The purpose of this study was to investigate the relationships among the
critical thinking disposition, nursing work environments, and clinical decision
making abilities of clinical nurses to provide basic data for strategies and
developing programs to improve their clinical decision making abilities.
Data were collected from 192 nurses who had worked for more than 6
months with a self-reported questionnaire in five general hospitals, from April
20 to May 22, 2015. The research variables were measured with the Critical
thinking disposition scale (Yun, 2004), the Nursing work environment scale
(Jo et al., 2011), and the Clinical decision making abilities scale used (Heo,
2014). The data were analyzed by Cronbach''s αlpha, descriptive statistics,
t-test, ANOVA, Pearson''s correlation coefficient, and hierarchical multiple
regression
The results were as follows:
1. The mean score was 3.50 on critical thinking disposition. The mean score
of the nursing work environments was 2.33, indicated that the subjects
perceived negatively about nursing work environments. The mean scored
3.46 on clinical decision making abilities. The score was lower than that of
nurses who worked in large-sized general hospitals of the metropolis or nursing specialists.
2. Critical thinking disposition was significantly different in age, marital
status, position, total clinical experience, clinical experience in present
hospital, and monthly salary. Nursing work environments was no
significant differences in any general and job-related characteristics.
Clinical decision making abilities was significantly different in age, marital
status, educational level, position, total clinical experience, clinical
experience in present hospital, and monthly salary.
3. Clinical decision making abilities was positively related to critical thinking
disposition and nursing work environments. Multiple regression analysis
showed that nurses'' clinical decision making abilities significantly
influenced by critical thinking disposition and nursing work environments
which explained 42% of variance of clinical decision making abilities
(F=15.39, p<.001).
Consequently, these findings indicated that critical thinking disposition
and nursing work environments are important predictors of clinical decision
making ability of nurses.
Based on these results, this study suggests the following:
1. It is needed to improve the nursing work environment where the nurses
can make a decision with their nursing jobs through critical thinking and
develop the educational programs to reinforce their critical thinking
disposition for enhancing their clinical decision making abilities.
2. It will be needed the nursing curriculum which provide to nursing students
with more opportunities for experiential learning to make a clinical decision
through the nursing cases so that they will improve their clinical decision
making abilities. The hospitals and nursing organizations should offer the
systematic and organizational supports and the career-based educational
programs.
3. The systematicity and prudence of critical thinking disposition scores were
lower than that of other sub-factors. Therefore, further studies will be
needed to make an inquiry into related variables such as work
environments and situations that make the nurses have a low perception of
systematicity and prudence.
4. Further studies will be needed to consider clinical decision making abilities
including various variables and other areas and hospitals.
Key words: Nurses, Critical thinking disposition, Work environment, Clinical
decision-making.