• clinical experience;
  • competency;
  • instructor;
  • Iran;
  • nursing student;
  • self-efficacy

Jahanpour F, Sharif F, Salsali M, Kaveh MH, Williams LM. International Journal of Nursing Practice 2010; 16: 595–602 Clinical decision-making in senior nursing students in Iran

Clinical decision-making is the basis for professional nursing practice. This can be taught and learned through appropriate teaching and clinical experiences. Unfortunately, it has been observed that many graduates are unable to demonstrate suitable clinical decision-making skills. Research and study on the process of decision-making and factors influencing it assists educators to find the appropriate educational and clinical strategies to teach nursing students. To explore the experience of nursing students and their view points regarding the factors influencing their development of clinical decision-making skills. An exploratory qualitative approach utilizing grounded theory methods was used; focus group interviews were undertaken with 32 fourth year nursing students and data were analysed using constant comparative analysis. Four main themes emerged from the data: clinical instructor incompetency, low self-efficacy, unconducive clinical learning climate and experiencing stress. The data indicated that students could not make clinical decisions independently. The findings of this study support the need to reform aspects of the curriculum in Iran in order to increase theory–practice integration and prepare a conductive clinical learning climate that enhances learning clinical decision-making with less stress.