School of Education


Doctor of Education in Curriculum & Instruction (EdD)


Meredith Park


Decision Making, Nursing Students, Clinical Placement, Critical Thinking, Clinical Judgment


Education | Higher Education | Medical Education | Nursing


Evidence suggests that new nursing graduates entering the workforce struggle with decision making. Poor clinical decisions often lead to undesirable patient outcomes. Utilizing quantitative, causal-comparative, pretest-posttest design, this research explored the effect of four categories of clinical unit placements (specialty units, acute care, critical care, and emergency departments) on senior bachelor of science in nursing (BSN) students’ cognitive decision-making processes to explore which type of unit, if any, significantly changes nursing student cognitive processes while making decisions. A convenience sample of 30 senior BSN students from a private, faith-based university completed both a demographic survey and the Nurse Decision Making Instrument-Revised 2014 (NDMI-R14) before and after a five-week clinical rotation in which each student was assigned to only one unit. A theoretical dyad of Hammond’s cognitive continuum theory and Benner’s novice to expert theory were the framework for this research. The instrument for this study was the NDMI-R14, which quantifies decision-making from analytical cognition to intuitive cognition. Analysis compared the NDMI-R14 posttest results of students assigned to one of the four categories of units while controlling for pretest scores on the NDMI-R14. Though the results of the analysis of covariance were not statistically significant, the results suggested a need to consider clinical curriculum design congruent with desired outcomes for BSN graduates.