An Evaluation and Comparison of Clinical Judgment in Junior and Senior Nursing Students

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2014-05

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The Ohio State University

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Abstract

While the majority of nursing research about clinical judgment has focused on the decision-making of experienced RNs, there is a scarcity of current research available on the development of clinical judgment in student nurses. Little is known about when clinical judgment begins and how clinical judgment develops throughout the course of education. In order to understand whether student nurses are equipped to participate in error mitigation we must begin with an empirically based understanding of how student nurses judge and classify errors. The specific aims of this study were to: (1) determine if nursing students judgments about errors (severity, level of risk, and contributing risk factors) changes after a year of clinical experience; and, (2) explore the perception of student nurses regarding promotion of safe environments and their perceived ability to participate in risk reduction and error mitigation practices in the clinical setting. The sample (n=43) consisted of junior (65.1%) and senior (34.9%) students of a baccalaureate-nursing program at a large Midwestern university. A cross sectional descriptive survey design was used in which each participant was given an envelope with a questionnaire presenting four clinical scenarios with instructions to: (1) rate the severity of the error (2) rate the perceived risk of the error and (3) identify potential contributing factors leading to the error. Descriptive and correlational analyses were used to summarize and compare responses. Across the four vignettes judgments about error classification were highly variable. There were differences between juniors and seniors in the severity of classification of the clinical errors and the probabilities that these errors occur. The results of this study have the potential to contribute valuable insight into the development of clinical judgment over time in student nurses, and can indirectly shed light upon the clinical judgment of new graduate nurses entering practice.

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Clinical judgment, Decision making, Student nurse

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