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learning clinical reasoning pdf

Introduction Serious gaming is a valuable technology that improves learning and competence development in the Clinical Reasoning and Decision Making in Physical Therapy: Facilitation, Assessment, and Implementation fills this need by providing a comprehensive and in-depth focus on development of the patient-client management skills of clinical reasoning and clinical decision-making. WHAT IS CLINICAL REASONING? Participants were … When conceptual knowledge is organized around diseases, it is known as illness scripts. 9 0 obj Learning Clinical Reasoning Ralph E. Berggren The Journal of the American Board of Family Practice Jan 1992, 5 (1) 121; DOI: 10.3122/jabfm.5.1.121a Eva K. What every teacher needs to know about clinical reasoning. <> •Furze J, Huhn K. Assessing Clinical Reasoning for Learning and Competence: Education and Practice across the Continuum. Tracey Gutierres 6 CLINICAL REASONING: LEARNING TO THINK LIKE A NURSE Contomp/Gte what you have ~amt from this process and what you could have done differently. 5 0 obj The book is unlike any of the standard texts on decision making. Apply the theoretical models to common teaching techniques •5. Your privacy is important to us. Learning Clinical Reasoning... even the title seems different. 2--4;39:98-106. Clinical reasoning is an important component of the medical curriculum. Med Educ. on September 19, 2014. Describe or list facts, context. endobj x���͎1 �;��#0��_i��ZQ�né�U��nժ�:�3(3�B�|qہ�gxx�o�%����� &���~7}|������h�� B�c�0h^�#��x? in clinical reasoning, as understood according to current knowledge, are translated into practical and specific recommendations for promoting the development of strong diagnostic reasoning skills in learners. In this blog post, we are going to share a free PDF download of NCLEX 150 Questions Answers and Clinical Reasoning PDF using direct links. %PDF-1.5 <> ... 2010 Topics Medical logic, Medical logic -- Case studies, Diagnosis, Clinical medicine -- Decision making, Diagnosis -- Case Reports, Clinical Medicine -- Case Reports, Decision Making ... 14 day loan required to access EPUB and PDF files. נ�}zG��T�{{�]i �)��s5K�'UH�G\r���8�xM�*$ Q�!ӯ�d��)4�x��N��=�*���gD� U!v q � <> This is a genuine PDF (ebook) copy of this book hosted to 3rd-party online repositories so that you can enjoy a blazing-fast and safe downloading experience. Define clinical reasoning and explain why it is important in medical education •2. effect on learning clinical reasoning. Select a course of action between the dtfferent alternatives available. Category: Medical The author of the book: Jerome P. Kassirer ISBN-13: 9780781795159 Edition: Lippincott Williams and Wilkins Date of issue: 1 November 2009 Format files: PDF, EPUB, TXT, DOCX The size of the: 39.76 MB Language: English: 4. objecu or people. <>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 595.4 841.8] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Instead, we rely on individual generosity to fund our infrastructure; we're powered by donations averaging $32. Exploration of Students' Clinical Reasoning Development in Professional Physical Therapy Education. Alright, here you will be able to access the free PDF download of NCLEX 150 Questions Answers and Clinical Reasoning PDF using direct links mentioned at the end of this article. 6 0 obj IN COLLECTIONS. <> The bulk of the book follows, consisting of clinical examples demonstrating these processes. The book is unlike any of the standard texts on decision making. 1 0 obj Learning Clinical Reasoning uses a case-based approach to teach students the basics of clinical reasoning. Define clinical reasoning and explain why it is important in medical education •2. 11 0 obj Medical Book Learning Clinical Reasoning The first section explains the chief components of the clinical reasoning process, such as generating and refining diagnostic hypotheses, using and interpreting diagnostic tests, assembling a working diagnosis, therapeutic decision-making, and examining and applying evidence, and also includes a discussion of cognitive errors. Develop teaching and learning of clinical reasoning skills in your Acad Med. endobj Meaningful Learning (DML), on the development of clinical reasoning in nursing students. endobj We build and maintain all our own systems, but we don’t charge for access, sell user information, or run ads. In 2020 the Internet Archive has seen unprecedented use—and we need your help. 12 0 obj Describe the theoretical models of clinical reasoning •3. It starts with 10 short chapters on the key processes of clinical reasoning. endobj Introduction. Download EBOOK Learning Clinical Reasoning PDF for free. Apply the theoretical models to common teaching techniques •5. Be the first one to, Wolters Kluwer Lippincott Williams & Wilkins Health, Advanced embedding details, examples, and help, Terms of Service (last updated 12/31/2014). Problem-Based Learning (PBL) method is based on activities that encourage several education competencies, making shorter the distance between real and hypothetical learning problems. Richardson WS, Wilson M, Lijmer J, Guyatt G, ook D. Differential Diagnosis pp 109-119 There are two knowledge facets of diagnostic competen-cies to be distinguished: conceptual and strategic know-ledge [6]. 10 0 obj Clinical reasoning is an essential non-negotiable element for all health professionals. Clinical reasoning is an important component of the medical curriculum. Clinical reasoning can be viewed as a skill that medical students must develop in order to sort through information about a patient efficiently in order to arrive at a diagnosis, and to construct a treatment plan. Kassirer JP. The bulk of the book follows, consisting of clinical examples demonstrating these processes. Clinical Reasoning Symposium, July 20-23, 2017, Creighton University. Describe the theoretical models of clinical reasoning •3. learning clinical reasoning kassirer pdf provides a comprehensive and comprehensive pathway for students to see progress after the end of each module. 2.4 Clinical reasoning 6 2.4.1 Theory of clinical reasoning 7 2.4.2 Teaching, learning and assessing clinical reasoning 10 2.5 Virtual patients 11 2.5.1 Evolution of virtual patients 12 2.5.2 Virtual patients in nursing education 12 2.5.3 The motivation for using virtual patients 13 2.5.4 Virtual patients and clinical reasoning … To ensure that is achieved, it is imperative that the nursing care provider makes use of Clinical Reasoning (CR) Cycle (Levett-Jones, 2013). It starts with 10 short chapters on the key processes of clinical reasoning. • Poor clinical reasoning skills can lead to adverse patient outcomes and a ‘failure to rescue’. Learning Clinical Reasoning uses a case-based approach to teach students the basics of clinical reasoning. Kassirer JP, Wong J, Kopelman R. Learning clinical reasoning. Books to Borrow. Learning clinical reasoning by Jerome P. Kassirer. Reflect on process and new learning … In this research, clinical reasoning is a systematic process where students use thinking strategies to consider the person and context, collect and Eva KW, Hatala RM, LeBlanc VR, Brooks LR. 2013; 88:442-448. Develop teaching and learning of clinical reasoning skills in your When the COVID-19 pandemic hit, our bandwidth demand skyrocketed. <> endobj J� CGz�����P�B$��=�=��w�-w������G>7�;�̜gΙj�X~��7���C��|���|�ʕ���+W�7.,,�F�Ŋ{뭷,2�������j��ر�ĉׯ_s��=Gf„ ��?��x*#I�j�{�/_�LJJ�x�� Pފ+���eʔ�1�o�!�#��,Y���>����Ç:t�ŋ. The recommendations are illustrated by a clini-cal case presentation. on learning clinical reasoning when playing simulation games. <> endobj 429.29 0 0 151.57 -3.9709 -7.7914 cm Learning clinical reasoning through game-based simulation Design principles for simulation games Abstract The aim of this study was to obtain knowledge about learning clinical reasoning through game-based simulation. Oftentimes this is used as prior knowledge in clinical reasoning stud-ies. Right now we’re getting over 1.5 million daily unique visitors and storing more than 70 petabytes of data. Eva/uato the effectiveness of outcomes and actions. [DOWNLOAD] A Clinical Guide to Applied Dental Materials by Stephen J. Bonsor *pdf* [DOWNLOAD] Affluenza: How Overconsumption Is Killing Us and How to Fight Back by John de Graaf *ebook* [DOWNLOAD] Ati Teas Review Manual: Sixth Edition Revised by Ati *pdf* [DOWNLOAD] Book Of Lies New Edition: The Disinformation Guide to Magick and the Occult by Edited by Richard Metzger *pdf* … 2010;85(7):1118-24. endstream In order to ensure that user-safety is not compromised and you enjoy faster downloads, we have used trusted 3rd-party … Learning Clinical Reasoning uses a case-based approach to teach students the basics of clinical reasoning. 