Author ORCID Identifier

Date of Award

Spring 5-5-2022

Degree Type


Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Dr. Lisa Cranwell-Bruce

Second Advisor

Dr. Alan Jones

Third Advisor


Fourth Advisor


Fifth Advisor


Sixth Advisor


Seventh Advisor




Background: Nursing students’ transition to professional practice is lengthy. Guidelines for best practices for nurse residency programs exist, but when guidelines are not followed, new nurses suffer from increased burnout, increased turnover, and worsening job satisfaction. These issues are tied to a lack of critical thinking and clinical reasoning skills, which also results in a lack of recognition of patient deterioration. Objective: To improve new nurse recognition of a deteriorating patient and institute a practice change through a Doctor of Nursing Practice (DNP) project. The project goal was to strengthen critical thinking and clinical reasoning in the specified population, thereby improving their recognition of a deteriorating patient. Method: The method was a pretest-posttest project design. The inclusion criterion was any NENGRN resident who started between July 1, 2021 and November 1, 2021. The sample size was 15. After the pretest, the initial concept mapping and problem-based learning intervention began the week of hire. Concept mapping of a deteriorating patient case study intervention occurred bi-weekly. In theory, this strengthens critical thinking, clinical reasoning, and self-confidence in the NENGRN population. Results: There was an overall increase in posttest scores when compared to pretest critical thinking scores. The overall increase in critical thinking scores was 7%. The Critical Care cohort had a larger increase in their scores when compared to the Acute Care cohort. There is enough evidence to suggest repeating the project with a larger population of participants to see if the same results can be achieved.


File Upload Confirmation