A DESCRIPTIVE STUDY OF THE DEVELOPMENT OF COGNITIVE DIAGNOSTIC REASONING SKILLS IN UNDERGRADUATE NURSING STUDENTS ACROSS A FOUR SEMESTER TIME PERIOD.
Contributors: Boston College.
Published: 1991
Number of pages: 147
Subjects: Health Sciences, Nursing.; Education, Higher.
Description: This longitudinal study examined thirty-two baccalaureate students' ability to differentiate nursing diagnosis labels from other terms, generate diagnostic hypotheses using NANDA accepted terms, include the hypothesis suggested by limited cues in the list of hypotheses generated and, finally, list the additional cues necessary to confirm the diagnostic hypothesis. Data were collected at the end of each of four semesters using the Diagnostic Reasoning Tests developed by Gordon.

The highest mean score (79.7%) in diagnostic language recognition occurred at the end of the first semester. Students' early acquisition of diagnostic language was further demonstrated by ability to state hypotheses in NANDA accepted terminology over 80% of the time at the end of the first semester. The mean number of NANDA hypotheses generated increased significantly from 1.8 to 2.2 between semesters one and four. The mean number of all hypotheses generated was 2.0 at the end of the first semester and there was no significant change longitudinally. Student agreement with expert diagnostic opinion varied from the first to the fourth semester (34%, 65%, 58%, 76%) and was significantly related to the form of the test used.

The number of additional cues listed to support a selected nursing diagnosis increased significantly from a mean of 1.47 per vignette at the end of the first semester to a mean of 1.92 at the end of the fourth semester. However, 54% of students still did not list major cues at the end of the fourth semester.

Students in this sample learned the language of nursing diagnosis early in the program. Concern that the diagnostic language used by these students represented labeling rather than skill in the diagnostic reasoning process was suggested by the low number of hypotheses generated and the limited number of major cues listed.

Further research is recommended to replicate the study in other nursing student populations, determine the relationship between faculty expertise and student diagnostic skill, improve the measurement instruments for future longitudinal studies, and validate the major cues for each nursing diagnosis.
Notes: Source: Dissertation Abstracts International, Volume: 52-07, Section: B, page: 3532.

Thesis (PH.D.)--BOSTON COLLEGE, 1991.

School code: 0016.