Year of Publication


Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Debra Hampton

Clinical Mentor

Dr. Julie Marfell

Committee Member

Dr. Kristin Ashford

Committee Member

Dr. Darlene Welsh



Background: Clinical reasoning and clinical judgement have been identified as essential skills for the delivery of quality patient care. Nursing education relies heavily on standardized exams like the HESI to predict success on the national licensure exam.

Purpose The purpose of this study was to determine the impact of clinical reasoning seminars (CRS) on medical-surgical specialty HESI exam scores of first semester junior BSN nursing students.

Methods: A retrospective correlational design was used for this study, which involved a review of medical-surgical HESI scores for 115 junior level baccalaureate nursing students who were identified as academically high-risk and who participated in a series of clinical reasoning seminars.

Results: The participation in CRS by high-risk students was not found to have a statistically significant impact on the medical-surgical HESI scores. Eighty percent of high-risk students who participated in at least one CRS scored greater than an 850 on the medical-surgical HESI. Students who attended CRS had a higher mean medical-surgical HESI score than students that did not attend any CRS.

Discussion: Although CRS did not have a statistically significant impact on medical-surgical HESI scores, 80% of students who scored below an 850 on the fundamental HESI, an assessment that takes place the sophomore year, scored above an 850 on the junior year medical-surgical HESI, which indicates that CRS may have enhanced students reasoning skills.

Conclusion. Though statistical differences were not found, it appears that high-risk students may have benefitted from participation in CRS. Further research is recommended.