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Bussard ME, Jessee MA, El-Banna MM, Cantrell MA, Alrimawi I, Marchi NM, Gonzalez LI, Rischer K, Coy ML, Poledna M, Lavoie P. Current practices for assessing clinical judgment in nursing students and new graduates: A scoping review. NURSE EDUCATION TODAY 2024; 134:106078. [PMID: 38184981 DOI: 10.1016/j.nedt.2023.106078] [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: 04/13/2023] [Revised: 12/11/2023] [Accepted: 12/18/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE To map current assessment practices for learning outcomes related to nurses' clinical judgment from undergraduate education to entry to practice. DESIGN Scoping review using the Joanna Briggs Institute guidelines and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). DATA SOURCES Electronic databases-Cumulative Index of Nursing and Allied Health Literature (CINAHL Complete; EBSCOhost), EMBASE (Ovid), MEDLINE (Ovid), PsycINFO (Ovid), and Web of Science (Social Sciences Citation Index, Citation Index Expanded)-using a combination of descriptors and keywords related to nursing students, newly graduated nurses, clinical judgment and related terms (e.g., critical thinking, clinical reasoning, clinical decision-making, and problem-solving), and assessment. METHODS Two reviewers independently extracted study characteristics and, for each outcome relevant to clinical judgment, the concept, definition and framework, assessment tool, and the number and schedule of assessments. Data were synthesized narratively and using descriptive statistics. RESULTS Most of the 52 reviewed studies examined the outcome of a discrete educational intervention (76.9 %) in academic settings (78.8 %). Only six studies (11.5 %) involved newly graduated nurses. Clinical judgment (34.6 %), critical thinking (26.9 %), and clinical reasoning (9.6 %) were the three most frequent concepts. Three assessment tools were used in more than one study: the Lasater Clinical Judgment Rubric (n = 22, 42.3 %), the California Critical Thinking Skills Test (n = 9, 17.3 %), and the Health Science Reasoning Test (n = 2, 3.8 %). Eleven studies (21.2 %) used assessment tools designed for the study. CONCLUSION In addition to a disparate understanding of underlying concepts, there are minimal published studies on the assessment of nursing students and nurses' clinical judgment, especially for longitudinal assessment from education to clinical practice. Although there is some existing research on this topic, further studies are necessary to establish valid and reliable clinical competency assessment methods that effectively integrate clinical judgment in clinical situations at relevant time points.
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Affiliation(s)
- Michelle E Bussard
- School of Nursing, Bowling Green State University, 924 Ridge St., Bowling Green, OH 43403, USA.
| | - Mary Ann Jessee
- School of Nursing, Vanderbilt University, 461 21(st) Avenue South, Nashville, TN 37240, USA.
| | - Majeda M El-Banna
- School of Nursing, George Washington University, 45085 University Drive, Innovation Hall, Ashburn, VA 20147, USA.
| | - Mary Ann Cantrell
- College of Nursing, Villanova University, 800 E. Lancaster Ave., Villanova, PA 19085, USA.
| | - Intima Alrimawi
- School of Nursing, Georgetown University, St. Mary's Hall, 3700 Reservoir Rd. NW, Washington, DC 20057, USA.
| | - Nadine M Marchi
- Inova Health System, 3300 Gallows Road, Falls Church, VA 22042-3300, USA.
| | - Lisa I Gonzalez
- College of Southern Maryland, 8730 Mitchell Rd, La Plata, MD 20646, USA.
| | - Keith Rischer
- KeithRN, 6417 Penn Ave S, Ste 8, iPMB 1383, Minneapolis, MN 55423, USA.
| | - Michelle L Coy
- Mayo Clinic College of Medicine and Science, 200 First Street Southwest, Rochester, MN 55905, USA.
| | - Mari Poledna
- Arizona State University, 411 North Central Ave, Phoeniz, AZ 85004, USA.
| | - Patrick Lavoie
- Faculty of Nursing, Université de Montréal, 2375 Chemin De la Côte-Sainte-Catherine, Montreal, Quebec H3C 3J7, Canada; Montreal Heart Institute Research Center, 5000 rue Bélanger, Montreal, Quebec H1T 1C8, Canada.
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Maurício AB, Cruz EDDA, Barros ALBLD, Tesoro MG, Lopes CT, Simmons AM, Lopes JDL, Guandalini LS. Effect of a guide for clinical reasoning on Nursing students' diagnostic accuracy: A clinical trial. Rev Lat Am Enfermagem 2022; 30:e3515. [PMID: 35319625 PMCID: PMC9015704 DOI: 10.1590/1518-8345.5452.3515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 12/23/2021] [Indexed: 12/03/2022] Open
Abstract
Objective to evaluate the effect of the Self-Instructional Guide for Clinical Reasoning on the diagnostic accuracy of undergraduate Nursing students. Method a randomized, parallel and double-blind (researchers and outcome evaluators) clinical trial, carried out with undergraduate Nursing students. Validated case studies were applied in two phases to identify the patient’s Nursing diagnosis/problem, etiology and clues, using the Guide with the intervention group in the second phase. The outcomes - diagnostic and etiological accuracy and number of clues - were evaluated using validated rubrics. Descriptive statistics were used to analyze demographic data; Fisher’s exact test for similarities in prior education and confidence; Mann-Whitney’s test for age; and non-parametric ANOVA test in the evaluation of the hypothesis of differences in performance. Results final sample composed of 24 students in the control group and 27 in the intervention group; no difference as to gender, age and schooling. There was a difference in diagnostic (p=0.041) and etiological (p=0.0351) accuracy in the intervention group, showing a negative effect of using the Guide. Conclusion the one-time self-instruction was not effective in impacting the diagnostic accuracy of students solving case studies. Repeated application of the Guide as a teaching tool can be effective in improving such outcome. REBEC: RBR-4bhr78.
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Affiliation(s)
- Aline Batista Maurício
- Universidade Federal do Paraná, Curitiba, PR, Brasil.,Bolsista da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
| | | | | | - Mary Gay Tesoro
- City University of New York, Lehman College, Nova York, NY, Estados Unidos da América
| | - Camila Takao Lopes
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, São Paulo, SP, Brasil
| | - Anne Marie Simmons
- City University of New York, School of Professional Studies, Nova York, NY, Estados Unidos da América
| | - Juliana de Lima Lopes
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, São Paulo, SP, Brasil
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Haley B, Palmer J. Escape Tasks: An Innovative Approach in Nursing Education. J Nurs Educ 2020; 59:655-657. [PMID: 33119780 DOI: 10.3928/01484834-20201020-11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 06/08/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Innovative teaching strategies that incorporate active learning could be beneficial to the nursing student's performance not only in the classroom but also in the clinical setting. The article provides implementation steps for integrating escape room tasks into a baccalaureate nursing program. METHOD Thirteen escape room tasks were developed by faculty and a dean to facilitate Quality and Safety Education for Nurses (QSEN) competencies. The tasks challenged seven senior students to think critically outside of the normal classroom and clinical setting. RESULTS Students reported the tasks empowered them to think critically, collaborate, and ultimately enhanced their knowledge. They enjoyed the group work and hands-on challenges. CONCLUSION Escape room tasks can be active learning teaching strategies that facilitate learning QSEN competencies. Nurse educators can easily implement the 13 escape room tasks outlined in this article. The positive outcome of this activity revealed future opportunities for nurse educators to design easy escape room tasks centered around curriculum learning objectives. [J Nurs Educ. 2020;59(11):655-657.].
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