Clinical decision-making process and associated factors among nursing students at Hanoi Medical University – Thanh Hoa Campus in 2025
Main Article Content
Abstract
A cross-sectional descriptive study was conducted among 194 full-time nursing students at the Thanh Hoa Campus of Hanoi Medical University in 2025 to assess clinical decision-making process and explore associated factors. Results: The median clinical decision-making process score was 73 (IQR: 69 – 75), with the quasi-analytical–intuitive level being predominant (75.3%). The multiple linear regression model was statistically significant (p < 0.001), explaining 37.1% of the variance in clinical decision-making process. Academic performance, self-confidence, and good conduct scores were identified as independent associated factors, with academic performance being the strongest predictor in the model.
Article Details
Keywords
Clinical decision-making process, nursing students
References
1. Candan Dönmez Y, Sahin Koze B, Durmaz Edeer A, et al. Evaluation of clinical decision-making perception of nursing students: the Aegean region case. BMC Nursing. 2025/05/02 2025;24(1):486. doi:10.1186/s12912-025-03123-8
2. Tiffen J, Corbridge SJ, Slimmer L. Enhancing clinical decision making: development of a contiguous definition and conceptual framework. Journal of professional nursing : official journal of the American Association of Colleges of Nursing. Sep-Oct 2014;30(5):399-405. doi:10.1016/j.profnurs.2014.01.006
3. Nibbelink CW, Brewer BB. Decision-making in nursing practice: An integrative literature review. Journal of clinical nursing. Mar 2018;27(5-6):917-928. doi:10.1111/jocn.14151
4. Hammond KR. The integration of research in judgment and decision theory. 1980.
5. Bộ Y tế. Quyết định số 3474/QĐ-BYT về việc phê duyệt tài liệu chuẩn năng lục cơ bản của cử nhân Điều dưỡng Việt Nam (2022).
6. Durmaz Edeer A, Sarıkaya A. Adaptation of Clinical Decision Making in Nursing Scale to Undergraduate Students of Nursing: The Study of Reliability and Validity. International Journal of Psychology and Educational Studies. 09/01 2015;2(3):1-9. doi:10.17220/ijpes.2015.03.001
7. Lauri S, Salanterä S, Chalmers K, Ekman SL, Kim HS, Käppeli S, MacLeod M. An exploratory study of clinical decision-making in five countries. Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing. 2001;33(1):83-90. doi:10.1111/j.1547-5069.2001.00083.x
8. Krishnan P. A Philosophical Analysis of Clinical Decision Making in Nursing. The Journal of nursing education. Feb 1 2018;57(2):73-78. doi:10.3928/01484834-20180123-03
9. Quach TBY, Nguyen TPL, Huynh TPH. The clinical decision-making of Vietnamese nursing students and related factors: A cross-sectional survey. Belitung nursing journal. 2025;11(2):126-132. doi:10.33546/bnj.3686
10. Hagbaghery MA, Salsali M, Ahmadi F. The factors facilitating and inhibiting effective clinical decision-making in nursing: a qualitative study. BMC Nursing. 2004/04/06 2004;3(1):2. doi:10.1186/1472-6955-3-2
11. Bộ Y tế. Quyết đinh số 1352/QĐ-BYT về việc phê duyệt tài liệu chuẩn năng lực cơ bản của Điều dưỡng Việt Nam. (2012).
12. Chan D. Development of the Clinical Learning Environment Inventory: using the theoretical framework of learning environment studies to assess nursing students’ perceptions of the hospital as a learning environment. The Journal of nursing education. Feb 2002;41(2):69-75. doi:10.3928/0148-4834-20020201-06
13. Ramsbotham J, Dinh TTH, Truong HT, et al. Vietnamese nursing students’ perspectives on learning environments: A multisite benchmarking study to inform future initiatives. 2018;
14. Nguyễn Thị Ngọc Hân, Ngô Thị Dung, Dương Thị Thùy Trang, Nguyễn Thị Thanh Trúc, Lư Trí Diến, Nguyễn Thái Thông. Tự đánh giá năng lực thực hành chăm sóc của sinh viên điều dưỡng và các yếu tố liên quan. Tạp chí Nghiên cứu Y học. 08/22 2023;168(7):208-214. doi:10.52852/tcncyh.v168i7.1728
15. Lauri S, Salanterä S. Developing an instrument to measure and describe clinical decision making in different nursing fields. Journal of professional nursing : official journal of the American Association of Colleges of Nursing. Mar-Apr 2002;18(2):93-100. doi:10.1053/jpnu.2002.32344
16. Phillips B. Clinical Decision Making in Last Semester Senior Baccalaureate Nursing Students. 2015.
17. Erbas SD, Sendur EG, Yilmaz AA. The influence of 21st-century skills on clinical decision-making in nursing students: a cross-sectional study. Teaching and Learning in Nursing. 2025;20(2):e464-e469.
18. Wiles LL, Simko LC, Schoessler M. What do I do now?: clinical decision making by new graduates. J Nurses Prof Dev. Jul-Aug 2013;29(4):167-72; quiz E1-2. doi:10.1097/NND.0b013e31829aeab3
19. Aktaş YY, Karabulut N. A Survey on Turkish nursing students’ perception of clinical learning environment and its association with academic motivation and clinical decision making. Nurse education today. Jan 2016;36:124-8. doi:10.1016/j.nedt.2015.08.015
20. Durmaz A, Sarıkaya A. Adaptation of Clinical Decision Making in Nursing Scale to Undergraduate Students of Nursing: The Study of Reliability and Validity. International Journal of Psychology and Educational Studies. 01/01 2015;2:1-9.
