From Noticing to Reflection: A Qualitative Exploration of Rapid Cycle Deliberate Practice Effects on Electrocardiographic Monitoring Judgment in Critical Cardiac Care Nurses

This qualitative phenomenological study explored how Rapid Cycle Deliberate Practice (RCDP), structured around Tanner’s Clinical Judgment Model, influenced electrocardiographic (ECG) monitoring judgment among 13 critical cardiac care nurses in a tertiary Chinese hospital. Semi-structured interviews and field observations revealed four interconnected themes: a shift from fragmented data perception to holistic pattern recognition (noticing); a transition from mechanical rule‑based matching to integrated intuition‑evidence reasoning (interpreting); a move from hesitant reactivity to confident proactive responses (responding); and a redefined professional role encompassing new identity, ethical responsibility, and continuous learning (reflecting). The psychologically safe “pause‑coach‑resume” mechanism of RCDP appeared central to enabling these perceived transformations. Findings suggest that competency development in ECG interpretation requires educational strategies that simultaneously address cognitive, behavioral, and identity dimensions, with implications for staff training and future longitudinal research.