Razonamiento clínico en la enseñanza de licenciado en enfermería: revisión de blanco

Menezes, Sáskia Sampaio Cipriano de; Corrêa, Consuelo Garcia; Silva, Rita de Cássia Gengo e; Cruz, Diná de Almeida Monteiro Lopes da

doi:10.1590/S0080-623420150000600021

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REVIEW ARTICLE • Rev. esc. enferm. USP 49 (6) • Dic 2015 • https://doi.org/10.1590/S0080-623420150000600021 copiar

Razonamiento clínico en la enseñanza de licenciado en enfermería: revisión de blanco

Autoría SCIMAGO INSTITUTIONS RANKINGS

Resumen

OBJETIVO

Este estudio tuvo como objetivo analizar el estado actual del conocimiento sobre razonamiento clínico en la enseñanza durante el licenciado en enfermería.

MÉTODO

Revisión sistemática de blanco mediante estrategia de búsqueda aplicada en la base de datos MEDLINE y análisis del material recuperado con extracción de los datos por dos revisores independientes. Los datos extraídos fueron analizados y sintetizados de forma narrativa.

RESULTADOS

De las 1380 citaciones recuperadas en la búsqueda, fueron mantenidas 23 para la revisión, y sus contenidos fueron sintetizados en cinco categorías: 1) la experiencia de desarrollar el pensamiento crítico/razonamiento clínico/proceso de toma de decisión; 2) estrategias de enseñanza relacionadas con el desarrollo del pensamiento crítico/razonamiento clínico/proceso de toma de decisión; 3) medición de variables relacionadas con el pensamiento crítico/razonamiento clínico/proceso de toma de decisión; 4) relación de variables involucradas en el pensamiento crítico/razonamiento clínico/proceso de toma de decisión; y 5) modelos teóricos de desarrollo del pensamiento crítico/razonamiento clínico/proceso de toma de decisión por estudiantes.

CONCLUSIÓN

El mayor desafío para desarrollar el conocimiento acerca de la enseñanza del razonamiento clínico parece ser obtener consistencia entre las perspectivas teóricas acerca del desarrollo de razonamiento clínico y las metodologías, métodos y procedimientos en las iniciativas de investigación en este campo.

Descriptores
Toma de Decisiones; Enfermería; Educación en Enfermería, Revisión

Type of study and methodology	N	%*
1. Empirical (type)	14	51.8
1.1 Qualitative (design)	5	21.8
Content analysis	2	8.7
Ethnography	1	4.3
Action research	1	4.3
Grounded theory	1	4.3
1.2 Quantitative (design)	9	39.1
Cross-sectional / Analytical	3	11.1
Methodological development	2	8.7
Quasi-experimental (before and after)	2	8.7
Quasi-experimental with non-randomized control group	1	4.3
Cohort	1	4.3
2. Theoretical (type)	9	39.1
2.1 Case studies (design)	4	17.4
2.2 Opinion (design)	3	11.1
2.3 Review (design)	2	8.7
Total	23	100

