One of the first questions typically asked by faculty members that have switched to a concept-based curriculum (CBC) is, “How do we utilize CBC in the clinical setting so it’s meaningful and enhances critical thinking skills?” One of the ways my college accomplishes this is by using concept mapping in pre- and post-clinical to increase clinical reasoning and clinical judgment.
Just like a concept-based curriculum, concept mapping is an innovative way to not only teach critical thinking, but also for students to utilize critical thinking so they can organize patient problems in a logical format and apply their clinical judgment to eliminate some of these problems (Kaddoura, VanDyke, Cheng & Shea-Foisy, 2016). Concept mapping is an effective way for students to demonstrate an understanding of how different concepts or key problems can relate to each other. A concept-based curriculum uses concepts, along with interrelated concepts, to stimulate critical thinking in much the same way. Combining these two different pedagogies can have a positive impact on nursing students as they participate in clinical rotations.
The Next Generation NCLEX-RN® exam is scheduled to roll out in the near future and will require nursing students to have a better understanding of clinical judgment and reasoning to successfully move forward. Combining a CBC with concept mapping can positively impact the student’s ability to not only critically think, but also improve their ability to independently utilize clinical judgment (Alfayoumi, 2019).
In clinical rotations, faculty and students should use concept mapping as a way to show relationships between patient problems and then organize the patient’s plan of care for the day. Concept mapping can also have a very positive effect on debriefing after clinical experiences (Alfayoumi, 2019).
In the post-clinical debriefing, the clinical instructors lead a discussion with each student about his/her patient(s) for the day. The students take turns discussing the patients by utilizing an SBAR (Situation, Background, Assessment, Recommendation) format. The SBAR format will usually inspire further conversation between faculty and students as they realize how all the priorities are interconnected and how they relate to different concepts. The concept maps can also help students realize how the priorities or concepts are connected to the patient plan of care and use their clinical judgment to anticipate future problems.
The students who are in a CBC and use concept mapping during and after clinical rotations seem more confident in their clinical reasoning abilities compared to those in the traditional curriculum based on the feedback from our faculty who have taught in CBC and traditional curriculum. The students that are more confident have a better understanding of advanced medical diagnosis with numerous comorbidities and are able to use that confidence to make better clinical judgments when on the floor as novice nursing students. A CBC that incorporates concept mapping has enhanced the overall clinical experience for the students, instructors, and patients at my college.
Alfayoumi, I. (2019). The impact of combined concept-based learning and concept mapping pedagogies on nursing students’ clinical reasoning abilities. Nurse Education Today, 72, 40-46. http://dx.doi.org/10.1016/j.nedt.2018.10.009
Kaddoura, M., VanDyke, O., Cheng, B. & Shea-Foisy, K. (2016). Impact of concept mapping on the development of clinical judgment skills in nursing students. Teaching and Learning in Nursing, 11, 101-107. http://dx.doi.org/10.1016/j.teln.2016.02.001
Want to learn more about concept mapping? Download Strengthening Students’ Clinical Judgment Through Conceptual Care Mapping by authors Barbara Yoost and Lynne Crawford.