Proposal of a digital tool to develop clinical reasoning of novice nurses in psychiatry: an exploratory study in France
In France, successive reforms in nursing education have resulted in a 90% reduction in hours of theoretical instruction in clinical psychopathology since 1972. As a result, novice nurses in psychiatry feel that they have not received sufficient theoretical training at the beginning of their careers. Earlier nursing education programs did not provide scientific education by integrating research. Today, this observation reflects the nurses’ lack of ability to search for reliable data to guide and orient their clinical judgment. A cross-sectional quotation qualitative study was conducted (ref) to understand the specific needs of novice nurses in psychiatry, regarding the knowledge they consider to be lacking and to validate the acceptance of mobile a application in order to improve clinical judgment skills. Our hypothesis is that a digital tool could enrich their clinical knowledge and promote the acquisition of Evidence-Based Nursing, during clinical reasoning. To our knowledge, there are no reports of such a system for nursing psychiatry in the literature. Semi-structured interviews were conducted with seventeen novice nurses in psychiatry with different backgrounds. The interview guide, based on Benner's theory and Tanner and Rabardel's models, addresses several topics: professional experience and motivation, evaluation of initial training, problems identified in practice, sources of information in the field of psychiatry, and finally acceptance of digital tools. The analysis of the interviews confirms the feeling of lack of knowledge among these professionals and indicates that a digital tool would be well accepted. Several examples were identified for the content of this tool, including ways to use it during the clinical reasoning process. The following files contain the verbatims of the interviews in French and the interview guide. All names have been changed to ensure anonymity.
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The analysis began with the transcription of the interviews. The verbatim speech was transcribed manually to facilitate the appropriation of the comments by indicating laughter, silence, and hesitation, including facial expressions and gestures noted during the interview. After anonymizing the transcripts, a vertical and horizontal content analysis was conducted for each interview in terms of the categories defined in the next section, based on the method proposed by Bardin (Bardin, 2013). We defined seven categories to conduct our content analysis. These categories are directly related to the theories in our conceptual framework in our article. We followed recommendations for qualitative study on equator network.