title: Clinical decision-making described by Swedish prehospital emergency care nurse students - An exploratory study.
abstract: OBJECTIVE
  The purpose of this study was to explore the PECN students' clinical decision-making during a seven-week clinical rotation in the ambulance services.
  
  
  BACKGROUND
  Developing expertise in prehospital emergency care practices requires both theoretical and empirical learning. A prehospital emergency care nurse (PECN) is a Registered Nurse (RN) with one year of additional training in emergency care. There has been little investigation of how PECN students describe their decision-making during a clinical rotation.
  
  
  METHODS
  A qualitative study design was used, and 12 logbooks written by the Swedish PECN students were analysed using content analysis.
  
  
  RESULTS
  The students wrote about 997 patient encounters - ambulance assignments during their clinical rotation. Four themes emerged as crucial for the students' decision-making: knowing the patient, the context-situation awareness in the ambulance service, collaboration, and evaluation. Based on the themes, students made decisions on how to respond to patients' illnesses.
  
  
  CONCLUSIONS
  The PECN students used several variables in their decision-making. The decision- making was an on-going process during the whole ambulance assignment. The university has the responsibility to guide the students during their transition from an RN to a PECN. The findings of the study can support the educators and clinical supervisors in developing the programme of study for becoming a PECN.
authors.affiliation: Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden; Academic EMS, Stockholm, Sweden; Falck Ambulance Service, Stockholm, Sweden.
authors.forename: Tomas
authors.initials: T
authors.lastname: Nilsson
authors.affiliation: Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden; Academic EMS, Stockholm, Sweden. Electronic address: veronica.lindstrom@ki.se.
authors.forename: Veronica
authors.initials: V
authors.lastname: Lindström
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000552:Ambulances; D002983:Clinical Competence / Q000592:standards; D003657:Decision Making; D004632:Emergency Medical Services / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D013338:Students, Nursing / Q000523:psychology*; D013548:Sweden; D000078329:Workforce
keywords: Ambulance; Clinical rotation; Decision-making; Education; Prehospital emergency care; Prehospital emergency care students