Categories and subcategories	Type of study
Categories and subcategories	Empirical	Theoretical	Total
Teaching strategies related to the development of clinical reasoning/decision-making/critical thinking	2	6	8
Strategies for developing critical thinking^{(3,11 -16)}	2	5	7
Strategies for developing clinical reasoning(¹⁷17 Baldwing KB. Friday night in the pediatric emergency department a simulate exercise to promote clinical reasoning in the classroom.. Nurse Educ 2007;32(1):24-9.)	-	1	1
Relationship of variables involved in clinical reasoning/decision-making/critical thinking	4	1	5
Development of critical thinking(¹⁸18 Spelic SS, Parsons M, Hercinger M, Andrews A, Parks J, Norris J. Evaluation of critical thinking outcomes of a BSN program. Holist Nurs Pract. 2001;15(3):27-34.)	1	-	1
Relationship between the curriculum and critical thinking/ Development of critical thinking(¹⁹19 Beckie TM, Lowry LW, Barnett S. Assessing critical thinking in baccalaureate nursing students: a longitudinal study. Holist Nurs Pract. 2001;15(3):18-26.)	1	-	1
Relationship between thinking styles and creativity(²⁰20 Almansa P, López-Martinez O, Corbolán J, Limiñana-Gras RM. Thinking styles and creativity preferences in nursing. Creat Nurs. 2013;19(2):91-100.)	1	-	1
Relationship between reflective skills and sense of coherence between theory and practice by students(²¹21 Hatlevik IKR. The theory-practice relationship: reflective skills and theoretical knowledge as key factors in bridging the gap between theory and practice in initial nursing education. J Adv Nurs. 2011;68(4):868-77.)	1	-	1
Relationship between critical thinking and performance in professional accreditation examinations (NCLEX-RN)(²²22 Romeo EM. Quantitative Research on critical thinking and predicting nursing students' NCLEX-RN Performance.. J Nurs Educ 2010;49(7):378-86.)	--	1	1
The experience of developing clinical reasoning/decision-making/critical thinking	3	1	4
Learn how to make clinical decisions (factors that favor/encourage or discourage/disfavor; conditions in which learning occurs)(²³23 Young N. An exploration of clinical decision-making among students and newly qualified midwives. Midwifery. 2012;(28):824-30.)	1	-	1
Development of critical thinking(²⁴24 Yuan H, Williams BA, Fan L. A systematic review of selected evidence on developing nursing students' critical thinking through problem-based learning. Nurse EducToday. 2008;28(6):657-63.)	-	1	1
Understanding the experience of developing critical thinking, clinical reasoning and problem solving(²⁵25 Lake S, Mclnnes R. Exploring cognitive skill development in midwifery education. Nurse Educ Pract. 2012;12(5):264-8.)	1	-	1
Situations/contexts that demand critical thinking(²⁶26 Mun MS. An analysis of narratives to identify critical thinking contexts in psychiatric clinical practice. Int J Nurs Pract. 2010;16(1):75-80.)	1	-	1
Measurement of variables related to the clinical reasoning/decision-making/critical thinking	3	-	3
Measurement of intuition(²⁷27 Smith AJ. Continued psychometric evaluation of intuition instrument for nursing students. J Holist Nurs. 2006;24(2):82-9.-²⁸28 Demir Y, Denat Y, Khorshid L, Eser I. Cultural validation of the "Use of Intuition by Nursing Students Scale - Turkish version". J Transcult Nurs. 2013;23(4):369-76.)	2	-	2
Measurement of critical thinking(²⁹29 Stone CA, Davidson LJ, Evans JL, Hansen MA. Validity evidence for using a general critical thinking test to measure nursing students' critical thinking.. Holist Nurs Pract 2001;15(4):65-74.)	1	-	1
Theoretical model of the development of clinical reasoning/decision making/critical thinking	2	1	3
Model of mental schemata construction for the development of skills in solving problems concerning calculating medicine dosages(³⁰30 Weeks KW, Higginson R, Closhesy JM, Coben D. Safety in numbers 7: veni, vidi, duci: A grounded theory evaluation of nursing students' medication problem-solving schemata construction. Nurse Educ Pract. 2013;13(2):78-87.)	1	-	1
Model of relationship between variables that contribute to critical thinking(³¹31 Redding DA. The development of critical thinking among students in baccalaureate nursing education. Holist Nurs Pract 2001;15(4):57-64.)	-	1	1
Decision-making model(³²32 Brooks EM, Thomas S. The perception and judgment of senior baccalaureate student nurses in clinical decision making. ANS Adv Nurs Sci. 1997;19(3):50-69.)	1	-	1
Total	14	9	23

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Sáskia Sampaio Cipriano de Menezes Rua Teresina, 495, Adrianópolis CEP 69057-070 - Manaus, AM, Brazilsaskiasampaio@gmail.com