The problem to be addressed in this essay is that novice nurses graduate from nursing programs ill-equipped to apply materials learned during school to real-

life situations. Novice graduate nurses recognize that a disconnect exists between nursing program course work and expectations of their skill levels in the

first-year of nursing practice (Sajadi, Rafii, Naseri, Salahshour, & Seyedfatemi, 2018). Hezaveh, Rafii, and Seyedfatemi (2014) conducted a study about novice

nurses’ inability to use knowledge learned in actual practice. The researchers found that the novice nurses had difficulty because of functional disability in

applying course work to practice, communicating, and managing challenges that occurred while providing care to patients.

The specific problem is that nursing students who recently graduated from nursing programs lack sufficient instructional training in decision making and

critical thinking skills that could negatively affect patient care. Reports indicate that approximately 20,000 patients die annually as a result of poor

decision-making skills because novice nurses tend to focus on tasks rather than distinguishing pertinent patient changes, failing to use clinical decision

making (Ghorbani & Strömmer, 2018; Walton, 2016). Research indicates that poor patient outcomes increased in healthcare organizations when nurses lack

critical thinking skills and poor clinical decision-making abilities (de Bock, Willems, & Weinstein, 2018). Instructional barriers may interfere with students

developing these skills (Cooke, Stroup, & Harrington, 2019; Li, Ye, & Chen, 2019). In fact, Blackslee (2019) reported that at one university from 2013 through

2016, the percentage of students scoring below average on critical thinking increased from 62% to 76%. Basic skills are demonstrated by novice nurses, but

they need additional instruction to develop critical thinking skills to make appropriate patient-care decisions, or these decreases in patient care will

likely continue (Kim, Kim, Lim, Kim, & Baek, 2018).

Purpose

The purpose of this essay is to determine if critical thinking and decision-making skills significantly differ between first-year nursing students who are in

a med-surg course taught using problem-based learning and those in a similar course taught traditionally. According to Moore-Cox (2017), through the use of

problem-based learning teaching strategies, critical thinking skills can begin to develop in nursing students early. Carbogim et al. (2019) suggested that

problem-based learning is a teaching strategy that can be used to promote higher levels of critical thinking.

☐ Include several subheadings specific to this essay.

☐ At the end of this section, list the databases accessed and the search engines used. List all the search parameters, including the search terms and their

combinations (with more detailed search terms located in an appendix, if appropriate), range of years, and types of literature.

☐ Devote approximately 5 or more pages and at least 5 relevant citations

☐ Describe how The Constructivist theory guides this essay, including the definitions of all the concepts, an explanation of the relationships among the

concepts, and a presentation of all the assumptions and propositions.

☐ Explain the origin and development of the The Constructivist theory. Demonstrate detailed knowledge of and familiarity with both the historical and the

current literature on the Constructivist theory .

☐ Identify existing research studies or articles that used this framework in a similar way. Mention alternative frameworks, with a justification of why the

Constructivist theory best fits this essay.

☐ Describe how and why the Constructivist theory relates to the present essay and how it fits with the above problem statement and purpose statement.

☐ Critically analyze (i.e., note the strengths and weaknesses) and synthesize (i.e., integrate) the existing research. Rather than reporting on each study

independently, describe everything known on the topic by reviewing the entire body of work.

Present a balanced integrative critical review of the literature, ensuring all points of view are included. Cover all the important issues with a discussion

of areas of convergence (i.e., agreement) and divergence (i.e., disagreement). Provide potential explanations for areas of divergence.