By Diana Rupert, PhD, RN, CNE
During any nursing program, preparing nursing students to “think like a nurse" is a tough task that needs to be completed in a relatively short time. Helping students to understand the clinical applications of nursing theory content provides a key step forward in accomplishing this goal and assists students to foster their clinical reasoning skills. A concrete way that faculty can establish the link between theory and application is to use NCLEX-style questions during classroom experiences and discussions.
Students come to nursing programs with different life experiences and various contacts with nursing activities. For example, they may have interacted with nurses at young ages while volunteering at hospitals or working at healthcare clubs. It is also not unusual to hear that family members have inspired a student's interest in nursing or a television show sparked curiosity about the profession. In such cases, students likely have had some exposure to clinical experiences in the nursing field. Other students start their nursing programs having already obtained licensure (e.g., licensed practical/vocational nurse) or other types of health care certification (e.g., nursing assistant). They, too, also will have familiarity with the kinds of scenarios or experiences likely to be encountered during clinical practice.
While experiences in and with nursing are helpful for orienting students and providing a baseline of familiarity with the profession, often we caution students to be careful in using past experiences as the basis for clinical reasoning. Many in practice find “short cuts" that facilitate care, but this may not necessarily follow the best nursing practice available. The items in the NCLEX are designed to focus on ideal practice, which is not always what the nurse will experience in reality. This is where nurses must use their clinical reasoning skills. Nursing schools cannot prepare students for every situation in which they may find themselves.
Many nursing curricula begin clinical experiences within the first nursing course. Students have instruction in theory content in a classroom setting and are required to relate the content to actual nursing situations. On occasion, nurse educators offer personal experiences highlighting a situation and clinical reasoning. Still, there can be disconnects in many content areas.