An Evidence-Based Cognitive Approach for Teaching Nursing Clinical Judgment Skills to Entry-Level Practitioners

The ability to make sound clinical judgment is a key differentiating factor between professional nurses and other auxiliary health care workers (Hughes & Young, 1990). With rapid changes in government regulations, patient acuity and health care technology, nurses at all practice levels face increasing cognitive demand at the clinical setting. This includes expert nurses and our novice colleagues. A large number of nursing research studies have identified that many nursing students are less than competent in their critical thinking and clinical judgment skills, especially in real-life patient care settings (e.g., Saintsing, Gibson, & Pennington, 2011). The gap between textbook knowledge and clinical judgment skills among novice nurses is an important topic to address in nursing education, as it could lead to poor patient outcome and negative impact for the novice nurses.

In this proposed session, a speaker from the National Council of State Boards of Nursing (NCSBN) will review a nursing clinical judgment model developed by the organization (Dickison, Luo, Woo, Muntean & Bergstrom, 2016). This model is based on current clinical judgment models and cognitive psychology decision-making research (e.g., Oppenheimer & Kelso, 2015). Describing nursing clinical judgment with an information-processing framework allows delineation of the mental processes in which nurses engaged to make decisions and the interactions among these internal processes. The clear separation of clinical judgment steps gives the proposed model great utility as a pedagogical tool.

To illustrate the clinical judgment model and its didactic applications, the speaker will map real-life clinical scenarios found among the current NCLEX test plan categories to the clinical judgment model. Audience will also learn how to use the clinical judgment model to vary sample scenarios to suit the curriculum and students’ needs. The speaker will explore using the model to construct standalone and unfolding scenarios for the instruction of classroom and clinical courses.