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Maffucci J, Vanderzwan K, Burt L. Evaluating a Shared Reflective Practice to Develop Nursing Student Clinical Judgment. Nurse Educ 2024; 49:147-151. [PMID: 38108376 DOI: 10.1097/nne.0000000000001570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
BACKGROUND Self-reflection is a valuable method that nurse educators can use to develop clinical judgment skills among prelicensure nursing students. Little research exists on improving clinical judgment in second-degree nursing students in the clinical setting. PURPOSE To determine the implications of increasing clinical judgment skills in prelicensure nursing students using a shared structured reflection teaching innovation within a required baccalaureate clinical course. METHODS This educational innovation used qualitative descriptive methods to evaluate its effectiveness in the clinical setting among students in the final semester of an accelerated prelicensure nursing program. RESULTS Students reported increased accountability for their learning, a sense of intentionality with their nursing practice, and a deeper sense of community with their peers. CONCLUSIONS Shared reflective practices in the clinical setting show promise for increasing clinical judgment and supporting a competency-based curriculum.
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Affiliation(s)
- Jennifer Maffucci
- Author Affiliations: Clinical Instructor (Dr Maffucci) and Clinical Assistant Professor (Drs Vanderzwan and Burt), Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois Chicago
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Lasater K, Nielsen A. The Lasater Clinical Judgment Rubric: 17 Years Later. J Nurs Educ 2024; 63:149-155. [PMID: 38442394 DOI: 10.3928/01484834-20240108-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
BACKGROUND Nearly 17 years ago, the Lasater Clinical Judgment Rubric (LCJR) was published to provide a common language and trajectory of students' development to think like a nurse. METHOD This article traces the uses of the LCJR from creation to the present and cites lessons learned from its use. RESULTS During the intervening years, the LCJR has been used effectively as a debriefing guide in simulation and as a research instrument, as well as for formative assessment. The LCJR has been translated or is in process in 19 languages besides English. CONCLUSION This article provides evidence of the efficacy of the LCJR and discusses important lessons learned. [J Nurs Educ. 2024;63(3):149-155.].
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Kwon SN, Park H. [Development of Nursing Clinical Judgment Scale]. J Korean Acad Nurs 2023; 53:652-665. [PMID: 38204348 DOI: 10.4040/jkan.23042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/22/2023] [Accepted: 09/14/2023] [Indexed: 01/12/2024]
Abstract
PURPOSE This study aimed to develop a nursing clinical judgment scale (NCJS) and verify its validity and reliability in assessing the clinical judgment of nurses. METHODS A preliminary instrument of the NCJS comprising 38 items was first developed from attributes and indicators derived from a literature review and an in-depth/focus interview with 12 clinical nurses. The preliminary tool was finalized after 7 experts conducted a content validity test based on a data from a preliminary survey of 30 hospital nurses in Korea. Data were collected from 443 ward, intensive care unit, emergency room nurses who voluntarily participated in the survey through offline and online for the verification of the construct validity and reliability of the scale. RESULTS The final scale comprised 23 items scored on a 5-point Likert scale. Six factors- integrated data analysis, evaluation and reflection on interventions, evidence on interventions, collaboration among health professionals, patient-centered nursing, and collaboration among nurse colleagues - accounted for 64.9% of the total variance. Confirmatory factor analysis supported the fit of the measurement model, comprising six factors (root mean square error of approximation = .07, standardized root mean square residual = .04, comparative fit index = .90). Cronbach's α for all the items was .92. CONCLUSION The NCJS is a valid and reliable tool that fully reflects the characteristics of clinical practice, and it can be used effectively to evaluate the clinical judgment of Korean nurses. Future research should reflect the variables influencing clinical judgment and develop an action plan to improve it.
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Affiliation(s)
- Shi Nae Kwon
- College of Nursing, Ewha Womans University, Seoul, Korea
| | - Hyojung Park
- College of Nursing, Ewha Womans University, Seoul, Korea.
