ABSTRACT
INTRODUCTION: We assessed the effectiveness of a simulation-based education program to improve novice nurses' clinical judgment skills. METHODS: A simulation education program was implemented for 21 novice nurses. Surveys were conducted on program satisfaction, learning, and clinical judgment skills before, immediately after, and two months after the program. RESULTS: Novice nurses were highly satisfied with the simulation education program. The following nine categories were identified as learnings: provide psychological care for patients, conduct sufficient observation, conduct assessment and make judgment based on observational findings, consult and report appropriately to senior nurses, take response action calmly, collect necessary information, acquire knowledge, predict patients' conditions, and make environmental arrangements. The subscale score for theoretical and practical reasoning was significantly higher immediately after and two months after the program than before it. In addition, the subscale for grasping the condition by observation was significantly higher two months after the program than before and immediately after it. CONCLUSION: The novice nurses learned to sufficiently observe, obtain necessary information, and prospectively assess patients' conditions by taking part in the simulation education program. The subscale score for grasping the condition by observation was significantly higher two months after the program than before and immediately after it. After the simulation program, novice nurses were likely actively practicing nursing; therefore, this program may not be directly responsible for the improvement of these new nurses' clinical judgment. Nevertheless, we found that the completion of the simulation program was correlated with enhanced clinical judgment.
ABSTRACT
BACKGROUND: The purpose of this study was to develop a scale to assess the clinical judgment of nurses based on the clinical judgment process. METHOD: Based on a qualitative analysis of interviews with specialized and certified nurses and extant literature, a scale comprising 44 question items was created. A questionnaire survey was conducted with 1,444 nurses working in 28 general hospitals, psychiatric wards, cardiac care units, and intensive care units in Japan. RESULTS: Valid responses were obtained from 610 nurses. Exploratory factor analysis was performed on the 23 items extracted by item analysis, and two factors, "theoretical and practical reasoning" and "grasping the condition by observation," were extracted. Confirmatory factor analysis revealed the fit of the model. Cronbach's alpha confidence factor was 0.943 for the first factor and 0.924 for the second factor. CONCLUSION: These results support the factor validity and reliability of the clinical judgment scale. [J Contin Educ Nurs. 2021;52(8):383-391.].
