Methods: The Code of Professional Responsibilities in Educational Measurement (1995) and work by Oermann and Gaberson (2017) guides faculty to: 1. Ensure that assessment products and services are developed to meet applicable professional, technical, and legal standards and 2. To provide realistic rehearsal for high stakes testing in nursing. These key measurement principles were drivers of this project. Based on the premise of fair testing in nursing education, faculty have applied these skills to the teaching learning environment in various nursing courses to enhance students’ clinical judgment.
Outcome Assessment data, gathered through the department’s systematic program assessment plan, indicated that students were not at the department benchmark for critical reasoning; a process linked to clinical judgment. A performance improvement plan (PIP) was initiated and led by a Teaching Circle (TC) comprised of seven faculty members representing the three academic levels in one nursing baccalaureate program. Three goals were identified: 1. Identify teaching-learning activities to improve nursing students’ clinical judgment, 2. Discuss challenges related to clinical judgment, and 3. Implement improvement measures related to clinical judgment.
Results: The teaching circle applied for and received funding to engage in professional development activities through the purchase of item-writing resources and viewing webinars sponsored by the National League for Nursing (NLN) and the NCSBN. The TC then disseminated this work through two faculty development workshops for our faculty, held within the same month. The first faculty development workshop focused on providing an overview of clinical judgment. Traditional item writing styles were discussed as well as the innovative assessment items guided by the Nursing Clinical Judgment model (Dickison et al. 2016) and the Next Generation NCLEX project. To further enhance faculty member’s item writing skills, test item analysis strategies were reviewed as one way to improve item writing. The second lunch and learn workshop provided participants with a variety of strategies for teaching clinical judgment in the classroom, clinical, and simulation settings including: case study examples, a demonstration of debriefing using an advocacy - inquiry model (Rudolph, Simon, Dufresne & Raemer, 2006), and additional item writing strategies including a discussion of Next Generation questions that assess clinical judgment. Lastly, the NLN Guide to Teaching Thinking (2019) was presented along with a clinical scenario example.
Conclusion: Both Professional Development sessions were well received. The outcome of this PIP is being monitored through ongoing measurement of critical reasoning as a student learning outcome and may direct future assessment strategies related to clinical judgment.