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clinical judgment, COVID-19, high-fidelity simulation, Lasater Clinical Judgment Rubric, mechanical ventilation, nursing students



  1. Salameh, Basma PhD, RN
  2. Ayed, Ahmad PhD, RN
  3. Kassabry, Maysa' MS, RN
  4. Lasater, Kathie EdD, RN, ANEF, FAAN


Background: Improving nursing students' knowledge and clinical judgment related to mechanical ventilation (MV) is paramount, considering the heightened need for MV due to the current COVID-19 (coronavirus disease 2019) pandemic. High-fidelity simulation (HFS) provides students with real-life clinical experiences that they would rarely confront in clinical training, especially complex case scenarios (such as a patient needing MV).


Purpose: This study assessed students' clinical knowledge and judgment after including HFS involving MV in an undergraduate nursing program.


Methods: This was a quasi-experimental design with a convenience sample of 151 nursing students using the Lasater Clinical Judgment Rubric.


Results: There were significant differences between the intervention and control groups in knowledge (t = 20.42; P = .001) and total clinical judgment scores (t = 19.55; P < .001) post-HFS.


Conclusions: Including a complex case study using MV and HFS significantly improved students' clinical decision-making, clinical knowledge, and self-confidence and enhanced their critical thinking, noticing, interpreting, reflecting, and responding capabilities.