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Manik MJ, Callaway P. The implementation of Tanner's Clinical Judgment Model and the Indonesian version of the Lasater Clinical Judgment Rubric in the clinical setting. Appl Nurs Res 2023; 73:151725. [PMID: 37722793 DOI: 10.1016/j.apnr.2023.151725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 07/20/2023] [Accepted: 08/01/2023] [Indexed: 09/20/2023]
Abstract
A critical component for nurses to provide safe and quality care with strong patient outcomes is clinical judgment. This study aimed to identify the difference in the clinical judgment score in newly graduated nurses by implementing Tanner's Clinical Judgment Model. This study followed an experimental design with a pretest-posttest and involved thirty-two newly graduated nurses from three private hospitals in Indonesia. The intervention group had a scheduled post-conference with their preceptors using Tanner's Clinical Judgment Model's guidelines with high-level, open-ended questions for two consecutive weeks. Independent samples t-test was used to compare pre-and post-test scores utilizing the valid and reliable Indonesia version of the Lasater Clinical Judgment Rubric. There was no significant difference between the pre-test results of the intervention and control groups, with a significance value of 0.647. The results indicated a significant difference in the mean clinical judgment scores between the intervention and control groups after two weeks of intervention, where the intervention group's scores were higher than the control group's with a significance value of <0.001 with a mean difference of 6.75 and CI of 95 % (4.18-9.31). Tanner's Clinical Judgment Model showed a significant impact in increasing clinical judgment scores. The Indonesia version of the Lasater Clinical Judgment Rubric is a valuable tool for assessing and evaluating the development of clinical judgment and provides detailed targeted areas needing improvement. Preceptors and nursing leaders in the clinical setting should continue to use this model and tools to assist newly graduated nurses in developing clinical judgment skills during their transition period.
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Affiliation(s)
| | - Penny Callaway
- Division of Doctoral Nursing, Indiana Wesleyan University, Marion, Indiana, United States of America
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Huang HM, Huang CY, Lin KC, Yu CH, Cheng SF. Development and Psychometric Testing of the Clinical Reasoning Scale Among Nursing Students Enrolled in Three Types of Programs in Taiwan. J Nurs Res 2023; 31:e263. [PMID: 36976537 DOI: 10.1097/jnr.0000000000000547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND There is no instrument currently available to assess the essential nursing competency of clinical reasoning (CR). PURPOSE The purpose of this study was to develop and test the psychometric properties of CR assessment instrument appropriate for use with nursing students across different types of programs. METHODS H. M. Huang et al.'s (2018) Framework of Competencies of Clinical Reasoning for Nursing Students was used to guide this study. Two rounds of Delphi study and confirmatory factor analysis (CFA) were conducted to test content and construct validity. Internal consistency was tested for reliability. RESULTS The four-domain, 16-item Likert-scale Clinical Reasoning Scale (CRS) was developed. One thousand five hundred four nursing students currently enrolled in three different types of nursing programs completed the CRS. The content validity index was .85-1.0, the CFA indicated goodness of fit, and the Cronbach's α score range was .78-.89. CONCLUSION The CRS is a valid and reliable tool for assessing CR in nursing students in different types of nursing program.
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Affiliation(s)
- Hui-Man Huang
- PhD, RN, Assistant Professor, School of Nursing, Tzu Chi University of Science and Technology, Hualien, Taiwan, ROC
| | - Chu-Yu Huang
- PhD, RN, Professor, School of Nursing, Cedarville University, Ohio, USA
| | - Kuan-Chia Lin
- PhD, Professor, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Chia-Hui Yu
- PhD, RN, Assistant Professor, Mass Communication Center, Chung Shan Medical University Hospital, and School of Nursing, Chung Shan Medical University, Taichung City, Taiwan, ROC
| | - Su-Fen Cheng
- PhD, RN, Professor, Department of Health Allied Education and E-learning, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, ROC
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Høegh-Larsen AM, Gonzalez MT, Reierson IÅ, Husebø SIE, Hofoss D, Ravik M. Nursing students' clinical judgment skills in simulation and clinical placement: a comparison of student self-assessment and evaluator assessment. BMC Nurs 2023; 22:64. [PMID: 36894974 PMCID: PMC9996978 DOI: 10.1186/s12912-023-01220-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/23/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Clinical judgment is an important and desirable learning outcome in nursing education. Students must be able to self-assess their clinical judgment in both the simulation and clinical settings to identify knowledge gaps and further improve and develop their skills. Further investigation is needed to determine the optimal conditions for and reliability of this self-assessment. AIMS This study aimed to compare the same group of students' self-assessment of clinical judgment with an evaluator's assessment in both simulation and clinical settings. The study further aimed to investigate whether the Dunning-Kruger effect is present in nursing students' self-assessment of clinical judgment. METHODS The study applied a quantitative comparative design. It was conducted in two learning settings: an academic simulation-based education course, and a clinical placement course in an acute care hospital. The sample consisted of 23 nursing students. The Lasater Clinical Judgment Rubric was used to collect data. The scores were compared using a t-test, intraclass correlation coefficient, Pearson's correlation coefficient, and Bland-Altman plots. The Dunning-Kruger effect was investigated using linear regression analysis and a scatter plot. RESULTS The results showed an inconsistency between student self-assessment and evaluator assessment of clinical judgment in both simulation-based education and clinical placement. Students overestimated their clinical judgment when compared to the more experienced evaluator's assessment. Differences between students' scores and the evaluator's scores were larger when the evaluator's scores were low, indicating the presence of the Dunning-Kruger effect. CONCLUSION It is vital to acknowledge that student self-assessment alone may not be a reliable predictor of a student's clinical judgment. Students who had a lower level of clinical judgment were likely to be less aware that this was the case. For future practice and research, we recommend a combination of student self-assessment and evaluator assessment to provide a more realistic view of students' clinical judgment skills.
