Background: Clinical reasoning (CR) is crucial for learning and improving. Today's
healthcare services require effective use of clinical reasoning complex nursing situations in
order to quickly assess the need for patient care. This study aimed to evaluate the effects of
guided clinical reasoning on nursing students' knowledge and achievement regarding
management of primary postpartum hemorrhage. Design: Quasi experimental research design
was utilized. Setting: The study was carried out at two settings; the first one was Maternity
Nursing Lab at the Faculty of Nursing-Mansoura University, Egypt, the second was Labor &
Delivery room of Mansoura University Hospital, Egypt. Subjects: One hundred and four
nursing students enrolled in the maternity course during 2nd term of the academic year 2018-
2019 were recruited in the study. Sample type: Purposive sampling technique. Tools: Data
were collected by using four tools (Structured Interviewing schedule, Students' achievement,
Observation checklist, Students' satisfaction scale). Results: The students in the clinical
reasoning group reported a significant improvement of knowledge regard CR than those of
traditional group (P=0.0001), Pretest data related to students achievement between CR group < /div>
and traditional group, showed no statistically significant difference between both groups (p =
0.182).While there was highly statistically significant difference in posttest with improvement
in CR group (P 0.0001). Also, there was a highly statistically significant difference between
both group regarding implementing CR steps of 1ry pphge management, moreover CR group < /div>
reported more satisfaction by training method than traditional group. Conclusion: It was
evident that CR teaching method was an effective; provided students with knowledge and
practices that translate into significantly higher achievements and higher satisfaction scores
compared to the traditional method. Recommendation: The study recommended that
integrating CR method in maternity nursing and midwifery curriculum for positive patient
outcomes.