Journal of Korean Academy of Nursing

Research Paper

Temporal Exploration of New Nurses’ Field Adaptation Using Text Network Analysis: Ahn, Shin Hye , Jeong, Hye Won , Yang, Seong Gyeong , Jung, Ue Seok , Choi, Myoung Lee , Kim, Heui Seon; J Korean Acad Nurs 2024;54(3):358-371. Published online August 31, 2024; DOI: https://doi.org/10.4040/jkan.24034

Abstract PDF: Purpose
This study aimed to analyze the experiences of new nurses during their first year of hospital employment to gather data for the development of an evidence-based new nurse residency program focused on adaptability. Methods: This study was conducted at a tertiary hospital in Korea between March and August 2021 with 80 new nurses who wrote in critical reflective journals during their first year of work. NetMiner 4.5.0 was used to conduct a text network analysis of the critical reflective journals to uncover core keywords and topics across three periods. Results: In the journals, over time, degree centrality emerged as “study” and “patient understanding” for 1 to 3 months, “insufficient” and “stress” for 4 to 6 months, and “handover” and “preparation” for 7 to 12 months. Major sub-themes at 1 to 3 months were: “rounds,” “intravenous-cannulation,” “medical device,” and “patient understanding”; at 4 to 6 months they were “admission,” “discharge,” “oxygen therapy,” and “disease”; and at 7 to 12 months they were “burden,” “independence,” and “solution.” Conclusion: These results provide valuable insights into the challenges and experiences encountered by new nurses during different stages of their field adaptation process. This information may highlight the best nurse leadership methods for improving institutional education and supporting new nurses’ transitions to the hospital work environment.

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Original Articles

Structural Equation Modeling on Clinical Decision Making Ability of Nurses: Min Kyoung Park, Soukyoung Kim; J Korean Acad Nurs 2019;49(5):601-612. Published online January 15, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.5.601

Abstract PDF

Abstract Purpose

The purpose of this study was to construct and test a hypothetical model of clinical decision-making ability of nurses based on the Decision Making Process model and the Cognitive Continuum theory.

Methods

The data were collected from nurses working at 11 hospitals in Busan, Daejeon, and South Gyeongsang Province from June 30 to August 1, 2017. Finally, the data from 323 nurses were analyzed.

Results

The goodness-of-fit of the final model was at a good level (χ ²/df=2.46, GFI=.87, AGFI=.84, IFI=.90, CFI=.90, SRMR=.07, RMSEA=.07) and 6 out of 10 paths of the model were supported. The clinical decision-making ability was both directly and indirectly affected by task complexity and indirectly affected by experiences, autonomy, and work environment. Specifically, it was strongly directly affected by analytical competency but was insignificantly affected by intuitive competency. These variables accounted for 66.0% of clinical decision-making ability.

Conclusion

The nurses’ clinical decision-making ability can be improved by improving their analytical competency. Therefore, it is necessary to organize nursing work, create a supportive work environment, and develop and implement various education programs.

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A Study of Critical Thinking Ability of Associate and Baccalaurate Degree Nursing Students: Kyung Rim Shin; Journal of Nurses Academic Society 1996;26(1):43-52. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1996.26.1.43

Abstract PDF

This descriptive study was done to investigate the critical thinking ability of senior nursing students in two types of nursing education programs: associate and baccalaureate programs. Data were convenently collected from 159 associate degree nursing(ADN)students and 158 baccalaureate degree nursing(BSN)students. All schools were the Ministry of Education accredited and located in Seoul City and Kyung gi Province. These data were collected by self reporting questionaire given over two months from March to May, 1995. The subjcets completed the Watson -Glaser Critical Thinking Appraisal (WGCTA)and a demographic questionnaire. The data was analyzed using descriptive statistics and t-test with the SAS program. The results of this study are as follows 1. The mean of critical thinking ability of the ADN students was 42.69. 2. The mean of critical thinking ability of the BSN students was 47.68. 3. There was significant difference in the WGCTA scores between the ADN and the BSN students (t=7.38 p<0.001) 4. This study suggests that critical thinking ability may increase with higher levels of nursing education. Possible explanations for these findings are discussed.

