Clinical judgment scripts as a strategy to foster clinical judgment

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University of Alabama Libraries

Clinical judgment is a term used to describe how nurses use their knowledge of the patient to generate, assess, and prioritize patient care alternatives. The purpose of this research was to investigate if the incorporation of a standard clinical judgment script, based on Tanner’s (2006) Clinical Judgment Model, into student experiential learning activities could foster the development of reflective thinking and clinical judgment. Participants were 53 senior nursing students, enrolled in their final semester of study. Data concerning student reflective thinking and clinical judgment skills were gathered and analyzed from three sources: (1) Results from two independent raters observing students in simulation were analyzed using a dependent t test; (2) A one-factor repeated measure ANOVA and descriptive statistics were used for data gathered from the students themselves; and (3) A one-factor repeated measures ANOVA was used to analyze data from the student’s clinical instructors. Research results from this study found that the use of a standardized clinical judgment script does improve student reflective thinking and clinical judgment. Further, the results indicated that most students found the standardized debriefing script to be an effective way to promote the development of clinical judgment. Particularly, the students found the script helpful when evaluating and analyzing key decision making points in their day. Of importance to nurse education, the research script included cues and prompts which stimulated student’s reflective self-assessment skills. The encouragement of reflective thinking allows students to view the entire clinical or simulated experience as a whole rather than a series of independent tasks, thus fostering clinical judgment. Further research is needed using the standardized debriefing script with more diverse student groups. Also, replicating this research with simulated learning experiences of a more analogous design is indicated.

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Educational leadership, Nursing