J Korean Acad Nurs.  2019 Oct;49(5):601-612. 10.4040/jkan.2019.49.5.601.

Structural Equation Modeling on Clinical Decision Making Ability of Nurses

  • 1Department of Nursing, Koje College, Geoje, Korea.
  • 2College of Nursing, Eulji University, Daejeon, Korea. ksy@eulji.ac.kr


The purpose of this study was to construct and test a hypothetical model of clinical decision-making ability of nurses based on the Decision Making Process model and the Cognitive Continuum theory.
The data were collected from nurses working at 11 hospitals in Busan, Daejeon, and South Gyeongsang Province from June 30 to August 1, 2017. Finally, the data from 323 nurses were analyzed.
The goodness-of-fit of the final model was at a good level (χ²/df=2.46, GFI=.87, AGFI=.84, IFI=.90, CFI=.90, SRMR=.07, RMSEA=.07) and 6 out of 10 paths of the model were supported. The clinical decision-making ability was both directly and indirectly affected by task complexity and indirectly affected by experiences, autonomy, and work environment. Specifically, it was strongly directly affected by analytical competency but was insignificantly affected by intuitive competency. These variables accounted for 66.0% of clinical decision-making ability.
The nurses' clinical decision-making ability can be improved by improving their analytical competency. Therefore, it is necessary to organize nursing work, create a supportive work environment, and develop and implement various education programs.


Clinical Decision Making; Critical Thinking; Intuition; Nurses; Clinical Competency
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