| Abstract | The present and categorical correspondence between how students approach their
learning and the way such approaches impact on the acquisition and augmentation
of clinical decision-making skills is neither well understood, nor yet clearly
established, in nurse education research. To address this gap, this study
investigated the approaches to learning and the clinical decision-making of adult
nursing students in their final year of training on two separate campuses of a central
London university. Approaches to Learning Theory, promulgated by Martin and Sӓljö
in 1976, and subsequently expanded and updated by Entwistle and colleagues,
provided a theoretical lens and explanatory framework for this study. Acknowledging
that the Approaches to Learning Theory adopts a hierarchy of three domains of
approach, surface, strategic, and deep, it is argued that students’ clinical decisionmaking
should be improved by changing their predominant approach to learning
from the surface or strategic to the deep approach. To test this hypothesis, a
research intervention was implemented for a purposive sample of participants who
adopted either the surface or strategic approach to learning. Consistent with the
underpinning principles of the deep approach to learning, the intervention focused on
enhancing engagement with learning, problem-solving, and critical thinking skills. A
second survey of approaches to learning and clinical decision-making was
administered after the intervention, and semi-structured interviews were conducted
to further corroborate the statistical findings. Instruments for data collection
comprised the Approaches to Study Skills Inventory for Students, known as the
ASSIST (Tait et al, 1998), Jenkins’ (1985) Clinical Decision-making Nursing Scale
(CDMNS), and a short demographic questionnaire designed by the researcher. This
research found that by altering the learning approach, consequent on the researchintervention, the adoption of the deep approach to learning enhanced clinical
decision-making. Post-intervention findings revealed a strong positive correlation
between the deep approach and clinical decision-making. Participants’ disposition for
the surface approach also decreased significantly. Male participants indicated an
affinity for the deep approach in comparison to female students who predominantly
adopted the strategic approach. The study concluded that by cultivating students’
deeper engagement, underpinned by the intention to seek meaning and understand
their learning, clinical decision-making was improved. |
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