Examining problem solving skills and related factors in undergraduate nursing students of Gilan University of Medical Sciences in 1392-93

Dissertation to receive a master's degree in nursing education

(children's orientation)

Abstract

Introduction: Problem solving is a basic skill for living in today's age. Problem-solving skills and knowledge-based decision-making are among the expected behaviors of nursing students, and learning these skills should start from the student days.

Purpose: The purpose of this study is to determine problem-solving skills and factors related to them in nursing undergraduate students of Gilan University of Medical Sciences.

Methodology: This research is a cross-sectional study of descriptive and analytical type, in which all first- to fourth-year undergraduate students Nursing of Gilan University of Medical Sciences participated in 2013. Data in this research, using a questionnaire consisting of two parts: 1) Heppner & Petersen problem solving inventory (PSI) 2) Individual-social and educational factors related to problem solving skills were collected and analyzed with descriptive (mean and standard deviation) and inferential statistical tests (Chi-square, Kruskal-Wallis, Mann-Whitney and Spearman's correlation coefficient and multiple logistic regression)

Results: The results showed that the average score of problem solving skills is 91.45±20.91. The examination of individual-social and educational factors showed that based on the multiple logistic regression model, the number of siblings (P=0.019), mother's education level (P=0.026), success in solving problems and problems (P=0.0001), assessment of mother's behavior type (P=0.013), college of study (P=0.024), satisfaction with the field of study (P=0.006), success in professional and clinical skills (P=0.03), Motivation (P=0.001) and internal motivation (P=0.004) are factors related to problem solving skills.

Discussion and conclusion: In this research, nursing students had a good level of problem solving skills. Problem solving skills can be learned. Therefore, it is recommended that by focusing on problem-based learning with a student-centered approach, these skills can be increased in any educational field.

Keywords: problem-solving skills, nursing students, related factors.

Research area:

Ever since formal education became popular in human societies, the cultivation of metacognitive capabilities, such as understanding And understanding, reasoning, thinking, creativity, problem solving and judgment have been emphasized (1). Problem solving is a basic skill for living in today's age (2), because people face many problems at different stages of life that require creative, critical and analytical thinking to solve them (3). Problem solving is a type of goal-oriented thinking (4). It is a mental process and logical and orderly thinking that helps a person to search for several solutions when facing problems and then choose the best solution (5). This concept; As a high-level cognitive process, it interacts with many other cognitive processes such as abstraction, search, learning, decision making, inference and analysis (6) so that; Mushirabadi considers it a systematic process that focuses on the analysis of the problem situation and expresses the ability of individuals to overcome obstacles and achieve goals, and includes three components: self-confidence in problem solving [1], approach-avoidance approach to the problem [2] and personal control [3], which, respectively, expresses a person's belief in the ability to solve problems, his desire to avoid problems or face them head-on, and the use of diverse and different solutions to control behavior and purposefulness in the solution process The problem is (1).

Actually; The goal of teaching problem solving is to learn the general method of dealing with issues and problems, teaching the method of reasoning, using beliefs and values, and making decisions in dealing with existing problems (7). Step-by-step training of problem-solving skills plays a significant role in people's cognitive, emotional and skill maturity and increases their decision-making power (8), people who have more ability to solve problems are less likely to suffer from depression, have high social skills and healthier communication, and their level of anxiety is lower than others (9, 10).Also, if problem solving is used effectively, it increases a person's resistance to external stress sources and reduces his vulnerability to depression and other emotional problems (5), in addition, problem solving has a significant effect on creating self-confidence and peace of mind, and gives a person a special strength and a suitable motivation to face problems constructively (11).

Effective performance is the ability to solve problems (12). Nurses are in a unique position in terms of influencing the health phenomenon, and having knowledge and skills alone is not enough for their professional success, but the way of dealing with various issues is also important (2). Each patient in clinical situations has unique characteristics and there is no fixed solution to eliminate or adjust the problems of different patients. Therefore, nurses, especially in new clinical situations, need independent responsibilities, judgment and correct decision-making (13). About 4.16-6.6% of patients admitted to hospitals in America, Australia and England have suffered injuries such as permanent disability and death due to the lack of appropriate and correct decision-making by nursing and healthcare personnel, but in hospitals where the participation and decisions of the treatment team were at a high level, the mortality rate was reported to be 41% lower than the expected amount (14). On the other hand, the development of technology, the need of patients for quality care, the emphasis on limiting the costs and duration of hospitalization, the increase in the elderly population, the complex processes of the disease and the increase in the intelligence and awareness of patients are the changes that are facing nurses, now; In order for nurses to be able to adapt to these changes and increased responsibilities, it is necessary to have high-level thinking skills in order to be able to present new ideas (1) and to be able to adopt the best solutions in dealing with the problems and needs of patients (2). and 16) so that students can apply the learned theoretical knowledge in real situations and solve the problem of the patient under their care (16). Therefore, before entering the workplace, students need to understand their feelings, attitudes and behaviors in relation to others, so that they can make decisions and solve problems easier and better (2).

       Considering that the main goal of education in medical sciences, including nursing, is the development of professional competence and the development of decision-making and problem-solving skills, nursing education is responsible for creating an environment that allows students to learn and acquire cognitive skills. Facilitate emotional and psychomotor skills in such a way that students are able to take care of people in need in different situations and it is necessary to train people who have the ability to recognize and solve problems. Therefore, in recent years, the nature of clinical practice has changed and has been influenced by step-by-step problem solving models (1). so that; Nizo[4] suggests a five-step problem-solving process similar to the nursing process. Therefore, the need for people who use problem-solving skills effectively in their work seems more necessary (18). The results of a study on nursing students showed that they lack problem-solving skills, but in today's complex health care environment, nurses must be able to solve problems accurately, completely and quickly (15). Many nursing students enter the clinical environment without being able to recognize the problem and plan to solve it. The results of some studies also indicate that this skill has a low score in nurses and nursing students (12). However, in his study at the University of Iran, Moshir Abadi has reported: the average score of nursing students' problem-solving skills is favorable (89.5±21.51) (1). Sinar's study[5] at Sakarya University[6] in Turkey indicates that nursing students have good problem solving skills (85.37±17.56) (15). While Beser[7] reported moderate problem solving skills in nursing students of Dokuzaylol University[8] in Türkiye (19).