Aug 2026· Journal of pediatric nursing· Vol 91, pp.
474-483
· 0 citations· 26 references
Medicine
TL;DR
Pediatric nursing clinical reasoning is reframed as situated, developmentally informed, family-centered, and communicatively accountable judgment rather than as individual problem solving alone.
Abstract
Background
Undergraduate pediatric nursing education must prepare students to integrate clinical information with developmental interpretation, family perspectives, communication, and uncertainty. Although case-based learning supports knowledge application, its conventional framing may underrepresent the relational, linguistic, and information-rich conditions in which pediatric judgment is formed.
Aim
To propose and justify a socio-clinical, case-based model of pediatric nursing clinical reasoning for undergraduate education.
METHODOLOGICAL APPROACH
A structured conceptual development process combined theory derivation and theory synthesis, guided by conceptual framework analysis. Sources from nursing science, educational theory, social theory, and contemporary information environments were selected for explanatory relevance. Concepts were retained according to theoretical relevance, definitional clarity, disciplinary compatibility, explanatory distinctiveness, and pedagogical operationalizability.
Findings
The resulting framework integrates four mutually reinforcing dimensions-phenomenological-clinical, dialogical-relational, sociotechnical-critical, and linguistic-epistemic-and translates them into three interacting pedagogical layers: instructional, cognitive-clinical, and sociotechnical-relational. Linguistic mediation operates across the model to make reasoning visible, shareable, and assessable.
Conclusion
Pediatric nursing clinical reasoning is reframed as situated, developmentally informed, family-centered, and communicatively accountable judgment rather than as individual problem solving alone.
IMPLICATIONS FOR PRACTICE
The model offers educators a course-level architecture for sequencing authentic cases, focused conceptual scaffolding, structured dialogue, reasoning with evolving information, and assessment tasks that require students to interpret, prioritize, justify, and communicate decisions. It provides a testable basis for faculty development, curricular implementation, and evaluation across comparable undergraduate pediatric nursing settings.
The reviewed literature shows that simulation-based learning and virtual simulation are the most common approaches that can improve students’ clinical reasoning, knowledge retention, self-efficacy, confidence, and satisfaction.
Nanxiang Zhang· Curriculum and Teaching Meth...· 0 citations
Introduction: The integration of Evidence-Based Practice (EBP) into nursing education faces challenges in linking theory to clinical application in complex family health contexts. Students struggle with efficiently accessing, appraising, and applying evidence influenced by sociocultural factors. Artificial intelligence (AI) offers transformative potential but requires pedagogical design to foster critical thinking and ethical use beyond technical skills.Method: An action research with mixed methods was conducted with 100 nursing students. The intervention had four phases: participatory family diagnosis, AI-assisted evidence retrieval and validation, community educational workshops design and execution, and multi-level evaluation.Results: A significant shift in AI use from basic to strategic, with a 40% reduction in literature search time. Qualitative data revealed enhanced critical awareness and ethical reasoning, while quantitative results indicated 90% of students improved critical appraisal skills and 70% felt more confident in evidence-based decisions. The project impacted 100 families, with 90% trusting evidence-based recommendations.Conclusions: Integrating AI in experiential pedagogies like Design Thinking and Service-Learning effectively develops nursing competencies, ensuring technology adoption supports context-sensitive family health learning outcomes.
Maria Graciela Villalba-Condori, Carla Cuya-Zevallos· Publicaciones· 0 citations
The nursing process is a systematic, patient-centered framework essential for clinical reasoning and decision-making in nursing education. It is commonly operationalized through the ADPIE (Assessment, Diagnosis, Planning, Implementation, and Evaluation) model, which guides nurses in identifying patient needs, developing care plans, implementing interventions, and evaluating outcomes in a structured and iterative manner. Although the nursing process is fundamental to nursing education and practice, some students may experience difficulties in applying ADPIE effectively, particularly the aspects of clinical reasoning and reflective practice. This was a quasi-experimental study conducted to compare the effects of a Generative Artificial Intelligence (GenAI)-assisted nursing process approach with traditional instruction on nursing students’ evidence-based critical thinking, learning self-efficacy, and self-reported clinical reasoning. Moreover, the study integrated the intervention into a second-year nursing course (i.e., nursing process via obstetric nursing internship) as part of formal curriculum activities. Students who participated in the GenAI-assisted nursing process approach demonstrated higher levels of evidence-based critical thinking, improved learning self-efficacy, and enhanced self-reported clinical reasoning ability compared with those in the traditional instruction group. The GenAI system provided adaptive feedback, real-time scaffolding, and iterative case refinement beyond traditional case-based learning. Integrating GenAI into the ADPIE framework within nursing education may enhance students’ critical thinking, learning self-efficacy, and self-reported clinical reasoning by supporting structured and reflective learning processes, offering a promising pedagogical approach for nursing education.
Clinical reasoning, defined as the thinking and decision-making processes that underpin clinical practice, is a critical outcome of health professions education. Clinical reasoning occurs across diagnostic, therapeutic, and contextual decision-making throughout complete episodes of patient care and develops through repeated engagement with authentic clinical problems.
This commentary examines intentional curricular integration, specifically the concurrent teaching of examination, diagnosis, and patient management, as a structural approach to creating opportunities for clinical reasoning development.
Curricular structures that fragment examination, diagnosis, and patient management may limit opportunities for learners to practice clinical reasoning in ways that reflect real-world clinical practice. Although instructional strategies such as case-based learning, problem-based learning, and simulation can support clinical reasoning development, their effectiveness may be influenced by how they are embedded within the broader curricular structure.
Drawing on literature from across health professions and athletic training education, we describe several feasible curricular integration models, including integrated courses, parallel course delivery, and sequenced but intentionally linked courses. These approaches provide different mechanisms for intentionally connecting examination, diagnosis, and patient management across complete episodes of care.
Curricular integration can increase opportunities for students to engage concurrently in diagnostic, therapeutic, and contextual reasoning and clinical decision-making across complete episodes of care.
Athletic training programs should consider intentionally structuring curricula around complete episodes of care and reinforcing integrated reasoning across both didactic and clinical education experiences. Integration may be achieved through multiple approaches and does not require wholesale curricular restructuring.
By intentionally connecting examination, diagnosis, and patient management and reinforcing integrated reasoning in classroom and clinical settings, athletic training programs can increase opportunities for students to practice clinical reasoning in ways that more closely reflect real-world clinical practice.
Barton E. Anderson, K. Mace, Kathryn Webster Rogers et al.· Journal of Athletic Training...· 1 citation
Communication with the child emerged as a core component of pediatric clinical practice experiences and simulation-based training and mentorship may enhance nursing students' confidence and self-efficacy in pediatric clinical settings.
Merve Oral, Tutku Kırcı Temiz, H. Boztepe· Journal of pediatric nursing· 0 citations
Medical students’ perceptions of nursing are strongly shaped by early and variably structured clinical experiences, particularly the nursing internship, and the findings suggest that current medical curricula insufficiently support the systematic development of interprofessional role understanding.
Lukas Valerius, Jonathan Hagedorn, Christian Albert et al.· Frontiers in Medicine· 0 citations
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