2.50
Hdl Handle:
http://hdl.handle.net/10755/157951
Type:
Presentation
Title:
Clinical Judgment Development: Using Simulation to Develop an Assessment Tool
Abstract:
Clinical Judgment Development: Using Simulation to Develop an Assessment Tool
Conference Sponsor:Western Institute of Nursing
Conference Year:2005
Author:Lasater, Kathie, EdD, RN
P.I. Institution Name:Oregon Health & Science University School of Nursing, SN-4S
Title:Assistant Professor
Co-Authors:Christine A. Tanner
Background: Clinical judgment is viewed as an essential skill for every nurse. Patient care problems are often ill-defined and complex, requiring this kind of critical thinking. In recent years, clinical judgment in nursing has become synonymous with the widely adopted nursing process model of practice. While this model may be useful in teaching beginning nursing students one type of systematic problem solving activity, numerous studies have shown that it fails to adequately describe the complex processes of nursing judgment required by professional nurses. Purposes/Aims: The purpose of this study was to develop an instrument to provide standards for clinical judgment as well as a tool for assessment. The Tanner Model of Clinical Judgment, derived from a synthesis of the research and literature on clinical judgment in nursing, was used as the conceptual framework to develop a rubric that breaks down and defines clinical judgment in a measurable fashion and assess students' development of it. Methods: An exploratory mixed methods study, utilizing qualitative expert observations followed by the development and trial of a quantitative instrument and a subsequent focus group, was utilized. The instrument, the Clinical Judgment in Simulation Rubric, was developed, based on 59 observations of 47 OHSU juniors in a simulation lab, employing high fidelity simulation as a weekly requirement of their clinical course. Data analysis was concurrent throughout the observation phase, utilizing categories from the four phases (Notice-Interpret-Respond-Evaluate) of the Model. The researcher tested the weekly findings with the simulation facilitator, the developer of the Model, and an educational consultant who assisted with the rubric development, providing internal construct validity. After its development, a focus group of 8 observed students was convened to corroborate the concepts of clinical judgment embedded in the rubric. Results: The instrument, based on the Tanner Model of Clinical Judgment, offers a resource for students to understand what is meant by clinical judgment, what the process is, as well as a means for faculty, peer, and/or self assessment. Though developed in the simulation lab, it seems applicable to most, if not all, nursing settings and situations as a definition of and assessment tool for clinical judgment. Implications: Having a concrete model of, and instrument for, assessment of clinical judgment offers nursing educators and students the means for discussing clinical judgment and a way to define this form of critical thinking in nursing where there has been little consensus. The Model and Rubric afford clinical faculty a means for teaching clinical judgment as well assessing student progress toward its development. More studies are underway to further refine the rubric, increasing its usefulness for a broader student population, as well as examine its use in the clinical practica setting in addition to the simulation lab. A larger study is needed to further refine the instrument and establish interrater reliability.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleClinical Judgment Development: Using Simulation to Develop an Assessment Toolen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157951-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Clinical Judgment Development: Using Simulation to Develop an Assessment Tool</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2005</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Lasater, Kathie, EdD, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Oregon Health &amp; Science University School of Nursing, SN-4S</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">lasaterk@ohsu.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Christine A. Tanner</td></tr><tr><td colspan="2" class="item-abstract">Background: Clinical judgment is viewed as an essential skill for every nurse. Patient care problems are often ill-defined and complex, requiring this kind of critical thinking. In recent years, clinical judgment in nursing has become synonymous with the widely adopted nursing process model of practice. While this model may be useful in teaching beginning nursing students one type of systematic problem solving activity, numerous studies have shown that it fails to adequately describe the complex processes of nursing judgment required by professional nurses. Purposes/Aims: The purpose of this study was to develop an instrument to provide standards for clinical judgment as well as a tool for assessment. The Tanner Model of Clinical Judgment, derived from a synthesis of the research and literature on clinical judgment in nursing, was used as the conceptual framework to develop a rubric that breaks down and defines clinical judgment in a measurable fashion and assess students' development of it. Methods: An exploratory mixed methods study, utilizing qualitative expert observations followed by the development and trial of a quantitative instrument and a subsequent focus group, was utilized. The instrument, the Clinical Judgment in Simulation Rubric, was developed, based on 59 observations of 47 OHSU juniors in a simulation lab, employing high fidelity simulation as a weekly requirement of their clinical course. Data analysis was concurrent throughout the observation phase, utilizing categories from the four phases (Notice-Interpret-Respond-Evaluate) of the Model. The researcher tested the weekly findings with the simulation facilitator, the developer of the Model, and an educational consultant who assisted with the rubric development, providing internal construct validity. After its development, a focus group of 8 observed students was convened to corroborate the concepts of clinical judgment embedded in the rubric. Results: The instrument, based on the Tanner Model of Clinical Judgment, offers a resource for students to understand what is meant by clinical judgment, what the process is, as well as a means for faculty, peer, and/or self assessment. Though developed in the simulation lab, it seems applicable to most, if not all, nursing settings and situations as a definition of and assessment tool for clinical judgment. Implications: Having a concrete model of, and instrument for, assessment of clinical judgment offers nursing educators and students the means for discussing clinical judgment and a way to define this form of critical thinking in nursing where there has been little consensus. The Model and Rubric afford clinical faculty a means for teaching clinical judgment as well assessing student progress toward its development. More studies are underway to further refine the rubric, increasing its usefulness for a broader student population, as well as examine its use in the clinical practica setting in addition to the simulation lab. A larger study is needed to further refine the instrument and establish interrater reliability.</td></tr></table>en_GB
dc.date.available2011-10-26T20:21:46Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:21:46Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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