Clinical Judgment Development Utilizing Structured Classroom Reflective Practice

Wednesday, 24 July 2013: 4:10 PM

Donna M. Glynn, PhD, RN, ANP-BC
School of Nursing and Health Sciences, Simmons College, Boston, MA

Learning Objective 1: The learner will be able to discuss the effects of structured reflective practice on the development of clincial judgment in nursing students

Learning Objective 2: The learner will be able to incorporate structured classroom reflective practice into curricula across the spectrum of nursing education

Purpose:

 The need to educate nursing students in the necessary skills and knowledge has led to a “theory-practice gap.” The development of clinical judgment and the utilization of reflective practice have been identified as key components in bridging the theory-practice gap.  The Model of Clinical Judgment in Nursing (Tanner, 2006) was developed as a framework to incorporate reflective practice to guide students through patient situations. This research evaluated the benefit of Structured Classroom Reflection on the development of clincial judgment.

Methods: This study examined the influence of “reflection-on-action” in a structured reflective classroom format as defined by the Model of Clinical Judgment (Tanner, 2006) on the development of clinical judgment and clinical confidence. A convenience sample of 44 BSN students participated in the mixed methodology study. The students, in the experimental group, were asked to present  patient care experiences in a weekly classroom setting. The experimental group participated in pre and post intervention interviews to assess the effects of structured reflective practice on their perceived development of clinical judgment and clinical confidence.  The experimental group and the control group completed a 9 question examination at the end of the study to evaluate the effect of reflective practice on the synthesis of nursing knowledge.

Results: The results supported the benefit of the intervention and answered the research questions that the structured reflective practice incorporating “reflection-on-action”, based on Tanner’s Model of Clinical Judgment (2006) did influence the perceived clinical judgment and perceived clinical confidence of BSN nursing students.  The students who participated showed an improved ability to synthesize nursing knowledge compared to the control group.

Conclusion:  Based on the test score results and analysis of data, this research confirmed the hypothesis that students who participated in structured reflective practice would demonstrate a higher percentage of correct responses on examination questions related to the synthesis of nursing knowledge.