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Determining how undergraduate student nurses develop professional wisdom: A Grounded Theory Study
Dissertation   Open access

Determining how undergraduate student nurses develop professional wisdom: A Grounded Theory Study

Suzanne Volejnikova-Wenger
University of the Sunshine Coast, Queensland
Doctor of Philosophy, University of the Sunshine Coast, Queensland
2026
DOI:
https://doi.org/10.25907/01048
pdf
Thesis 14.86 MBDownloadView
Thesis Open Access CC BY-NC V4.0

Abstract

Nursing not elsewhere classified nursing students professional wisdom decision making interpreting grounded theory
Nurses are healthcare professionals who spend the most time with patients. Being on the frontline, they are pivotal in identifying deterioration in those they provide care for, and sensing if something is not quite right. Recognising and responding promptly and adequately to deterioration is key for positive patient outcomes. Objective data, such as changes in vital signs alert the nurse when a patient’s physiological changes indicate a deterioration. However, nurses often rely on subjective information to escalate their concerns about a patient. Nurses are in some cases reluctant to activate medical escalation, as ‘feeling’ is subjective and known interchangeably as intuition, ‘the fifth vital sign’, the art of nursing, or ‘the worry factor’, when presented with a situation of concern and associated with Professional Wisdom in Nursing. Whilst there are studies that suggest how professional wisdom development occurs in the registered nurse workforce, undergraduate student nurses are seldom considered as participants. The premise being that professional wisdom requires time and chronological experience to be developed, and as novices, student nurses do not have capacity to develop this as their professional exposure in nursing is minimal. However, this does not take into consideration that the profile of an undergraduate student nurse has changed considerably since the 1980s and the adoption of Patricia Benner’s theory ‘From Novice to Expert’. To understand student professional wisdom development, the question driving this research was ‘How do undergraduate student nurses develop professional wisdom to inform decision making in nursing practice’? In this Grounded Theory study, 16 student nurses at various stages of their Bachelor of Nursing Science degree and from diverse backgrounds, and two new graduates prior to commencing work as RNs, provided the data, interwoven with literature and analysed through Constant Comparative Analysis. Interpreting was identified as the Basic Social Process. This is a dynamic cognitive analytical process that, through a subconscious internal dialogue of coding, creates contextual meaning enabling Professional Wisdom in Nursing. This resulted in the substantive theory of Interpretive Professional Wisdom in Nursing (InterProWiN) which includes the 7 Degrees of Professional Wisdom in Nursing. This theory includes the five categories of realising, processing, deciding, practising and reflecting. Each category includes aligned concepts, properties and theoretical propositions and explains what happens when student nurses are faced with a situation of concern and their worry factor is activated. This leads to a pathway of determining a solution and implementing a decision in nursing practice, which explains how interpreting contributes to the development of Professional Wisdom in Nursing. This thesis addresses a gap in current knowledge, and provides tangible benefits for advancing nursing practice, nurse education, transition to practice and future development of the nursing workforce by increasing knowledge regarding how development of professional wisdom can be nurtured and assist in preventing adverse health events.

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