Building evidence for the development of clinical reasoning using a rating tool with the Outcome-Present State-Test (OPT) Model

As nurses strive to adopt evidence-based practice, those who teach nursing must provide evidence of student learning, both in class and in clinical practicums. The purpose of this study was to describe the use of a tool to rate students’ work in medical-surgical clinical practicums using the Outcome-Present State-Test (OPT) Model of clinical reasoning. The OPT model is a third generation nursing process meta-model designed to assist students in planning and evaluating their nursing care. A sample of 48 students enrolled in a medical-surgical course completed a total of 405 OPT models and Clinical Reasoning Webs, which were re-rated after the students had completed clinical experiences in the course using a new rating tool developed for this study. The rating tool was useful for rating students’ work and noting their development of clinical reasoning skills; however, it needs further refinement and testing. Suggestions are included for faculty members who wish to develop tools for evaluating students’ clinical reasoning.