21. Guerrero J. Review of the clinical decision-making skills in undergraduate nursing students. J Nurs Care. 2019;8(479):2167-1168.
22. Arkan B, Yılmaz D, Çinar HG, Uzun R. Clinical decision-making levels of nursing students and affecting factors. Cyprus Journal of Medical Sciences. 2023.
2. Tiffen J, Corbridge SJ, Slimmer L. Enhancing clinical decision making: development of a contiguous definition and conceptual framework. Journal of professional nursing : official journal of the American Association of Colleges of Nursing. Sep-Oct 2014;30(5):399-405. doi:10.1016/j.profnurs.2014.01.006
3. Nibbelink CW, Brewer BB. Decision-making in nursing practice: An integrative literature review. Journal of clinical nursing. Mar 2018;27(5-6):917-928. doi:10.1111/jocn.14151
4. Hammond KR. The integration of research in judgment and decision theory. 1980.
5. Bộ Y tế. Quyết định số 3474/QĐ-BYT về việc phê duyệt tài liệu chuẩn năng lục cơ bản của cử nhân Điều dưỡng Việt Nam (2022).
6. Durmaz Edeer A, Sarıkaya A. Adaptation of Clinical Decision Making in Nursing Scale to Undergraduate Students of Nursing: The Study of Reliability and Validity. International Journal of Psychology and Educational Studies. 09/01 2015;2(3):1-9. doi:10.17220/ijpes.2015.03.001
7. Lauri S, Salanterä S, Chalmers K, Ekman SL, Kim HS, Käppeli S, MacLeod M. An exploratory study of clinical decision-making in five countries. Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing. 2001;33(1):83-90. doi:10.1111/j.1547-5069.2001.00083.x
8. Krishnan P. A Philosophical Analysis of Clinical Decision Making in Nursing. The Journal of nursing education. Feb 1 2018;57(2):73-78. doi:10.3928/01484834-20180123-03
9. Quach TBY, Nguyen TPL, Huynh TPH. The clinical decision-making of Vietnamese nursing students and related factors: A cross-sectional survey. Belitung nursing journal. 2025;11(2):126-132. doi:10.33546/bnj.3686
10. Hagbaghery MA, Salsali M, Ahmadi F. The factors facilitating and inhibiting effective clinical decision-making in nursing: a qualitative study. BMC Nursing. 2004/04/06 2004;3(1):2. doi:10.1186/1472-6955-3-2
11. Bộ Y tế. Quyết đinh số 1352/QĐ-BYT về việc phê duyệt tài liệu chuẩn năng lực cơ bản của Điều dưỡng Việt Nam. (2012).
12. Chan D. Development of the Clinical Learning Environment Inventory: using the theoretical framework of learning environment studies to assess nursing students’ perceptions of the hospital as a learning environment. The Journal of nursing education. Feb 2002;41(2):69-75. doi:10.3928/0148-4834-20020201-06
13. Ramsbotham J, Dinh TTH, Truong HT, et al. Vietnamese nursing students’ perspectives on learning environments: A multisite benchmarking study to inform future initiatives. 2018;
14. Nguyễn Thị Ngọc Hân, Ngô Thị Dung, Dương Thị Thùy Trang, Nguyễn Thị Thanh Trúc, Lư Trí Diến, Nguyễn Thái Thông. Tự đánh giá năng lực thực hành chăm sóc của sinh viên điều dưỡng và các yếu tố liên quan. Tạp chí Nghiên cứu Y học. 08/22 2023;168(7):208-214. doi:10.52852/tcncyh.v168i7.1728
15. Lauri S, Salanterä S. Developing an instrument to measure and describe clinical decision making in different nursing fields. Journal of professional nursing : official journal of the American Association of Colleges of Nursing. Mar-Apr 2002;18(2):93-100. doi:10.1053/jpnu.2002.32344
16. Phillips B. Clinical Decision Making in Last Semester Senior Baccalaureate Nursing Students. 2015.
17. Erbas SD, Sendur EG, Yilmaz AA. The influence of 21st-century skills on clinical decision-making in nursing students: a cross-sectional study. Teaching and Learning in Nursing. 2025;20(2):e464-e469.
18. Wiles LL, Simko LC, Schoessler M. What do I do now?: clinical decision making by new graduates. J Nurses Prof Dev. Jul-Aug 2013;29(4):167-72; quiz E1-2. doi:10.1097/NND.0b013e31829aeab3
19. Aktaş YY, Karabulut N. A Survey on Turkish nursing students’ perception of clinical learning environment and its association with academic motivation and clinical decision making. Nurse education today. Jan 2016;36:124-8. doi:10.1016/j.nedt.2015.08.015
20. Durmaz A, Sarıkaya A. Adaptation of Clinical Decision Making in Nursing Scale to Undergraduate Students of Nursing: The Study of Reliability and Validity. International Journal of Psychology and Educational Studies. 01/01 2015;2:1-9.
21. Guerrero J. Review of the clinical decision-making skills in undergraduate nursing students. J Nurs Care. 2019;8(479):2167-1168.
22. Arkan B, Yılmaz D, Çinar HG, Uzun R. Clinical decision-making levels of nursing students and affecting factors. Cyprus Journal of Medical Sciences. 2023.