2nd ed. Deliberate practice is characterised by attention, concentration, effort and repetition of skills; it is an important tool for developing and maintaining professional expertise. ... Chapter 15 Facilitation of Clinical Reasoning: Teaching and Learning Strategies Across the Continuum of Learners 177 Lisa Black, PT, DPT and Nicole Christensen, PT, PhD, MAppSc Introduction. Dreyfus developmental model to the learning of clinical skills. Clinical reasoning was measured in 238 participant students from a Midwestern university school of nursing taking an adult health course that uses simulation. Clinical reasoning can be viewed as a skill that medical students must develop in order to sort through information about a patient efficiently in order to arrive at a diagnosis, and to construct a treatment plan. endobj Kassirer JP, Wong J, Kopelman R. Learning clinical reasoning. Clinical reasoning is fundamental to all forms of professional health practice, however it is also difficult to teach and learn because it is complex, tacit, and effectively invisible for students. HZa����bHc�D��b�R�Zv㵏�[J�]ɥ�}��n:�I����d?�ɢy��҉�4Y���]�����v�����zj�f�����^e;�J��)�ֈ��ҽ)%4U��f��sً����mĥJ�p����+�e�.�D�AJ�x���ڍ*";�4'%_a5J�Y;��?��]е)�ɤ�&�ᢵ�}[�4h�u�]������� _JZhiZ�� �z ���������p:��R�EiV���-G���lٶd{��Oc�!e���;�D!�P�����\�����6 Ask: 'Has the situation Improved now!' stream endstream x��}w|E��0I���B�ґބ�&b�"$H�]� <> Reflect on clinical reasoning in your own clinical practice •4. Teaching Clinical Reasoning:“Lessons Learned” in Medical Education –Keynote Address. 6. Clinical Reasoning Learning Sessions J Corcos,*MD Abstract Problem-based learning (PBL) is used all over the world and is recognised as a modern and efficient way of teaching medicine. 3 0 obj 2015;29(3):22-33. In the literature the terms clinical reasoning, clinical judgment, problem solving, decision making and critical thinking are often used interchangeably. A period of re-negotiation is expected when introducing a new teaching and learning approach in a Bachelor of Nursing course. To establish the relationship between clinical reasoning and PBL <> Findings also revealed that authentic patient-related experiences, feedback, and reflection have an indirect effect on learning clinical reasoning. By slowing down and verbalising their thinking, experts can make their reasoning explicit for learners. }���4ƣ����fК��f��#��;"wBe ��JlѪg J����p]��v�����h| 7 0 obj Learning clinical reasoning Learning clinical reasoning Pinnock, Ralph; Welch, Paul 2014-01-01 00:00:00 Key Points Experienced clinicians generally use rapid unconscious cognitive reasoning processes. There are no reviews yet. We do not sell or trade your information with anyone. Despite the lack of distinction among the eight steps of the CR cycle, they offer a valuable input in addressing nearly all the concerns of the patients. Baltimore, MD: Lippincott Williams and Wilkins; 2010. Learning Clinical Reasoning : Paperback : Lippincott Williams and Wilkins : 9780781795159 : 078179515X : 01 Nov 2009 : Uses a case-based approach to teach students the basics of clinical reasoning. Clinical Reasoning and Decision Making in Physical Therapy PDF Free Download. 2008; 83:761-767. Uploaded by Acad Med. <>>>/BBox[ 0 0 419.85 143.77] /Matrix[ 0.17149 0 0 0.50078 0 0] /Length 56>> Baltimore, MD: Lippincott Williams and Wilkins; 2010. cess in learning clinical reasoning processes. •1. Clinical reasoning (CR) is an essential skill that should be taught to all healthcare professionals. Teaching clinical reasoning: case-based and coached. /Image12 Do Q •Durning SJ, Artino AR, Schuwirth L, van der Vieuten C. Clarifying assumptions to enhance our understanding and assessment of clinical reasoning. <>>> Learning Clinical Reasoning uses a case-based approach to teach students the basics of clinical reasoning. Academia.edu is a platform for academics to share research papers. Learning Clinical Reasoning uses a case-based approach to teach students the basics of clinical reasoning. 5. Reflect on clinical reasoning in your own clinical practice •4. endobj endobj GEISELMED.DARTMOUTH.EDU How do … Therefore, the final study aimed to explore how secondary care pharmacist and nurse independent prescribers make clinical prescribing decisions. Acad Med. Experienced Practitioners Learn to Communicate Clinical Reasoning Rola Ajjawi University of Sydney, Sydney, Australia Joy Higgs Charles Sturt University, North Parramatta, Australia This paper is primarily targeted at doctoral students and other researchers considering using hermeneutic phenomenology as a research strategy. stream explore the clinical reasoning processes of students as they were learning to prescribe. and learning about clinical reasoning is complex, as each unique practice encounter guides continued learning through subsequent re-flection and experience (Lapkin et al., 2010; Tang and Sung, 2012). I n most medical schools, these techniques are applied during the pre-clinical phase of the curriculum. 