Content area
Full text
Dr. Bussard is Faculty, Firelands Regional Medical Center School of Nursing, Sandusky, Ohio.
The author has disclosed no potential conflicts of interest, financial or otherwise.
Graduates of prelicensure nursing programs are expected to have developed clinical judgment skills upon entering the workforce (Decker, 2012; Kantar & Alexander, 2012; Kupier, Murdock, & Grant, 2010; Lasater, 2011). Therefore, nurse educators must develop innovative and appropriate educational strategies for prelicensure nursing students to acquire clinical judgment decision-making skills (Kantar, 2010; Kupier et al., 2010). Traditional nursing education consists of lecture, skills laboratory, and clinical experiences. A strong consensus exists among nurse educator scholars that the traditional lecture-type format in the classroom setting does not support an active learning environment and therefore does not improve the development of clinical judgment in prelicensure nursing students (Alfes, 2011; Banfield, Fagan, Janes, 2012; Cazzell & Howe, 2012; Gates, Parr, & Hughen, 2012; Phillips & Dowie, 2011).
High-fidelity simulation (HFS) has become an innovative and successful approach to decreasing the theory-practice gap and improving clinical judgment among prelicensure nursing students (Cato, 2012; Lasater, 2007). Many studies suggest that HFS can improve student self-confidence, communication, interprofessionalism, patient safety, medication administration, critical thinking, and clinical judgment skills (Blum, Borglund, & Parcells, 2010; Coffman, 2012; Harder, 2010; Howard, Englert, Kameg, & Perozzi, 2011; Rizzolo, 2012). After an HFS scenario, oral debriefing is conducted. Debriefing has been identified in the literature as the most important aspect of the HFS scenarios because it narrows the theory-practice gap and assists in the development of clinical judgment (Mariani, Cantrell, Meakim, Prieto, & Dreifuerst, 2013; Neill & Wotton, 2011; Shinnick, Woo, Horwich, & Steadman, 2011; Thomas-Dreifuerst, 2009; Thomas-Dreifuerst & Decker, 2012; Wickers, 2010).
The purpose of the current study was to identify an effective teaching-learning strategy to assist prelicensure nursing students in the development of clinical judgment prior to graduation.
Background
Tanner's clinical judgment model provided the theoretical scaffolding for this study. Clinical judgment is defined as "an interpretation or conclusion about a patient's needs, concerns, or health problems, and/or the decision to take action (or not), use or modify standard approaches, or improvise new ones as deemed appropriate by the patient's responseâ[euro]* (Tanner, 2006, p. 204). The clinical judgment model utilizes four main components as methods of developing clinical judgment:...