Addressing the development of both knowledge and clinical reasoning in nursing through the perspective of script concordance: An integrative literature review

Abstract

Background: In clinical practice settings, where situations of uncertainty exist, clinical reasoning is situated or contextualized. It calls upon honed knowledge, wherein nurses rely on highly-developed and organized knowledge networks known as “mental scripts”.

Methods: The aim of this integrative literature review was to address ways to develop knowledge and clinical reasoning in nursing through the use of mental scripts, and to tackle these pedagogical considerations. The literature search was performed using the following data sources: CINHAL, MEDLINE Google Scholar, PubMed, ProQuest, PsycINFO, Scopus and Web of Science.

Results: Script concordance, which optimises situated clinical reasoning, ties in with the socio-cognitive perspective of cognitive apprenticeship, using role models to guide the development of knowledge and clinical reasoning in nursing. Moreover, this perspective proposes implementing new teaching strategies, which focus on situational awareness, reflective acuity, and cognitive dialogue.

Conclusions: The perspective of script concordance allows a foreseeable innovative formulation of practices favourable to the development of clinical reasoning in nursing.