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Critical Thinking Disposition and Problem Solving Ability in Nursing Students
Seung-Ae Yang
Journal of Korean Academy of Nursing Administration.2010; 16(4): 389. CrossRef
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Factors Influencing Nurses' Clinical Decision Making: Focusing on Critical Thinking Disposition: Seungmi Park, In Gak Kwon; Journal of Korean Academy of Nursing 2007;37(6):863-871. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2007.37.6.863

Abstract PDF

PURPOSE: The purpose of this study was to investigate the factors influencing nurses' clinical decision making focusing on critical thinking disposition. METHODS: The subjects of this study consisted of 505 nurses working at one of the general hospitals located in Seoul. Data was collected by a self-administered questionnaire between December 2006 and January 2007. Data was analyzed by one way ANOVA, Pearson correlation coefficients, and stepwise multiple regression using SPSS Win 14.0. RESULTS: The mean scores of critical thinking disposition and clinical decision making were 99.10 and 134.32 respectively. Clinical decision making scores were significantly higher in groups under continuing education, with a master or higher degree, with clinical experience more than 5 years, or with experts. Critical thinking disposition and its subscales have a significant correlation with clinical decision making. Intellectual eagerness/curiosity, prudence, clinical experience, intellectual honesty, self-confidence, and healthy skepticism were important factors influencing clinical decision making(adjusted R2=33%). CONCLUSION: Results of this study suggest that various strategies such as retaining experienced nurses, encouraging them to continue with education and enhancing critical thinking disposition are warranted for development of clinical decision making.

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Development of a Critical Thinking Disposition Scale for Nursing Students: In Soo Kwon, Ga Eon Lee, Gyung Duck Kim, Young Hee Kim, Kyung Min Park, Hyun Sook Park, Sue Kyung Sohn, Woo Sook Lee, Keum Seong Jang, Bok Yae Chung; Journal of Korean Academy of Nursing 2006;36(6):950-958. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2006.36.6.950

Abstract PDF

Purpose

The purpose of this study was to develop a critical thinking disposition scale for nursing students.

Method

The developmental process was construction of a conceptual framework, development of preliminary items, verification of content validity, development of secondary items, verification of construct validity and extraction of final items. The conceptual framework and first preliminary 60 items were obtained through a review of relevant literature and the development of critical disposition scales by 10 researchers who had been studying critical thinking for one year. These items were reviewed by five specialists for content validity and finally 55 items were chosen. The data was collected from October 1 to 15, 2004 and was analyzed using factor analysis and Cronbach's alpha with the SPSS program. The subjects were composed of 560 Bachelor of Science nursing students from 8 nursing schools.

Result

There were 35 final items which were sorted into 8 factors. The factors were identified as ‘ intellectual integrity(6 items)’, ‘ creativity(4 items)’, ‘ challenge(6 items)’, ‘ open-mindedness(3 items)’, ‘ prudence(4 items)’, ‘ objectivity(4 items)’, ‘ truth seeking(3 items)’ and ‘ inquisitiveness(5 items)’. The cumulative percent of variance was 55.107%. The reliability of the scale, Cronbach's alpha was .892 and the factors' ranged from .562-.836.

Conclusion

The result of this study could be used for measuring critical thinking dispositions of nursing students. However, for further validity and reliability, repeated research is necessary.

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A Longitudinal Study of Critical Thinking Dispositions & Critical Thinking Skills in Baccalaureate Nursing Students: Kyung Rim Shin, Ju Young Ha, Kon Hee Kim; Journal of Korean Academy of Nursing 2005;35(2):382-389. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2005.35.2.382

Abstract PDF

Purpose

This longitudinal study was done to investigate critical thinking dispositions and critical thinking skills of nursing students enrolled in a 4-year baccalaureate program at a university in Korea.

Method

The study used a longitudinal design. A convenience sample of 32 nursing students who were completing their 1st, 2nd, 3rd, and 4th year in a baccalaureate program at a selected university was included. The subjects completed the California Critical Thinking Dispositions Inventory (CCTDI), the California Critical Thinking Skill Test (CCTST), and a demographic questionnaire. Data was analyzed by descriptive statistics, repeated ANOVA, adjusted p-values, and Pearson's correlation coefficient with SAS 8.12.

Results

There was statistically significant improvement according to academic year in the CCTDI total mean score (F=7.54, p= .0001) and subscales of Open-mindedness, Self-confidence, and Maturity. Contrarily, no statistically significant difference was found in the CCTST total mean score and subscales' score except Analysis.

