A Technology-Supported Guidance Model to Support the Development of Critical Thinking Among Undergraduate Nursing Students in Clinical Practice: Concurrent, Exploratory, Flexible, and Multimethod Feasibility Study (Preprint)

Abstract

BACKGROUND There is widespread recognition and acceptance of the need for critical thinking in nursing education, as critical thinking is needed to provide high-quality nursing. The aim of this study was to evaluate the feasibility of a newly developed intervention prior to a randomized controlled trial (RCT). The intervention, the Technology-Supported Guidance Model (TSGM), was carried out during clinical practice among undergraduate nursing students and aimed to support the development of critical thinking. A major element of this newly developed intervention is an app, Technology Optimized Practice Process in Nursing (TOPP-N), combined with the daily guidance of nursing students from nurse preceptors and summative assessment based on the Assessment of Clinical Education (AssCE). OBJECTIVE The objective of this study is to evaluate the feasibility and acceptability of a newly developed intervention prior to a randomized controlled trial (RCT). METHODS This study was designed as a concurrent, exploratory, flexible, and multi-method feasibility study of the TSGM intervention that included quantitative and qualitative data from nursing students, nurse preceptors, and nurse educators. The primary outcome measures were the feasibility and acceptability of the intervention. Secondary outcomes included the suitability and acceptance of the outcome measures (critical thinking, self-efficacy, clinical learning environment, metacognition and self-regulation, technology acceptance, and competence of mentors), the data collection strategy, the recruitment strategy, challenges to dropout, hindrances to recruitment, retention, and intervention fidelity and adherence. RESULTS Nursing students, nurse preceptors, and nurse educators had varied experiences with the TSGM intervention. We identified factors that make the intervention feasible and factors that make the intervention challenging and may influence the feasibility, acceptability, dropout rate, adherence and fidelity of the intervention. We also identified areas for future improvement of the intervention. CONCLUSIONS The use of a newly developed intervention, TSGM, is feasible and accepted among undergraduate nursing students, nurse preceptors, and nurse educators; however, refinement and improvement of the intervention and the TOPP-N app, improvement in intervention management, and the mitigation of negative factors are necessary prior to an RCT. INTERNATIONAL REGISTERED REPORT RR2-10.2196/31646