Transforming undergraduate nursing curriculum by aligning models of clinical reasoning through simulation

Whilst clinical reasoning skills are deemed essential in health care professions, undergraduate nursing students often struggle to develop these requisite skills. Teaching nursing students the skills to engage clinical reasoning requires a strategic and systematic approach by educators to make these tacit processes explicit. This paper reports on the design phase of an innovative curriculum re-design for the purpose of enhancing clinical reasoning skills in nursing students through simulation-based learning. Many approaches to simulation-based learning focus on the post-simulation debrief as the forum for engaging students in clinical reasoning. In contrast, this curriculum re-design brought together two existing models of clinical reasoning in order to align the simulation scenario and the post-simulation debrief with a clinical reasoning framework. These models were the Clinical Reasoning Cycle (Levett-Jones & Hoffman, 2013; Levett-Jones, Hoffman, Dempsey, et al., 2010), and Debriefing for Meaningful Learning© (Dreifuerst, 2012; 2015). An analysis of the two models revealed the differences in the processes advocated by both works. We argue however that the synergies created by bringing together the two models represented a pedagogically sound approach to simulation design, assisted facilitators to engage students in clinical reasoning through simulation, and reinforced the cognitive and metacognitive processes of clinical reasoning for student nurses.