Clinical decision making in nursing practice with case-based reasoning

This paper describes the development of a self-paced multimedia learning resource designed to facilitate the transition of graduating nurses into the workplace. The resource uses an authentic case to simulate the complexities of life in a typical hospital ward, and place graduating nurses in the role of problem-solvers. Problem solving in the simulation is based on a rich repertoire of cases and stories that have been extracted from the experiences of expert practitioners. This case-based reasoning architecture reflects a model of learning where graduating nurses are coached in the development of decision-making skills within the context of a contrived but an authentic presenting problem. Outcomes of formative evaluation carried out in a semi-structured format with individuals and small groups of nurse practitioners have revealed a positive disposition towards the resource and the approach to learning it utilises.