Building Practice Ready Nurses: Strengthening the Development of Clinical Reasoning Skills in Undergraduate Nursing Programs

Purpose: The purpose of this integrative review was to determine the effectiveness of the implementation of different measurement tools by undergraduate nursing programs in developing practice-ready clinical reasoning by the time of graduation. Background: Clinical reasoning is essential to quality nursing care and positive patient outcomes. The academic-to-practice gap that exists in part from the way nursing content is taught has been critiqued in the literature over the past two decades. In the current nursing climate, it is crucial for nursing programs to produce practice-ready nurses, equipped with strong clinical reasoning skills, at the time of graduation to prevent failure to save events and poor patient outcomes. Literature Search: A comprehensive literature search was performed using CINAHL and PubMed databases for articles within the specified inclusion and exclusion criteria. Fifteen articles were selected for systematic review and synthesized using thematic analysis. Discussion: To produce practice-ready nurses undergraduate nursing programs have a variety of pedagogical skills at their disposal. Undergraduate programs need to ensure their curriculum design aligns with their clinical reasoning goals. Students are best supported in developing clinical reasoning when provided with proper scaffolding and feedback from an instructor. Clinical reasoning measurement tools need to be used for formative evaluations of clinical reasoning as students progress in the program to ensure they will be practice ready at graduation. Conclusion: It is imperative that undergraduate programs take the necessary steps to design curriculums and utilize pedagogy that molds students' clinical reasoning skills to be equivalent to those of a practice-ready nurse.