Clinical decision-making of bachelor and clinical internship (professional) nursing students in Indonesia

  • Annissa Novalia
    Faculty of Nursing, Universitas Indonesia, Depok, West Java, Indonesia.
  • Shanti Farida Rachmi
  • Krisna Yetti
    Department of Basic Science and Fundamentals of Nursing, Faculty of Nursing, Universitas Indonesia, Depok, West Java, Indonesia.


Background: Clinical decision-making is an essential element of every professional nursing career. A nurse's aptitude for clinical decision-making influences the quality of the healthcare they provide. This research aims to describe the clinical decision-making among nursing students at Universitas Indonesia.

Design and Methods
: This research employed a cross-sectional design by sampling 216 students across several types and level of students programs in the University. The samples were selected using a stratified random sampling technique and met the inclusion criteria. The instrument of this research was the 2014 Nursing Decision Making Instrument (NDMI-R2014).  The survey instrument was translated from English into Indonesian, and its validity and reliability were tested (α Cronbach value = 0.816).

: The results of the univariate analysis revealed that students’ clinical decision-making abilities vary; 59.2% in the analysis category, 40.3% in the quasi-rational category, and 0.5% in the intuitive category.

: This research concludes that the clinical decision-making ability of bachelor and professional nursing students program is in the analysis category which indicate that students’ clinical decision-making abilities involve their explicit-theoretical knowledge and are supported by evidence-based practices. Therefore, their clinical decision-making can be logically defended, though it requires a longer duration of time to strengthen those abilities.  The students’ clinical decision-making must continuously be improved to enable them to create precise decisions based on various situations and clinical conditions.


Krishnan P. A philosophical analysis of clinical decision making in nursing. J Nurs Educ 2018;57:73–8.

Standing M. Clinical judgement and decision-making in nursing interprofessional healthcare. New York: The McGraw-Hill Companies; 2010.

Potter PA, Perry AG, Stockert PA, Hall AM. Fundamentals of nursing. 9th ed. St. Louis: Elsevier; 2017.

Muntean WJ. Nursing clinical decision-making: a literature review. Chicago: National Council of State Boards of Nursing; 2012. Available from:

Phillips BC. Clinical decision making in last semester senior baccalaureate nursing students. [Unpublished dissertation]. Milwaukee: University of Wisconsin-Milwaukee; 2015.

Baxter PE, Boblin S. Decision making by baccalaureate nursing students in the clinical setting. J Nurs Educ 2008;47:345–50.

Jahanpour F, Sharif F, Salsali M, et al. Clinical decision-making in senior nursing students in Iran. Int J Nurs Pract 2010;16:595–602.

Aktaş YY, Karabulut N. A survey on Turkish nursing students’ perception of clinical learning environment and its association with academic motivation and clinical decision making. Nurse Educ Today 2016;36:124–8.

Noohi E, Karimi-Noghondar M, Haghdoost A. Survey of critical thinking and clinical decision making in nursing student of Kerman University. Iran J Nurs Midwifery Res 2012;17:440–4.

Krumwiede KA. An examination of accelerated and basic baccalaureate nursing students’ perceptions of clinical decision making. [Unpublished dissertation]. Minneapolis: Capella University; 2010.

Bjørk IT, Hamilton GA. Clinical decision making of nurses working in hospital settings. Nursing Research and Practice 2011;2011:524918.

Stinson KJ. Benner’s framework and clinical decision-making in the critical care environment. Nurs Sci Q 2017;30:52–7.

Gladstone N. Comparative theories in clinical decision making and their application to practice: a reflective case study. Br J Anaesth Recov Nurs 2012;13:65–71. DOI:

Syahreni E, Waluyanti FT. [Pengalaman mahasiswa S1 keperawatan program reguler dalam pembelajaran klinik (Experience of regular undergraduate nursing students in clinical learning)].[Article in Indonesian] Jurnal Keperawatan Indonesia 2007;11:47–53. DOI:

Lauri S, Salanterä S. Developing an instrument to measure and describe clinical decision making in different nursing fields. J Prof Nurs 2002;18:93–100.