Nurses with effective clinical reasoning skills have a positive impact on patient outcomes; conversely, those with poor clinical reasoning skills often fail to detect impending patient deterioration (Aiken et al 2003)1. This is significant when viewed against the background of increasing numbers of adverse patient outcomes and escalating healthcare complaints (NSW Health, 2006)2. The Quality in Australian Healthcare Study (Wilson et al, 1995)3 found that "cognitive failure" was a factor in 57% of adverse clinical events. Education must begin at the undergraduate level to develop critical thinking and clinical reasoning skills.

This website profiles some of the approaches used to teach clinical reasoning to nursing students at The University of Newcastle.

Related resources


  1. Aiken, L.H., Clarke, S.P., Cheung, R.B., Sloane, D.M. and Silber, J.H. (2003) Educational levels of hospital nurses and surgical patient mortality. Journal of American Medical Association 290 (12), 1617– 1620.
  2. NSW Health (2006) Patient Safety and Clinical Quality Program: Third report on incident management in the NSW Public Health System 2005-2006, NSW Department of Health. Sydney.
  3. Wilson, R. (1995). The Quality in Australian Health Care Study. Medical Journal of Australia. 163, pg. 458-471.