Clinical decision-making skills in nursing: senior students’ perceptions

  • Fátima Mendes Marques
  • Carlos David
  • Anabela Ferreira dos Santos
  • Sandra Neves
  • Maria José Pinheiro
  • M. Teresa Leal


Decision making is a fundamental skill for nurses' clinical performance (Johansen & O'Brien, 2016; Standing, 2007; Tanner, 2006; Thompson & Stapley, 2011), which is why it should be developed since initial nursing education (Johansen & O'Brien, 2016; Standing, 2007).

It is important to design a curriculum with classroom experiences on learning clinical decision-making needed for, as they improve its learning, (Ramadan & El-Demerdash, 2017) without the stress of real situations (Suarez-Garcia, Maestro-Gonzalez, Zuazua-Rico, Sánchez-Zaballos, & Monastery-Diaz, 2018). The most evident strategies in the literature are the simulation (Nibbelink & Brewer, 2018; Ramadan & El-Demerdash, 2017) and problem-based learning (PBL) (Al-Kloub, Salameh, & Froelicher, 2014; Sharma, 2015).

The Lisbon School of Nursing (ESEL), according to the directives of the European Union and the National Nursing Association (Ordem dos Enfermeiros) (OE), "Regulation No 190/2015 of OE" (2015), for undergraduate education, designed a second year course called Nursing Decision-making Process (NDMP). The purpose is to "empower the student to understand the decision-making process, its strategies, the factors influencing it and the construction of the care process along the life cycle of the client" (ESEL, 2018, p. 2). To achieve it, structuring themes are taught in class, then in theoretical-practical classes the appropriation of knowledge is developed through exercises in which the theories of decision-making are mobilized; and further training of nursing decision making is structured through PBL, in practical classes and in autonomous work.

The aim of this study is to understand the perceptions of undergraduate nursing students about which skills acquired in the course, had impact on clinical practice and influenced on their clinical decision-making.