Abstract
•There are few studies on clinical judgment development of nursing students in the clinical setting.•Clinical reasoning exercises improved clinical judgment and confidence with decision making.•Teaching clinical reasoning concepts is an effective means to improve students’ clinical judgment.
Studies of graduate nurses demonstrate unpreparedness for practice, leaving nursing education programs to examine methods of instruction that support clinical judgment development.
To evaluate effectiveness of active-learning concept-based themes to improve clinical judgment and self-confidence in nursing students.
A quasi-experimental, repeated-measures design was conducted using Gonzalez clinical reasoning concepts during a medical-surgical clinical. Pre-, mid- and post-clinical judgment scores were measured using the Lasater Clinical Judgment Rubric by students and faculty. Pre-and postself-confidence student scores were measured using White's Nursing Anxiety & Self Confidence with Clinical Decision-Making scale.
Improved overall clinical judgment scores were noted by students (t27 = 10.12, p <. 001) and instructors (t27 = 12.58, p < .001). Overall confidence scores increased (t22 = 3.72, p < .001) while anxiety scores decreased (t22 = -3.28, p < .001).
Clinical nurse educators should assess and support the development of clinical reasoning skills in nursing students with active learning concepts.