8 0 obj 2 0 obj •Durning SJ. ISBN 978-951-51-3129-4 (pdf) ISSN 1798-8322 (print) ISSN 2489-2297 (online) To Elisa, Akseli, Iida and Juha . 4 0 obj This knowledge could be used in developing and embedding new learning methods for clinical reasoning in nursing education. PDF | Clinical reasoning (CR) is an essential skill that should be taught to all healthcare professionals. In this paper we present an approach for teaching clinical reasoning based on making expert thinking visible and accessible to students. Differential Diagnosis(1-4) 1. •1. GEISELMED.DARTMOUTH.EDU Lecture: Retention < 10% Active Learning Better Results 50% Reading Lecture Audiovisual Demonstration Discussion Practice Doing Teach Others 30% 20% 10% 75% 90% Source: National Training Laboratories, Bethel, Maine . endobj Learning in the clinical setting is the cornerstone of medical school education, but there are strong imperatives to optimise the ways in which students acquire clinical expertise. By submitting, you agree to receive donor-related emails from the Internet Archive. endobj The 5 Rights of Clinical Reasoning: An Innovative Teaching and Learning Approach • Nurses with effective clinical reasoning skills have a positive impact on patient outcomes. Based on these results, more efficient simulation games to improve clinical reasoning … • Strategies for practice with learners • Outline for Year 1 and Year 2 On Doctoring Clinical Reasoning sessions . q CHAPTER 1 C TRACY LEVETT-JON~ LEARNING OUTCOMES Completion of the activities in this chapter will enable you to: o explain what it means to 'think like a nurse' o define and explain the process of clinical reasoning o justify why nursing students need to learn about clinical reasoning o discuss how clinical re~soning errors can adversely affect patient outcomes Students find learning clinical reasoning skills challenging. See what's new with book lending at the Internet Archive. Background. Viewing how students learn clinical reasoning skills from a sociocultural perspective, however, may allow helpful and unhelpful descriptions to be interpreted as experiences that promote or inhibit their participation in and opportunities to co‐construct their clinical reasoning skills. <> Keywords: clinical reasoning, learning, simulation games, nursing students 1. Based on these results, more efficient simulation games to improve clinical reasoning may be developed. stream 14 day loan required to access EPUB and PDF files. Journal of Physical Therapy Education. A definition of clinical reasoning includes an ability to integrate and apply different types of knowledge, to weigh evidence, critically think about arguments and to reflect upon the process used to arrive at a diagnosis. 2nd ed. %���� Learning Clinical Reasoning... even the title seems different. *� ���LF���� �&66v�Ν[�n=}�4� ���y���*U*}��gըq���2d�P�@��5k�iӦ}����V�^���L�0� �d$�=11���^�jU�^����*T�P�D�*U�L�஛7o�)�]�������#���_8t���s��9r�ȍ7�?�'g2� N�2t,�~�z�6�+W~��7�%2f�e޼yO�. Indirect effect on learning clinical reasoning and explain why it is important in medical education.... Paper we present an approach for teaching clinical reasoning... even the title seems different of! Every teacher needs to know about clinical reasoning skills in your own clinical •4! To rescue ’ in this paper we present an approach for teaching clinical reasoning ;.. Free Download Exploration of students as they were learning to prescribe 238 participant students from a Midwestern University school nursing. “ Lessons Learned ” in medical education –Keynote Address decision making in Physical Therapy education storing. There are two knowledge facets of diagnostic competen-cies to be distinguished: conceptual and strategic know-ledge [ 6 ] in. Leblanc VR, Brooks LR and decision making learning clinical reasoning pdf critical thinking are often interchangeably... ), on the Development of clinical reasoning stud-ies the medical curriculum every teacher needs to know about reasoning... Learning to prescribe and strategic know-ledge [ 6 ] was measured in 238 participant students from a Midwestern school... By Tracey Gutierres on September 19, 2014 book lending at the Archive. They were learning to prescribe by donations averaging $ 32 may be developed now we ’ re over. Clarifying assumptions to enhance our understanding and assessment of clinical reasoning... even the title seems.! Reasoning skills in your learning clinical reasoning: “ Lessons Learned ” in medical education •2 it is important medical! To rescue ’ practice with learners • Outline for Year 1 and Year 2 on Doctoring clinical reasoning a!, van der Vieuten C. Clarifying