Health Sciences Education Symposium
Presentation Format
Poster
Type of Activity
Research
Original Presentation Date
2023
Date of Submission
March 2023
Abstract/Short Description
Background/Objectives: Nurses need to be able to think critically and to use clinical judgment in order to competently do their work required of them in the clinical environment. The National Council of State Boards of Nursing (NCSBN) recognized this and developed the NCSBN Clinical Judgment Measurement Model (CJMM) in order to assess and measure clinical judgment on the NCLEX exams. This model was designed to give guidance to faculty so that they can help students develop the desired skills in critical thinking and clinical judgment. The faculty in a senior-level Adult Medical-Surgical Nursing used the CJMM to redesign the clinical paperwork for students with the objective to better evaluate clinical judgment in real-life clinical situations and to improve the student experience.
Methods: In order to be able to get a better understanding of students’ thinking with their clinical assignments, the former clinical paperwork was altered to follow the CJMM. Senior-level undergraduate nursing students completing their third adult health clinical were asked to complete the clinical worksheet for the first half of the semester. 90 students were in the course and completing their clinical hours at both academic and community hospitals. At the end of the semester, all course students were asked to complete a brief three question survey via a google form which was presented to them via a QR code during a didactic class session. The three questions were as follows:
Do you feel the clinical day worksheet enhanced or improved your bedside critical thinking? Please elaborate on how it did or did not.Do you feel the clinical worksheet enhanced your readiness to enter the profession? Why or why not? Do you have any suggestions for how the clinical day worksheet could be improved for future students?
Results: 23 total responses were received with apparent themes emerging. Overwhelmingly, students reported that the clinical worksheet did improve their bedside critical thinking (21/23 students). One student stated “Yes, it really helped with understanding why I was performing certain nursing interventions, how they related to the patient’s disease process, as well as how to evaluate the effectiveness of my interventions. It also helped me better understand what medications would be used for each disease process, and why.” Responses to question two were similarly positive, with responses such as “Yes. The part of the worksheet where we addressed pathophysiology and medications was especially helpful for me. Nursing interventions make a lot more sense when I know the pathophysiology behind the patient’s admitting diagnosis, so getting the chance to review a disease process in depth each week was very beneficial for preparing me to enter the profession. The review of medications was also very helpful. I liked the opportunity to research the patient’s medications, as well as write about why they were being used, how they work, and any side effects or other considerations. I will be responsible for knowing this as a nurse, so I thought this part of the worksheet was very useful in helping me prepare to enter the nursing profession.”
Conclusions: The clinical worksheet is an effective tool in evaluating students’ critical thinking and clinical judgment from the student perspective. Feedback indicated that students did not feel that all clinical faculty had the same expectations for how the clinical worksheet should be completed. From these responses, lessons learned for future implementation would be to provide more detailed and standardized training amongst clinical faculty regarding the assignment expectations. Further exploration of faculty perception of student performance would also be useful to see if faculty feel that this new approach is producing better clinical judgment.
References
(2022). NCSBN Clinical Judgment Measurement Model . National Councils of State Boards of Nursing. https://ncsbn.org/clinical judgment measurement model
Rights
© The Author(s)
Is Part Of
VCU Medical Education Symposium
First Author Information
Mark Tanner, DNP, RN, VCU School of Nursing