Authors

  1. Sommer, Sheryl K. PhD, MSN, RN, CNE

Article Content

Increased focus on measuring clinical judgment (CJ) of nursing students raises important questions about evidence-based strategies needed to help students develop CJ skills. The nursing process and Tanner's1 Clinical Judgment Model are frequently used as the basis for teaching CJ. The National Council of State Boards of Nursing (NCSBN) designed the Clinical Judgment Measurement Model (CJMM)2 to test clinical judgment on the nursing licensure examination. Later they developed the Clinical Judgment Action Model (CJAM) to connect what is measured on the licensure exam to what is taught in nursing education. The CJAM is a resource for educators to use as they help students develop clinical judgment skills. Some educators question how the NCSBN's CJAM relates to the nursing process and Tanner's model. All 3 models are unique, yet they have similarities as illustrated in the Supplemental Digital Content, Figure, http://links.lww.com/NE/A732. Assessment (nursing process) aligns with Recognize Cues (CJAM) and Noticing (Tanner's model). All involve collecting data about the client, identifying relevant information, gaining understanding about the client, and relating it to the individual's typical patterns. Analysis (nursing process) aligns with Analyze Cues (CJAM) and Interpreting (Tanner's model), which involve analyzing collected data to identify actual and potential health problems. Planning (nursing process) aligns with Prioritize Hypotheses and Generate Solutions (CJAM) and Interpreting (Tanner's model) when the nurse prioritizes client problems, determines the need for nursing intervention, and identifies appropriate actions. Implementation (nursing process), Take Actions (CJAM), and Responding (Tanner's model) refer to the ability to select and implement appropriate interventions to promote health and minimize risk. Evaluation (nursing process), Evaluate Outcomes (CJAM), and Reflecting (Tanner's model) involve evaluating the client's response to interventions/actions, determining the extent to which treatment goals are met, and adjusting interventions/actions based on the assessment. By considering the similarities of these models, educators can confidently use the nursing process or Tanner's Clinical Judgment Model to promote development of CJ skills and prepare students for the next-generation NCLEX.

 

References

 

1. Tanner CA. Thinking like a nurse: a research-based model of clinical judgment in nursing. J Nurs Educ. 2006;26(6):204-211. [Context Link]

 

2. National Council of State Boards of Nursing. The clinical judgment model and action model. Next Generation NCLEX News. 2019;(spring):1-6. [Context Link]