Utilizing Technology and Reflective Practice to Develop Clinical Judgment in Nursing Students

Wednesday, 1 August 2012: 8:50 AM

Carole A. McKenzie, PhD, CNM
Nursing Division, Northwestern Oklahoma State University, Alva, OK
James L. Bowen, EdD, MEd, BS
School of Professional Studies, Northwestern Oklahoma State University, Alva, OK
Leslie N. Collins, RN, BSN
Division of Nursing, Northwestern Oklahoma State University, Alva, OK

Learning Objective 1: The learner will be able to describe methodologies to improve the development of reflective judgment and clinical reasoning in undergraduate nursing students.

Learning Objective 2: The learner will be able to utilize these methodologies to develop appropriate simulations and learning experiences for undergraduate nursing students.

Purpose:  Utilizing the pilot work completed by McKenzie and Bowen (2008, 2009, 2010) on the use of simulation in developing reflective judgment, this study compares  two groups of students—one at  different times in their nursing curriculum and the other comparing junior and senior students .   The theoretical framework for the study was the model developed by (Spurgeon and Bowen, 2002; King and Kitchener, 1994.  Student epiphanies in the clinical simulation experience provided the context for students to reflect on their experience and be assessed in terms of reflective judgment.  Students became more cognizant of learning needs and deficits, clearer about the nursing role and recognition of their lack of judgment regarding a crisis situation. 

Methods: Nursing students were evaluated for reflective judgment at the end of their junior year and again at the end of their senior year. For this study, students were given a higher acuity clinical situation upon which to proactively reflect.  A reflective journal template recorded their proactive reflections as well as their post experience reflections. They were videotaped during the clinical scenario presentation to determine if anticipatory or “proactive” reflection enhanced insight into appropriate solutions to clinical situations.  In the second phase of the study and for the comparison group evaluation, students were evaluated utilizing the same methodology.

Results: Study results provide mandates for utilization of simulation and reflection in assisting students to gain appropriate levels of clinical reasoning , and also in assisting faculty in teaching clinical (reflective) judgment.   The research further supports earlier findings.

  Conclusion: The results of each phase were correlated with their reflective judgment period at the time of each data collection.  Students were significantly progressed in their clinical judgment.  Students gained insight into their behaviors during these clinical situations via the videotaping and debriefing, particularly when the manikin ”expired”. on: