Impact of clinical reasoning and diagnostic error education for nurses
Akiko Kobayashi, Taiju Miyagami, Yuji Nishizaki, Keiko Sanbe, Seiko Furusaka, Toshio NaitoAbstract
Objectives
Diagnostic errors occur frequently and significantly affect patient prognosis and medical safety. Nurses, who are closest to patients, are often the first to detect abnormalities. However, owing to insufficient knowledge of medical diagnoses and diagnostic errors, they tend to hesitate in voicing concerns. This study investigated the hypothesis that clinical reasoning and diagnostic error education for nurses improve their knowledge of diagnostic errors and learning motivation.
Methods
A self-administered questionnaire survey was conducted before and after a lecture among nurses working in the outpatient department of Juntendo University Hospital. Eight domains related to diagnostic errors, including knowledge, confidence, motivation, feelings of guilt, and others, were assessed using a seven-point Likert scale. Pre- and post-lecture responses were compared using paired t -tests. Statistical significance was set at p<0.05.
Results
Valid responses were obtained from 35 of the 70 participants in this study (response rate, 50 %), and the mean years of experience among the participants was 15.0 ± 9.0 years. Knowledge of diagnostic errors significantly increased (Pre: 2.1 ± 1.1 to Post: 4.6 ± 1.3), and motivation to learn about diagnostic errors also significantly increased (Pre: 6.1 ± 1.1 to Post: 6.6 ± 0.7).
Conclusions
The above findings suggest that clinical reasoning and diagnostic error education for nurses significantly improve their knowledge, confidence, and motivation to learn about diagnostic errors. Furthermore, diagnostic error education may influence nurses’ perceptions and enhance their ability to participate in the diagnostic process.