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Affiliation(s)
- Anne Mette Høegh-Larsen
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway, Postbox 235, Kongsberg, 3603, Norway.
| | - Marianne Thorsen Gonzalez
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway, Postbox 235, Kongsberg, 3603, Norway
| | - Inger Åse Reierson
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway, Postbox 235, Kongsberg, 3603, Norway
| | - Sissel Iren Eikeland Husebø
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Department of Surgery, Stavanger University Hospital, Stavanger, Norway
| | - Dag Hofoss
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway, Postbox 235, Kongsberg, 3603, Norway
| | - Monika Ravik
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway, Postbox 235, Kongsberg, 3603, Norway
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Høegh-Larsen AM, Ravik M, Reierson IÅ, Husebø SIE, Gonzalez MT. PEARLS Debriefing Compared to Standard Debriefing Effects on Nursing Students’ Professional Competence and Clinical Judgment: A Quasi-Experimental Study. Clin Simul Nurs 2023. [DOI: 10.1016/j.ecns.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Lo KW, Yang BH. Development and learning efficacy of a simulation rubric in childhood pneumonia for nursing students: A mixed methods study. NURSE EDUCATION TODAY 2022; 119:105544. [PMID: 36115070 DOI: 10.1016/j.nedt.2022.105544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 08/24/2022] [Accepted: 09/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Nursing students often lack knowledge, skills, and appropriate attitudes toward chest physiotherapy, which affects the quality of care provided to children with pneumonia in clinical practice. Helping students learn about the effectiveness of simulations can improve their nursing ability. OBJECTIVES To develop a rubric associated with the simulation of childhood pneumonia and to examine the learning efficacy of students using the rubric to assess the knowledge, skills, and attitudes in the simulation. DESIGN A mixed methods study using a post-test survey and a descriptive qualitative analysis of students' reflective journals. SETTINGS A paediatric simulation classroom at the University Clinical Skills Centre in Northern Taiwan. PARTICIPANTS 214 third-year students enrolled in a four-year nursing programme. METHODS Quantitative and qualitative data were collected after the course to obtain a comprehensive understanding of its effects. Quantitative data from the questionnaire were analysed using descriptive statistics. Qualitative data were analysed using content analysis. RESULTS The quantitative results showed that mean knowledge and nursing students' attitudes were moderate. Of the six sub-indices, chest percussion technique and communication with family and children had the highest mean with 3.32 ± 0.67 and 3.01 ± 0.68, respectively. The students discovered that they often focused on performing technical steps without pre-analysing patient information. Most students also indicated difficulty showing emotional caring behaviours toward patients. The qualitative results revealed that students reflected on their learning post-self-evaluation of the rubric, particularly regarding knowledge of systemic assessments, patient-centred nursing skills, and caring attitudes. CONCLUSIONS The knowledge, skills, and attitude rubric can help students develop their learning process in a more organised manner, promote the development of their caring performances toward children, and assist them in their future clinical care practices.
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Affiliation(s)
- Kao-Wen Lo
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
| | - Bao-Huan Yang
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan; Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan.
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Duarte HMS, Lasater K, Dixe MDACR. Transcultural Translation and Validation of Lasater Clinical Judgment Rubric©. Rev Bras Enferm 2022; 75:e20210880. [PMID: 35766756 DOI: 10.1590/0034-7167-2021-0880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/01/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to translate and cross-culturally validate the Lasater Clinical Judgment Rubric© (LCJR©) instrument for nursing students. METHODS the application of LCJR-PT© was preceded by a linguistic translation into Portuguese, based on the translation-back-translation method. This psychometric study involved 32 nursing students from a program in Portugal. Data were collected through observations of two independent observers during the performance of the practices developed by the students, through the scenarios validated by experts of high and of medium-fidelity simulation. RESULTS of the 64 observations obtained from the practices of nursing students, the value of intra-class correlations in the 4 aspects of the instrument exceeded 0.792. There was a global Cronbach's alpha of LCJR-PT© of 0.921 and 0.876 in Observers 1 and 2 respectively, with a statistically significant level of agreement. CONCLUSIONS the LCJR-PT© is a valid and reliable instrument, demonstrating a high potential for its use in clinical education and nursing research.
