Authors

  1. Want, David R. DNP, FNP-C, RN, CHSE

Article Content

While the literature supports that entry-level nurses struggle with clinical judgment, it also demonstrates the efficacy of high-fidelity simulation-based learning experiences (SBLEs) in facilitating its development. Faculty crafted an SBLE to foster and refine undergraduate students' clinical judgment in preparation for entering the clinical setting. Students participated in an SBLE focused on prioritizing interventions regarding oxygenation and pain. Facilitators then led students through debriefing with scripted questions structured around the layers of the National Council of State Boards of Nursing's Clinical Judgment Measurement Model (CJMM)1, which permitted faculty to analyze the thinking behind students' actions. For example, during SBLE, the patient presented with groaning and reports of shortness of breath, which students recognized as cues of problems with oxygenation and pain. Facilitators used the CJMM-scripted questions to clarify on which assessment findings students drew to develop their hypotheses regarding the causes of these problems (recognized/analyzed cues); then deconstructed how students prioritized to which problem they responded first (prioritize hypotheses); and finally explored the interventions which students planned and enacted to correct the problems (take action). Comments from evaluations supported the positive experience, indicating that students found the scripted debriefing beneficial in exploring clinical judgment during the SBLE, providing them with a structure to apply in the future. A scripted, CJMM-layered debriefing fosters and refines clinical judgment, while also promoting consistency across debriefing experiences.

 

Reference

 

1. National Council of State Boards of Nursing. Clinical judgment measurement model. Next Generation NCLEX News. 2019. Accessed March 26, 2022. https://www.ncsbn.org/NGN_Winter19.pdf[Context Link]