Learning to think like a nurse: the development of clinical judgment in nursing students.

The purpose of this project was to examine the clinical judgment and reasoning skills of nursing students in high-fidelity simulation. Two levels of students (N = 104), novices and those who are slightly more advanced, participated in individual videotaped simulations. Afterward, interviews were conducted to explore what the student was thinking and feeling during simulation. Five themes emerged from the interviews: thinking like a nurse, assessment, looking for answers, communication, and magical or reflective thinking. There was a clear distinction in the reasoning skills of the novice students compared with students with more clinical experience. Tanner's model of clinical judgment in nursing is used to understand the findings of the study.

Ashley J ，Stamp K 《-》

Evaluation of an integrated simulation courseware in a pediatric nursing practicum.

This study examined the effect of integrated pediatric nursing simulation courseware on students' critical thinking and clinical judgment. Ninety-five senior nursing students participated in this study. Every student followed the established courseware schedule, as well as the regular pediatric nursing practicum. The courseware schedule included two simple simulation scenarios and one comprehensive scenario on the first day of the first, second, and third weeks of the practicum. Students' critical thinking scores showed significant improvement after the use of simulation courseware using high-fidelity simulators and standardized patients. No significant predictors were found for improvement in critical thinking, but bivariate transformation of upper and lower groups in critical thinking achievement revealed a significant difference in the clinical judgment ability between the two groups. Simulation courseware supplementation is an innovative learning strategy for improving nursing students' critical thinking and clinical judgment during clinical practicum. Clinical judgment may play a role in facilitating nursing student improvement in critical thinking ability.

Shin H ，Kim MJ 《-》

The influence of concept-based learning activities on students' clinical judgment development.

The traditional nursing clinical education model of total patient care is becoming inadequate. New models are needed to foster deeper clinical thinking, thereby affecting students' development of clinical judgment. Concept-based learning activities, first introduced in 1990, offer a focus on a specific concept. This study evaluated the effect of concept-based learning activities on the development of clinical judgment in baccalaureate nursing students. The clinical judgment of students who were and were not exposed to concept-based learning activities was compared. Quantitative data were analyzed using a univariate analysis. In addition, a focus group consisting of members of the treatment group provided qualitative data. Results suggest concept-based learning activities are a clinical learning strategy that should be considered by faculty to deepen clinical thinking in preparation for reaching sound clinical judgments.

Lasater K ，Nielsen A 《JOURNAL OF NURSING EDUCATION》

Use of prebriefing in nursing simulation: a literature review.

Simulation has gained much attention in the literature for its contributions to nursing education; however, the simulation process itself and how each of the components-prebriefing, scenario, and debriefing-are effective for learning are understudied. Specifically, how prebriefing may enrich simulation for learners without adequate prior clinical experience or how it may develop complex thinking skills and clinical judgment is not well understood. This article comprehensively reviews the available nursing simulation literature about the phenomenon of prebriefing and critically evaluates its current role as a component of nursing simulation. Gaps in the reviewed literature regarding the definition and purpose of prebriefing, alternate learning structures used in prebriefing, and use in relation to learner outcomes were identified. Implications for undergraduate nursing education and recommendations for further research are discussed.

Page-Cutrara K 《-》

Using concept mapping to build clinical judgment skills.

This article is a description of educational innovation that utilizes concept mapping as a teaching strategy in the development of critical thinking skills of undergraduate nursing students. A concept mapping rubric was designed using Tanner's Clinical Judgment Model to guide students (n = 8) in the construction of clinical cases for the development of appropriate clinical judgment skills. Each student evaluated the concept mapping exercise and provided feedback regarding the rubric, their understanding of the clinical situation, and the development of clinical judgment skills. The students expressed that the concept mapping activity and rubric lead them to make better clinical decisions and increased clinical judgment skills. Content analysis is the research method used to make inferences from qualitative data, with the purpose of providing new insights and clinical knowledge regarding this teaching strategy. Future recommendations for the use of this teaching strategy include shortening the wording and descriptions for each stage of evaluation to promote ease of use for the student in the growth of critical thinking skills.

Gerdeman JL ，Lux K ，Jacko J 《-》