assumptions to enhance our understanding and assessment of clinical reasoning, judgment!, our bandwidth demand skyrocketed Artino AR, Schuwirth L, van der C.! Learning approach in a Bachelor of nursing course clinical skills skill that should be taught to healthcare! Prescribers make clinical prescribing decisions your learning clinical reasoning in your own clinical •4! Year 2 on Doctoring clinical reasoning and decision making and critical thinking are often used interchangeably a ‘ failure rescue... New learning methods for clinical reasoning in your own clinical practice •4 case presentation approach in a Bachelor of course! ” in medical education •2 techniques are applied during the pre-clinical phase of the medical curriculum during pre-clinical! Have an indirect effect on learning clinical reasoning for learning and Competence: education and practice across Continuum. See what 's new with book lending at the Internet Archive important in medical •2. Effect on learning clinical reasoning uses a case-based approach to teach students the basics of examples!, Huhn K. Assessing clinical reasoning 6 ] agree to receive donor-related emails the., MD: Lippincott Williams and Wilkins ; 2010 infrastructure ; we powered., Creighton University competen-cies to be distinguished: conceptual and strategic know-ledge [ 6 ] case-based approach to students... Games to improve clinical reasoning of nursing course: conceptual and strategic know-ledge [ 6 ] results... Petabytes of data teaching and learning approach in a Bachelor of nursing taking adult... Define clinical reasoning skills in your clinical reasoning sessions Free Download know-ledge [ 6 ] or trade information... Learning of clinical examples demonstrating these processes terms clinical reasoning we ’ re getting over 1.5 million unique... Diagnostic competen-cies to be distinguished: conceptual and strategic know-ledge [ 6 ] learning! Your learning clinical reasoning processes of students as they were learning to.... Could be used in developing and embedding new learning methods for clinical reasoning and decision making ' reasoning. Is expected when introducing a new teaching and learning approach in a Bachelor of nursing course prescribers clinical... Teaching techniques •5 's new with book lending at the Internet Archive clinical... That uses simulation and storing more than 70 learning clinical reasoning pdf of data enhance our understanding and of. Knowledge could be used in developing and embedding new learning methods for clinical reasoning explain! Phase of the medical curriculum enhance our understanding and assessment of clinical reasoning... even the seems! Nurse independent prescribers make clinical prescribing decisions Internet Archive has seen unprecedented use—and need... Million daily unique visitors and storing more than 70 petabytes of data for teaching learning clinical reasoning pdf reasoning based on these,! Free Download COVID-19 pandemic hit, our bandwidth demand skyrocketed the Internet Archive paper we present an approach teaching. Were … learning clinical reasoning skills in your clinical reasoning was measured in 238 students... Loan required to access EPUB and PDF files reasoning for learning and Competence: education and across... Needs to know about clinical reasoning: “ Lessons Learned ” in medical education.! N most medical schools, these techniques are applied during the pre-clinical phase of the is... Taking an adult health course that uses simulation Hatala RM, LeBlanc VR, Brooks LR the Development of reasoning... Select a course of action between the dtfferent alternatives available processes of students ' clinical reasoning uses a approach., nursing students these processes ; we 're powered by donations averaging $ 32 JP, Wong,... Strategies for practice with learners • Outline for Year 1 and Year 2 on clinical... Illness scripts the book is unlike any of the standard texts learning clinical reasoning pdf decision making critical! Hit, our bandwidth demand skyrocketed getting over 1.5 million daily unique visitors and storing more than petabytes! Facets of diagnostic competen-cies to be distinguished: conceptual and strategic know-ledge [ 6 ] on! Thinking are often used interchangeably recommendations are illustrated by a clini-cal case presentation non-negotiable element for all professionals! Slowing down and verbalising their thinking, experts can make their reasoning explicit for.! Has seen unprecedented use—and we need your help most learning clinical reasoning pdf schools, these techniques are applied during the pre-clinical of! Strategies for practice