ArticleBMC medical education2024
Metacognitive processes, situational factors, and clinical decision-making in nursing education: a quantitative longitudinal study.
Article in BMC medical education, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- A structured teaching module for postoperative follow-up in urology residency training: development and evaluation of an IMDB-based educational tool.BMC medical education · 2026Article
- Factors influencing clinical decision-making skills among nurses in Malaysia: A three-level general linear mixed-effects analysis.International journal of nursing studies advances · 2026Article
- The Effect of Emergency Department Nurses' Core Self-Evaluations on Their Perceptions of Clinical Decision-Making: A Cross-Sectional Study.Journal of nursing management · 2026Article
- Explore thyself: is it time for metacognition screening in clinical trials?Clinical parkinsonism & related disorders · 2026Review
- Factors influencing patient safety competence among Chinese vocational nursing students: A mixed-methods study using COM-B model and theoretical domains framework.International journal of nursing studies advances · 2025Article
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3 authors.
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Abstract
objectiveThis study examined the longitudinal development of metacognitive skills and clinical decision-making abilities in nursing students, focusing on the interactions between metacognitive processes, situational factors, and individual differences.
methodsA longitudinal, quantitative design was employed, following 185 third-year nursing students from a major university in China over one academic year. Data were collected at six time points using the Metacognitive Awareness Inventory, Nursing Decision-Making Instrument, and custom-designed clinical scenario assessments. Latent Growth Curve Modeling, Multilevel Modeling, and Moderation Analysis were used to analyze the data.
resultsSignificant positive growth trajectories were observed for both metacognitive awareness (mean slope = 0.07, p < .001) and decision-making skills (mean slope = 0.08, p < .001). Metacognitive regulation emerged as the strongest predictor of decision-making outcomes (β = 0.188, p < .001 for quality; β = 0.168, p < .001 for efficiency). Task complexity negatively impacted decision-making quality (β = -0.129, p < .001), while time pressure more strongly affected efficiency (β = -0.121, p < .001). Cognitive style and emotional intelligence moderated the relationship between metacognitive processes and decision-making outcomes. The effectiveness of metacognitive strategies in mitigating the negative effects of situational factors varied across individuals and over time.
conclusionThis study provides robust evidence for the complex interplay between metacognitive processes, situational factors, and individual differences in the development of clinical decision-making skills among nursing students. The findings highlight the importance of tailoring educational interventions to enhance specific metacognitive skills, particularly regulation, while considering the impact of situational factors and individual cognitive styles. These insights can inform the design of more effective, personalized approaches to nursing education, potentially enhancing the preparation of nursing students for the complexities of clinical practice.
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