Conclusion

There is no significant correlation between critical thinking dispositions and skills, so it will be necessary to repeat a study like this, and the translated instruments should be modified by considering Korean culture.

Citations

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The Effects of PBL(Problem-Based Learning) on the Metacognition, Critical Thinking, and Problem Solving Process of Nursing Students: Heejung Choi; Journal of Korean Academy of Nursing 2004;34(5):712-721. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2004.34.5.712

Abstract PDF

Purpose

This investigation examined the effect of PBL on the meta-cognition, critical thinking, and problem solving process.

Method

The research design was pre-posttest with a nonequivalent control group design. Scenarios for PBL sessions were developed on the basis of textbooks and patients' charts and tested for content validity. Seventy six nursing students who took a ‘Nursing Process’ course from two nursing schools participated in the experimental group and control group. The experimental group performed PBL during the semester. Meta-cognition and problem solving processes were assessed by questionnaires which were developed using pedagogics. Critical thinking was measured by the CCTST(California Critical Thinking Skill Test) Form 2000. The data was analyzed by repeated measure (pretest-posttest) MANOVA, and correlation analysis.

Result

PBL improved the participants' meta-cognition and problem solving process but not critical thinking. The relationship between meta-cognition and the problem solving process was supported but the relationship between critical thinking and problem solving was not supported.

Conclusion

These results suggest that PBL has a positive effect on nursing students' educational outcomes. To improve the problem solving ability of nursing students, PBL should be applied to more subjects in the nursing curriculum.

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Development of Critical Thinking Skill Evaluation Scale for Nursing Students: So Young You, Nam Cho Kim; J Korean Acad Nurs 2014;44(2):129-138. Published online April 30, 2014; DOI: https://doi.org/10.4040/jkan.2014.44.2.129

Abstract PDF

Purpose

To develop a Critical Thinking Skill Test for Nursing Students.

Methods

The construct concepts were drawn from a literature review and in-depth interviews with hospital nurses and surveys were conducted among students (n=607) from nursing colleges. The data were collected from September 13 to November 23, 2012 and analyzed using the SAS program, 9.2 version. The KR 20 coefficient for reliability, difficulty index, discrimination index, item-total correlation and known group technique for validity were performed.

Results

Four domains and 27 skills were identified and 35 multiple choice items were developed. Thirty multiple choice items which had scores higher than .80 on the content validity index were selected for the pre test. From the analysis of the pre test data, a modified 30 items were selected for the main test. In the main test, the KR 20 coefficient was .70 and Corrected Item-Total Correlations range was .11-.38. There was a statistically significant difference between two academic systems (p=.001).

Conclusion

The developed instrument is the first critical thinking skill test reflecting nursing perspectives in hospital settings and is expected to be utilized as a tool which contributes to improvement of the critical thinking ability of nursing students.

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Critical Thinking Disposition and Clinical Competence in General Hospital Nurses: Jin-Ah Park, Bog-Ja Kim; J Korean Acad Nurs 2009;39(6):840-850. Published online December 31, 2009; DOI: https://doi.org/10.4040/jkan.2009.39.6.840

Abstract PDF

Purpose

This study was done to investigate the relationship between critical thinking disposition and clinical competence among nurses in general hospitals.

Methods

This study was a descriptive-correlational study with a convenience sample of 560 nurses from 5 general hospitals. The data were collected by self-administered questionnaires. Critical thinking disposition was measured using the Critical Thinking Disposition Scale for Nursing Students. Clinical competence was measured using the Standardized Nurse Performance Appraisal Tool.

Results

The mean score for critical thinking disposition and clinical competence was 3.37 and 4.10 respectively on a 5 point scale. A statistically significant correlation was found between critical thinking disposition and clinical competence. A regression model explained 72.8% of clinical competence. Prudence is the most significant predictor of clinical competence (R²=.728).

Conclusion

Study findings suggest that nurses with a higher level of critical thinking disposition would have a higher level of clinical competence. Furthermore, prudence might be the most important predictor of clinical competence. In order to strengthen clinical competence in nurses, the development and enhancement of critical thinking should be emphasized at the college level and nurses should be encouraged to make a clinical decision with greater prudence.

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