Nursing students’ development of using physical assessment in clinical rotation—a stimulated recall study

Abstract

Background The overall aim of this study was to explore third-year bachelor nursing students’ stimulated recall reflections on their physical assessment competence development. The choice of learning strategies in nursing education seems to have great impact on nursing students’ use of physical assessment skills while in clinical rotation. There is a need to explore nursing students’ learning processes related to the use of physical assessments. Methods Explorative qualitative design using a triangulation of data collection methods. Nine final-year nursing students’ physical assessment performances during patient encounters were audio-taped and observed. Shortly after, an individual stimulated recall interview based on the audio-recorded patient encounter and observation notes was conducted. A two-fold analysis was conducted: 1) analysis of students’ performed assessments, and 2) a meaning condensation analysis of the stimulated recall interviews. Results 1) Students’ assessments shifted from a checklist approach to a symptom-based approach, and they emphasized conversation as part of their assessments. 2) Through the stimulated recall interviews, students described reasons for using physical assessments in patient encounters, how the learning environment facilitated or hindered their use of physical assessments, and their own learning strategies. Conclusions Findings contribute a novel, in-depth description of what influenced nursing students’ learning processes of using physical assessment during clinical rotation. This study reveals the importance of designing and implementing learning activities in practical and theoretical courses to support and strengthen students’ learning processes. Further, findings suggest that stimulated recall as a reflective practice should be used systematically to enhance clinical reasoning skills and thus provide deep learning. A more targeted course design for physical assessment— building on and emphasizing nursing students’ prior knowledge and competence—may lead to more confident registered nurses and promote patient safety in different health care contexts.