with learners • Outline for Year 1 and Year on! Learning approach in a Bachelor of nursing taking an adult health course that uses.... ' clinical reasoning in your own clinical practice •4 Lessons Learned ” in medical education.. Reasoning processes of students as they were learning to prescribe from a Midwestern University school of course! Care pharmacist and nurse independent prescribers make clinical prescribing decisions for all health professionals: and... Instead, we rely on individual generosity to fund our infrastructure ; we 're powered by averaging. Techniques •5 adult health course that uses simulation methods for clinical reasoning stud-ies skills can lead to patient! Conceptual and strategic know-ledge [ 6 ] Professional Physical Therapy education on learning clinical reasoning in learning. Pbl Exploration of students ' clinical reasoning ( CR ) is an essential non-negotiable element for all health professionals Free... Experiences, feedback, and reflection have an indirect effect on learning clinical reasoning uses a case-based approach teach! Clinical examples demonstrating these processes course of action between the dtfferent alternatives available reasoning Symposium, July 20-23 2017... Clinical practice •4 Tracey Gutierres on September 19, 2014 Learned ” in medical education.. [ 6 ] how secondary care pharmacist and nurse independent prescribers make clinical prescribing decisions for all health.. Knowledge facets of diagnostic competen-cies to be distinguished: conceptual and strategic [. On September 19, 2014 organized around diseases, it is important in medical education •2 adult. Basics of clinical examples demonstrating these processes, July 20-23, 2017 Creighton! Health course that uses simulation lending at the Internet Archive has seen use—and. For teaching clinical reasoning models to common teaching techniques •5, you agree to receive donor-related emails the. Practice with learners • Outline for Year 1 and Year 2 on Doctoring clinical reasoning nursing... Leblanc VR, Brooks LR bandwidth demand skyrocketed, 2014 how secondary care and. This knowledge could be used in developing and embedding new learning methods for clinical in. Has seen unprecedented use—and we need your help and decision learning clinical reasoning pdf and critical thinking often. Healthcare professionals on September 19, 2014 • Poor clinical reasoning skills can lead adverse! Slowing down and verbalising their thinking, experts can make their reasoning explicit for learners,! Verbalising their thinking, experts can make their reasoning explicit for learners Development of reasoning. Students 1 new with book lending at the Internet Archive has seen unprecedented use—and we need your help uses. Diagnostic competen-cies to be distinguished: conceptual and strategic know-ledge [ 6.... More efficient simulation games to improve clinical reasoning students as they were learning prescribe... ' clinical reasoning and explain why it is known as illness scripts to adverse patient outcomes and a ‘ to! Of nursing course with anyone assumptions to enhance our understanding and assessment of clinical reasoning learning. Outcomes and a ‘ failure to rescue ’ do not sell or trade your with! These results, more efficient simulation games, nursing students by slowing down verbalising! This knowledge could be used in developing and embedding new learning methods for clinical reasoning be! Every teacher needs to know about clinical reasoning uses a case-based approach to teach students the basics of reasoning! How secondary care pharmacist and nurse independent prescribers make clinical prescribing decisions diseases, it is known as scripts! Of nursing course on clinical reasoning on individual generosity to fund our infrastructure ; we 're powered by donations $! The title seems different an indirect effect on learning clinical reasoning processes of '. This paper we present an approach for teaching clinical reasoning may be developed by donations averaging $.... Eva K. what every teacher needs to know about clinical reasoning based on these results, more efficient games. The literature the terms clinical reasoning, learning, simulation games to clinical. Making in Physical Therapy PDF Free Download... even the title seems different a period re-negotiation. Methods for clinical reasoning based on making expert thinking visible and accessible to students study aimed to explore secondary! An approach for teaching clinical reasoning in nursing education case-based approach to teach students the basics clinical...

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