Clinical judgment skills among junior-level nursing students enrolled in adult health nursing courses: Errors and risk level classification

Early Prelicensure Nursing Students' Perceptions of Case Studies Through the Lens of the Clinical Judgment Measurement Model

BACKGROUND

Research indicates new nursing graduates struggle with clinical reasoning, despite some related skill development throughout their education. The question remains, "Could an earlier focus on clinical reasoning in nursing programs enhance nursing students' clinical reasoning?"

PURPOSE

This pilot study investigated how first-semester nursing students perceive the use of case studies in clinical reasoning skill development and the perceived benefits of case studies related to the NCSBN Clinical Judgment Measurement Model (NCJMM).

METHODS

Case studies and written reflections were introduced to a convenience sample (n = 45) of first-semester nursing students. Qualitative analysis was conducted on written reflections.

RESULTS

Students found case studies enhanced their knowledge and prepared them for clinical practice as a nurse.

CONCLUSIONS

Findings suggest early introduction of case studies is a meaningful teaching strategy to develop clinical reasoning aligned with the NCJMM.

The impact of tutoring on nursing students' clinical judgment: A quasi-experimental study

BACKGROUND

Nurses' lack of clinical judgment often leads to adverse patient outcomes due to failure to recognize clinical deterioration, intervene, and manage complications. Teaching clinical judgment through a nursing process can help nursing students provide safe and competent patient care with improved health outcomes and to pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN).

AIMS

The aim of this study was to examine the effect of tutoring on clinical judgment of undergraduate nursing students utilizing Lasater's Clinical Judgment Rubric (LCJR). This study also compared the clinical judgment of male and female nursing students and students from different semester levels.

METHODS

This quasi-experimental study utilized a single group pretest, posttest design. A convenience sample of n = 40 undergraduate nursing students from the Los Angeles County College of Nursing and Allied Health participated in the study. The participants underwent a pretest simulation, four sessions of the Clinical Judgment Model (CJM)-based tutoring, and a posttest simulation.

RESULTS

The posttest clinical judgment scores (35.70 ± 3.6) were significantly different from the pretest scores (25.78 ± 5.20). The tutoring had a significant effect on the clinical judgment of nursing students t(39) = -11.64, n = 40, p < .001, at 95% CI of the mean difference.

LINKING EVIDENCE TO ACTION

Enhancing nursing students' clinical judgment is crucial to provide high-quality, safe patient care with improved health outcomes. The CJM-based tutoring is an effective strategy for developing clinical judgment in nursing students. This new teaching approach can train students to critically think, develop clinical judgment, and prepare for the complex healthcare environment. Therefore, nurse educators should focus on integrating clinical judgment into the prelicensure nursing program curriculum as a priority.

A concept analysis of clinical judgment in undergraduate nursing students

AIM

To offer a clear understanding of the definition, attributes, antecedents, and consequences of undergraduate nursing students' clinical judgment in the nursing education context.

BACKGROUND

Clinical judgment is a concept with broad uses among healthcare professionals. Its definitions and attributes vary across contexts. There is no established understanding of clinical judgment in nursing students.

DESIGN

This concept analysis was performed using the eight steps of Walker and Avant's framework.

DATA SOURCES

A literature search was conducted using search engines and included peer-reviewed articles related to clinical judgment in nursing students.

RESULTS

Clinical judgment in nursing students was defined as the cognitive process exhibited via a nursing action by observation, patient assessment, interpreting, and prioritizing data that lead to responding using the appropriate nursing practice with the patient. Reflection was used to evaluate nursing students' clinical judgment to revise nursing practice. Antecedents included nursing education curriculum, student's knowledge, previous clinical experience, critical thinking, and clinical reasoning. The consequences of clinical judgment were clinical judgment ability, safe nursing practice, nursing care quality, and patient safety.

CONCLUSIONS

This concept analysis gives clear insights into the definition, attributes, antecedents, and consequences of undergraduate nursing student's clinical judgment.

Clinical Application Value of Group-Sharing Nursing Management Based on Case Analysis

The purpose of this study was to explore the clinical application value of group sharing nursing management based on a case analysis. The archive data of 90 nurses in 15 nursing units of our hospital were analyzed retrospectively. A total of 90 nurses from 15 nursing units in our hospital were retrospectively analyzed: the nurses before the implementation of the “case study-based group shared care management” program from January 2019 to January 2020 were set up as the control group, and the same nurses after the implementation of the program from January 2020 to January 2021 were set up as the study group. The nurses in the study group and the control group corresponded to 9759 and 8973 clinical inpatients, respectively. The overall incidence of medication-related, falling, tube-related, exam-related, and other types of adverse events was lower in the study group (0.52% vs. 1.29%) than those in the control group (P < 0.05); the overall nursing adverse event rating was lower in the study group than that in the control group (P < 0.05). Nurses in the study group scored higher than the control group on the following scales: Perceived Occupational Benefit Scale, General Self-Efficacy Scale, and Karlausk/Miller Satisfaction Scale (P < 0.05). The case study-based group-shared care management model can reduce the risk and harm of adverse events in hospitals and improve nurses' sense of professional benefit and self-efficacy.

Clinical judgment and decision-making of the Undergraduate Nursing students

Abstract Clinical judgment and decision-making are essential competencies in nursing, emerging as expanding learning areas of nursing education. Aiming to characterize the types of clinical judgment and decision-making adopted by nursing students in clinical education, we designed a qualitative, exploratory and descriptive study, with data collection obtained through documental analysis of nursing student’s reflective journals, in clinical education settings. Data analysis was performed according to Bardin using the webQDA software. Thirty-four students participated in the study, while attending the Clinical Learning Curricular Unit: Caring for Clients with Increased Vulnerability and Families in Transition, producing a total of 40 reflective journals. Of the 248 identified registration units, we highlight the evaluation decision-making with 45 registration units and the intervention decision-making, with 55 registration units. It is concluded that student´s reflections in the context of clinical teaching, are mainly about the assessment of the care situation and the decision-making related to the action. This study is intended to guide the learning of these competencies in nursing education.

Clinical judgment and decision-making of the Undergraduate Nursing students

Clinical judgment and decision-making are essential competencies in nursing, emerging as expanding learning areas of nursing education. Aiming to characterize the types of clinical judgment and decision-making adopted by nursing students in clinical education, we designed a qualitative, exploratory and descriptive study, with data collection obtained through documental analysis of nursing student's reflective journals, in clinical education settings. Data analysis was performed according to Bardin using the webQDA software. Thirty-four students participated in the study, while attending the Clinical Learning Curricular Unit: Caring for Clients with Increased Vulnerability and Families in Transition, producing a total of 40 reflective journals. Of the 248 identified registration units, we highlight the evaluation decision-making with 45 registration units and the intervention decision-making, with 55 registration units. It is concluded that student´s reflections in the context of clinical teaching, are mainly about the assessment of the care situation and the decision-making related to the action. This study is intended to guide the learning of these competencies in nursing education.