets completed by a student for a patient with decreased cardiac output related to septic shock. Pesut and Herman (1999) have defined clinical reasoning as "reflective, concurrent, creative, critical thinking processes embedded in practice; used to frame, juxtapose, and test the match between a present state and outcome state and make judgments about achievement of desired outcomes" (p. 4).
Self-regulated learning during a clinical preceptorship: the reflections of senior baccalaureate nursing students
Nursing Education Perspectives
This research was conducted to test the efficacy of audiotapes as a method of recording reflectio... more This research was conducted to test the efficacy of audiotapes as a method of recording reflections of senior baccalaureate nursing students in a clinical preceptorship. The over-all aim of the research was to promote cognitive and metacognitive thinking processes with self-regulated learning strategies for problem solving in clinical situations. Verbal protocol technique revealed a consistent use of self-regulated learning strategies with a focus on environmental structuring for metacognitive activities. Common themes of thought were found in both clinical experiences and the use of critical thinking skills.
Journal of Continuing Education in Nursing: Continuing Competence for the Future
An important concern of nursing practice and education is the difficulty new graduates experience... more An important concern of nursing practice and education is the difficulty new graduates experience while making the transition from graduate nurse to practicing nurse. Using a comparative descriptive design, self-regulated learning strategies were used to enhance metacognitive critical thinking abilities as 32 new graduate nurses reflected during 8-week preceptorship programs. Verbal protocol analysis revealed the majority of noun referents as metacognitive with thinking nouns increasing in rank from Week 1 to Week 8, present tense verbs were used most frequently with lower-level thinking phrases. Common themes in the narrative were knowledge observation, thinking strategies, judgments of self-improvement, judgments of competence, judgments of resources, self-reactions, and self-correction strategies. New graduate nurses have unique circumstances to overcome in making a transition to the workplace, and having self-regulatory skills would enable this process. The data suggest nursing ...
Leadership Development through the Nurse Faculty Leadership Academy (NFLA) and a Nurse Practitioner (NP) Education Project
Unveiling the use of NANDA, NIC, and NOC (NNN) Languate with the Outcome-Present State Test Model of Clinical Reasoning
International Journal of Nursing Terminologies and Classifications, 2006
The Essentials of Clinical Reasoning for Nurses: Using the Outcome-Present State Test Model for Reflective Practice
Unveiling the use of NANDA, NIC, and NOC Language With Clinical Reasoning Activities Using the Outcome Present State Test Model
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Evaluating the PDA as a ?Point of Care? Resource for Clinical Reasoning of Baccalaureate Nursing Students
Comparing the Use of Audio-Taping Versus Hand Written Journaling
Care Coordination Clinical Reasoning Model for Advanced Practice Nurses
Clinical Reasoning and Care Coordination in Advanced Practice Nursing
This book describes an innovative model for helping APRN students develop the clinical reasoning ... more This book describes an innovative model for helping APRN students develop the clinical reasoning skills required to navigate complex patient care needs and coordination in advanced nursing practice. This model, the Outcome-Present-State-Test (OPT), encompasses a clear, step-by-step process that students can use to learn the skills of differential diagnosis and hone clinical reasoning strategies. This method facilitates understanding of the relationships among patient problems, outcomes, and interventions that focus on promoting patient safety and care coordination. It moves beyond traditional ways of problem solving by focusing on patient scenarios and stories and juxtaposing issues and outcomes that have been derived from an analysis of patient problems, evidence-based interventions, and desired outcomes.
Promoting Cognitive and Metacognitive Thinking Skills by Reflecting with Self-Regulated Learning Prompts
Aim: The purpose of this paper is to describe the research surrounding the theories and models th... more Aim: The purpose of this paper is to describe the research surrounding the theories and models the authors united to describe the essential components of clinical reasoning in nursing practice education. The research was conducted with nursing students in health care settings through the application of teaching and learning strategies with the Self-Regulated Learning Model (SRL) and the Outcome-Present-State-Test (OPT) Model of Reflective Clinical Reasoning. Standardized nursing languages provided the content and clinical vocabulary for the clinical reasoning task. Materials and Methods: This descriptive study described the application of the OPT model of clinical reasoning, use of nursing language content, and reflective journals based on the SRL model with 66 undergraduate nursing students over an 8 month period of time. The study tested the idea that self-regulation of clinical reasoning skills can be developed using self-regulation theory and the OPT model. Results: This research supports a framework for effective teaching and learning methods to promote and document learner progress in mastering clinical reasoning skills. Self-regulated Learning strategies coupled with the OPT model suggest benefits of self-observation and self-monitoring during clinical reasoning activities, and pinpoints where guidance is needed for the development of cognitive and metacognitive awareness. Recommendations and Conclusions: Thinking and reasoning about the complexities of patient care needs requires attention to the content, processes and outcomes that make a nursing care difference. These principles and concepts are valuable to clinical decision making for nurses globally as they deal with local, regional, national and international health care issues.
Reasoning Into the Future: Complexity Thinking and The OPT Model of Clinical Reasoning
The use of a homeless shelter as a clinical rotation for nursing students
The Journal of nursing education, 1995
Homeless persons are a population at risk in the community with health problems which nursing can... more Homeless persons are a population at risk in the community with health problems which nursing can impact. They are a heterogeneous group from all levels of society with a variety of acute and chronic health problems. Senior nursing students learn the theories and causative factors of becoming homeless as well as the resources available to them in this southeastern city. The students are also introduced to the mechanisms by which homeless persons interact with the present healthcare system. The clinical experience is described as it occurs in this inner city location. Learning activities include health assessments, treatments, education, and referrals. The value of this experience to the student is that it promotes independence, self-direction, and priority setting. The advantages and disadvantages of this clinical experience for senior nursing students and their clients are discussed.
A Comparison of Clinical Reasoning Abilities in Senior Baccalaureate Nursing Students: Authentic Clinical Experience versus Human Simulations
Simulation In Healthcare: The Journal of the Society for Simulation in Healthcare
Promoting Cognitive and Metacognitive Thinking Skills by Reflecting with Self-Regulated Learning Prompts
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Papers by RuthAnne Kuiper