||New nurses entering practice must possess the competence to recognize patient problems and make appropriate decisions to promote safe care. Evidence from the literature indicates that new graduate nurses generally lack this competence and struggle with making appropriate decisions about patient needs and priorities. Clinical reasoning and decision-making are vital nursing skills for promoting patient safety and quality health care. Nurse educators need to evaluate how these skills are taught, and consider the needs of students while learning these skills. Evidence-based teaching strategies are needed to promote development of clinical reasoning and clinical decision-making skills early and often in nursing curricula. This study employed a researcher-developed teaching strategy, a standardized clinical preparation guide, designed to promote development of reasoning and decision making skills in clinical learning experiences. The purpose of this descriptive phenomenological study was to describe senior-level baccalaureate nursing student experiences of clinical preparation, clinical reasoning, and decision making while using a standardized clinical preparation guide. Data from focus group interviews were analyzed to determine common themes of student experiences and perceptions of how the use of the guide facilitated their development of clinical reasoning and decision-making skills. The data revealed 15 themes and four sub-themes about nursing student learning needs, barriers to effective clinical preparation, and benefits of using the preparation guide. The findings supported the use of the clinical preparation guide to promote effective and efficient student preparation for patient care and the development of clinical reasoning and decision-making skills in clinical learning experiences, within the context of these students' experiences.