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Affiliation(s)
- Hugo Miguel Santos Duarte
- Universidade Católica Portuguesa, Instituto Ciências da Saúde de Lisboa. Lisboa, Portugal.,Centro Hospitalar de Leiria. Leiria, Portugal.,Instituto Politécnico de Leiria, Escola Superior de Saúde. Leiria, Portugal.,Instituto Politécnico de Leiria, Center for Innovative Care and Health Technology, ciTechCare. Leiria, Portugal
| | - Kathie Lasater
- Oregon Health & Science University. Portland, Oregon, United States of America.,Edinburgh Napier University. Edinburgh, United Kingdom
| | - Maria Dos Anjos Coelho Rodrigues Dixe
- Instituto Politécnico de Leiria, Escola Superior de Saúde. Leiria, Portugal.,Instituto Politécnico de Leiria, Center for Innovative Care and Health Technology, ciTechCare. Leiria, Portugal
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Brentnall J, Thackray D, Judd B. Evaluating the Clinical Reasoning of Student Health Professionals in Placement and Simulation Settings: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020936. [PMID: 35055758 PMCID: PMC8775520 DOI: 10.3390/ijerph19020936] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 11/16/2022]
Abstract
(1) Background: Clinical reasoning is essential to the effective practice of autonomous health professionals and is, therefore, an essential capability to develop as students. This review aimed to systematically identify the tools available to health professional educators to evaluate students' attainment of clinical reasoning capabilities in clinical placement and simulation settings. (2) Methods: A systemic review of seven databases was undertaken. Peer-reviewed, English-language publications reporting studies that developed or tested relevant tools were included. Searches included multiple terms related to clinical reasoning and health disciplines. Data regarding each tool's conceptual basis and evaluated constructs were systematically extracted and analysed. (3) Results: Most of the 61 included papers evaluated students in medical and nursing disciplines, and over half reported on the Script Concordance Test or Lasater Clinical Judgement Rubric. A number of conceptual frameworks were referenced, though many papers did not reference any framework. (4) Conclusions: Overall, key outcomes highlighted an emphasis on diagnostic reasoning, as opposed to management reasoning. Tools were predominantly aligned with individual health disciplines and with limited cross-referencing within the field. Future research into clinical reasoning evaluation tools should build on and refer to existing approaches and consider contributions across professional disciplinary divides.
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Affiliation(s)
- Jennie Brentnall
- Work Integrated Learning, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia;
- Correspondence:
| | - Debbie Thackray
- Physiotherapy, School of Health Sciences, University of Southampton, Southampton SO17 1BJ, UK;
| | - Belinda Judd
- Work Integrated Learning, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia;
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Clemett VJ, Raleigh M. The validity and reliability of clinical judgement and decision-making skills assessment in nursing: A systematic literature review. NURSE EDUCATION TODAY 2021; 102:104885. [PMID: 33894591 DOI: 10.1016/j.nedt.2021.104885] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 02/25/2021] [Accepted: 03/25/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To appraise the validity and reliability of approaches to assessing the clinical decision-making skills of nurses, and use findings to inform the assessment of students as they transition to newly qualified nurses. DESIGN The preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were used to conduct the review. DATA SOURCES Medline, CINAHL and the British Nursing Index were searched from inception to November 2019. REVIEW METHODS Studies were grouped according to their assessment approach following a competency framework with findings presented as a narrative synthesis. RESULTS 38 articles were included in the review which assessed clinical decision-making in a variety of settings; clinical practice, simulation, written examinations and self-assessment. Multi-level rubric and checklist approaches demonstrated good validity and reliability in practice and simulation settings, and the former was effective at differentiating between students at different stages of their training. Written, case study examinations were also effective at assessing clinical decision-making, although an optimum structure for their presentation was not possible to discern. Students tended to score themselves more highly than faculty staff when undertaking rubric-based self-assessments. CONCLUSIONS Findings suggest that the best approach to assess clinical decision-making for final year students is to use several low-stakes, snap-shot summative assessments in practice environments, which are marked using a multi-level observational rubric. To assure reliability, it is recommended that a small team of expert practice assessors undergo regular training and peer review, have protected time to complete their assessor role and are appropriately supported.
