An Innovative Clinical Concept Map to Promote Clinical Judgment in Nursing Students

An integrative review of teaching strategies to support clinical judgment development in clinical education for nurses

OBJECTIVES

Historically, emphasis on task-completion and lack of intentional approaches that develop students' thinking skills have dominated clinical education. One contributing factor may be the limited literature about teaching to develop clinical reasoning and clinical judgment in the clinical environment. This integrative review accessed available literature to answer the question, What strategies are used to develop clinical judgment in the clinical education environment?

DESIGN

The Whittemore and Knafl approach framed the integrative review. The framework includes the following steps 1) problem identification, 2) literature search, 3) data evaluation, 4) data analysis, and 5) presentation.

DATASOURCES

The data bases CINAHL Plus with Full Text, OVID, and ProQuest were searched through the period of January 2000 through July of 2022.

REVIEW METHODS

The PRISMA protocol informed review and screening of the literature. Authors assessed articles for eligibility via first screening by abstract review, followed by review of the full text. Both authors reviewed the articles, assessing qualification for inclusion and evaluating the content. Data from eligible articles were analyzed and synthesized to answer the research question.

RESULTS

Of the initial 427 articles, a total of 20 articles met inclusion criteria for final analysis. Five general themes emerged for clinical judgment during clinical education. The findings identified the teaching strategies nurse educators use. Many of the teaching methods include deliberateness and intentionality in planning and implementing the strategies. In addition to evaluating clinical judgment, nurse educators guided and mentored student thinking. Finally, this review identified reported outcomes and results of the teaching strategies and methods.

CONCLUSIONS

A limited number of articles describing teaching for clinical judgment in clinical environment were found. The articles analyzed found that nurse educators used a variety of teaching strategies for the purpose of developing students' clinical judgment. More research is needed to guide best-practices in clinical education. We must move the science forward to transform and leverage clinical education more deliberately to teach thinking in practice and decision-making about patient care.

Current Practices for Teaching Clinical Judgment: Results From a National Survey

BACKGROUND

Safe patient care is closely linked to clinical judgment. Concerns about inadequate practice readiness and the impending inclusion of clinical judgment items on the NextGen NCLEX have resulted in increasing interest and publications about teaching clinical judgment. However, little is known about actual current practices for teaching this skill.

PURPOSE

This research describes findings about current strategies to teach clinical judgment used in US prelicensure nursing programs.

METHODS

Cross-sectional methodology was used to survey program deans and directors across the United States.

RESULTS

Programs are using multiple strategies to teach clinical judgment. The most common strategies used include case studies and simulation. Participants believed strategies have a positive impact on student thinking, practice readiness, and program outcomes. They described insights into implementation of teaching for clinical judgment.

CONCLUSION

The results of this research provide foundational data to inform current teaching practices and further research for this essential skill.

The Mathematical Knowledge for Teaching Model as a Pedagogical Framework for Clinical Nursing Educators

BACKGROUND

Clinical education is essential to the development of nursing students and future nursing practice. However, research often focuses on pedagogies used in the classroom and not in the clinical environment.

PROBLEM

Presently, there is no framework in nursing education to describe the subject matter and pedagogical knowledge educators draw upon when teaching in the clinical setting.

APPROACH

This article describes how the mathematical knowledge for teaching framework was applied to nursing education to examine clinical educators' subject matter and pedagogical knowledge.

OUTCOMES

By applying the framework, facets of subject and pedagogical knowledge used by clinical educators were identified, defined, and described.

CONCLUSIONS

Applying the mathematical knowledge for teaching framework to clinical education may be an initial step to describe the types of knowledge that nursing educators draw upon in the clinical setting. It may also be used in the design of professional development and mentoring programs for nurse educators.