The Clinical Decision-Making Processes of Student Nurses

Abstract

This descriptive study examined the clinical decision-making processes used by 19 female senior diploma nursing students in a simulated client situation. The subjects were divided into two groups, with either an internal or external locus of control, as measured by the Rotter Internal-External Locus of Control Scale. From a content analysis of the data, six decision-making elements and eight decision-making processes were identified. The frequency and pattern of use of the decision-making processes differed between internally and externally oriented subjects. Internal subjects used a significantly higher proportion of complex decision-making processes than the external subjects (z = 3.48; p < .01). All subjects were found to use decision-making elements and processes in a manner that reflected novice characteristics and supported the theoretical framework of information-processing theory. These findings have implications for nurse educators in relation to teaching strategies that facilitate clinical decision-making ability and internalization strategies for students with an external locus of control.