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Affiliation(s)
- Victoria J Clemett
- King's College London, Florence Nightingale Faculty of Nursing and Midwifery, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, United Kingdom of Great Britain and Northern Ireland.
| | - Mary Raleigh
- King's College London, Florence Nightingale Faculty of Nursing and Midwifery, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, United Kingdom of Great Britain and Northern Ireland.
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Canto VBD, Silva TGD, Santos GAD, Carvalho ECD, Morais SCRV, Frazão CMFDQ. Clinical judgment performance of undergraduate Nursing students. Rev Lat Am Enfermagem 2021; 29:e3452. [PMID: 34190943 PMCID: PMC8253357 DOI: 10.1590/1518-8345.4843.3452] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 09/27/2020] [Indexed: 11/23/2022] Open
Abstract
Objective: to evaluate the reported performance regarding clinical judgment by
undergraduate Nursing students. Method: a cross-sectional study with the application of the Lasater Clinical
Judgment Rubric-Brazilian Version in 166 undergraduate Nursing
students from a Brazilian public university. The data were analyzed
descriptively and analytically (by comparing the level of clinical judgment
among students from the initial, intermediate, and concluding groups). The
following tests were applied: Chi-square, Fisher’s Exact and Kruskal-Wallis,
and a p-value of 0.05 was adopted. The reliability of the global instrument
(Cronbach’s alpha) was 0.786. Results: of the 166 students, 65.7% evaluated themselves as proficient in relation to
the reported performance on clinical judgment. Of the rubric’s 11 dimensions
(focused observation, recognizing deviations from expected patterns,
information seeking, prioritizing data, making sense of data, calm and
confident manner, clear communication, well-planned
intervention/flexibility, being skillful, evaluation/self-analysis, and
commitment to improvement), only four groups did not present significant
differences among them (p<0.05): focused observation, information
seeking, prioritizing data, and calm and confident manner. Conclusion: the performance on clinical judgment reported as proficient was pointed out
by 65.7% of the students and a significant statistical difference was
verified in seven dimensions, among beginners, intermediate, and concluding
students, compatible with the evolution of learning.
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Affiliation(s)
| | | | | | - Emilia Campos de Carvalho
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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Psychometric properties of the virtual patient version of the Lasater Clinical Judgment Rubric. Nurse Educ Pract 2019; 38:14-20. [DOI: 10.1016/j.nepr.2019.05.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 04/11/2019] [Accepted: 05/27/2019] [Indexed: 11/20/2022]
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Yang F, Wang Y, Yang C, Zhou MH, Shu J, Fu B, Hu H. Improving clinical judgment by simulation: a randomized trial and validation of the Lasater clinical judgment rubric in Chinese. BMC MEDICAL EDUCATION 2019; 19:20. [PMID: 30642320 PMCID: PMC6332860 DOI: 10.1186/s12909-019-1454-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 01/04/2019] [Indexed: 05/27/2023]
Abstract
BACKGROUND The development and assessment of clinical judgment ability are essential in nursing education. The Lasater Clinical Judgment Rubric (LCJR) was shown to be valid in evaluating nursing students' learning outcomes and skills in western cultures but has not been validated in mainland China. This study aimed to compare a simulation-teaching model with a traditional teaching method in enhancing the clinical judgment ability of nursing undergraduate students and to validate the Chinese version of the Lasater Clinical Judgment Rubric (C-LCJR). METHODS Four classes of nursing students (n = 157) at Hubei University of Chinese Medicine, China, were randomly assigned to two control and two experimental classes. The experimental classes were taught using simulation teaching with standardized patients, while the control classes were taught using traditional teaching methods. At the end of the experiment, students in both kinds of classes evaluated their clinical judgment using the C-LCJR. Teachers also rated the students but without knowing who had received the simulation teaching. Confirmatory factor analysis and a Multiple Indicators Multiple Causes (MIMIC) model with Bayesian estimation was fit to the rating data to investigate measurement properties and experimental effects. RESULTS Compared to the control classes, students in the experimental classes performed better in all subdomains of C-LCJR (noticing, interpreting, responding, and reflecting). The measurement properties of the C-LCJR were found to be satisfactory with high factor loadings and reliabilities and no bias from age, gender, and raters. CONCLUSIONS The simulation teaching model is more effective than the traditional (non-simulation-based) teaching method in improving clinical judgment of Chinese nursing students. The C-LCJR is a valid and reliable instrument for measuring clinical judgment in nursing students in China.
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Affiliation(s)
- Fen Yang
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Yuncui Wang
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Chongming Yang
- Research Support Center, Brigham Young University, Provo, UT, USA
| | - M Huifang Zhou
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Jing Shu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Bei Fu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Hui Hu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China.
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