A Systematic Review of Educational Practices That Improve Clinical Judgment of Students in Health Sciences

Purpose:

Competence is the ability to integrate foundational knowledge from different disciplines during the decision making process and to apply that knowledge and profession specific skills in a real life situation (Nursing Education Stakeholders (NES), 2012). The performance of the person indicates the degree to which the person was able to apply classroom knowledge in the clinical setting  (Holton, Chen, & Naquin, 2003). Clinical judgment (functional knowledge) is equivalent to clinical performance as it is the culmination of critical thinking (foundational knowledge) and clinical reasoning (conditional knowledge) (Chang, Chang, Kuo, Yang, & Chou, 2011).

The ability to demonstrate sound clinical judgment is an essential skill for all nurses but especially in developing countries whose healthcare services are nurse led as these nurses are often the sole providers of healthcare in remote areas. It is therefore imperative that nurse educators use teaching and learning methods that develop the thinking processes and ability to demonstrate sound clinical judgment.

The aim of this presentation is to describe a systematic literature review on teaching and learning methods that develops clinical judgment competence in students in health sciences.

Methods:

The steps of a systematic review process was used. Twenty two data bases were searched for relevant articles. Collaborative researchers screened the abstracts and eliminated a large number based on the inclusion and exclusion criteria. Eighty one full length articles were selected according to the inclusion and exclusion criteria. The collaborative researchers critically appraised 7 articles according to the CASP appraisal tool. Based on the appraisal of the articles only four articles were used for data extraction.

Results:

Web-based, case-based and simulation-based educational strategies improved clinical judgment without alliance with another educational strategy when they adhered to the design principles of authenticity active student engagement interactive learning cooperating learning, learner-focusses education and scaffolding

Sequencing of learning opportunities that fist simulate cognitive thinking and thereafter afford the students the opportunity to practice psychomotor skills support integration of theory and practice and promotes development of clinical judgment 

Conclusion: No conclusion was reached regarding the research question as only four primary studies were found.  Further research is needed to answer the research question. The implication for nursing education practice is that these preliminary findings provide clear guidance on the elements that educators should adhere to when designing nursing programmes.