Clinical judgment and diagnostic reasoning of nursing students in clinical simulation

Nunes, Janaina Gomes Perbone; Amendoeira, José; Cruz, Diná de Almeida Lopes Monteiro da; Lasater, Kathie; Morais, Sheila Coelho Ramalho Vasconcelos; Carvalho, Emı́lia Campos de

doi:10.1590/0034-7167-2018-0878

Cited by 12 publications

(19 citation statements)

References 22 publications

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“…These results are consistent with those found by Craig et al (2021), Amendoeira et al (2020), Yang et al (2019), Victor (2017), Bussard (2016), Chmil et al (2015), and Aschcraft et al (2013. Yang et al (2019) found that simulation participation enhanced nursing students' clinical judgment skills and the members of the experimental group performed better on their nursing care and responding on patient safety.…”

Section: Quantitative Findingssupporting

confidence: 93%

“…Research by Ashcroft et al (2013) noted that simulation participation helped nursing students in the development of clinical judgement when dealing with patient problems or issues within a simulated setting. Amendoeira et al (2020) found that nursing students improved their clinical judgment skills; especially, the skills to interpret patient data. All of these studies support the use of HFS as an important teaching strategy for improving nursing students' clinical judgment skills.…”

Section: Quantitative Findingsmentioning

confidence: 99%

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High Fidelity Simulation and the Development of Clinical Judgment in Senior Nursing Students: A Mixed Method Approach

Nilphet¹

2021

GJHS

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Clinical judgment is defined as an understanding and interpretation regarding patient’s needs, health problems or concerns (Tanner, 2006). There are four interrelated processes in Tanner’s model that consist of noticing, interpreting, responding, and reflecting (Tanner, 2006). Because clinical judgment is extremely complex and encompasses many ways of thinking and types of knowledge, it requires a flexible capability to identify significant features of indeterminate clinical circumstances. Mixed methods study was conducted to describe senior nursing students’ experience in using high-fidelity simulation to evaluate the development of clinical judgment skills. A convenience sampling of 30 senior nursing students who signed the consent, met the inclusion criteria, and attend the selected school of nursing in the fall of 2020 were used for this study. All participants answered questionnaires regarding the quantitative survey. Participants interviewed face-to-face and video call using Zoom meeting program and recorded using an audio recorder. Both the quantitative and qualitative findings identified that learning through high-fidelity simulation supports the improvement in the participants’ clinical judgment skills. All participants reported their perceptions and experiences from using high-fidelity simulation develop and support their clinical judgment skills from the beginning through the end of the simulation, especially improving prioritizing data and working as a team with providing effective communication.

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Section: Quantitative Findingssupporting

confidence: 93%

Section: Quantitative Findingsmentioning

confidence: 99%

High Fidelity Simulation and the Development of Clinical Judgment in Senior Nursing Students: A Mixed Method Approach

Nilphet¹

2021

GJHS

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“…The CDSS applied to nursing education also enables the development of cognitive skills, such as clinical rationale, problem solving, and decision making in nursing. As positively assessed by studies, students are satisfied with the use of simulated clinical scenarios and consider them useful for their development in clinical practice (Nunes et al, 2020; Sousa, Lopes, Keenan, & Dunn, 2018).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Accuracy of Nursing Diagnoses Determined by Users of a Clinical Decision Support System

Diogo

Gengo

Butcher

et al. 2021

J of Nursing Scholarship

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Purpose To analyze the accuracy of nursing diagnoses determined by users of a clinical decision support system (CDSS) and to identify the predictive factors of high/moderate diagnostic accuracy. Methods This is an exploratory‐descriptive study carried out from September 2017 to January 2018. Participants were nurses, resident nurses, and senior year undergraduates. Two written case studies provided the participants with the clinical data to fill out the assessment forms in the CDSS. The accuracy of the selected diagnostic labels was determined by a panel of experts using the Diagnostic Accuracy Scale, Version 2. Descriptive statistics were used to describe the level of accuracy according to each group of participants. Analysis of variance was used to compare the mean percentages of accuracy categories across groups. A linear regression model was used to identify the predictors of diagnostic accuracy. The significance level was 5%. The study was approved by the Ethics Committee. Results Fifteen undergraduates, 10 residents, and 22 nurses were enrolled in the study. Although resident nurses and students had selected predominantly highly accurate diagnoses (51.8 ± 19.1 and 48.9 ± 27.4, respectively), and nurses had selected mostly diagnoses of moderate accuracy (54.7 ± 14.7), there were no differences in the accuracy level of selected diagnoses across groups. According to the linear regression model, each diagnosis added by the participants decreased the diagnostic accuracy by 2.09% (p = .030), and no experience or a low level of experience using the system decreased such diagnostic accuracy by 5.41% (p = .022). Conclusions The CDSS contributes to decision making about diagnoses of less experienced people. Adding diagnoses not indicated by the CDSS and experience with the system are predictors of diagnostic accuracy. Clinical Relevance In‐service education regarding the use of CDSSs seems to be crucial to improve users’ clinical judgment and decision making.

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“…Se cree que este conocimiento es de suma importancia para evaluar y orientar la enseñanza de esta importante etapa del proceso de enfermería. Outra competência essencial no processo de raciocínio diagnóstico é o pensamento crítico, que é o julgamento intencional que resulta em interpretação, análise, avaliação e inferência, sendo centrado na tomada de decisão (5,27) . A tomada de decisão diz respeito à interpretação dos dados coletados com foco na escolha de uma ação⁽⁵⁾.…”

Section: Introductionunclassified

Tecnologias Educacionais No Ensino Do Raciocínio Diagnóstico Em Enfermagem:

Cruz¹,

Lopes²,

Leopoldino³

et al. 2022

Rev. Enferm. Atual In Derme

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Objetivo: O presente estudo objetivou sintetizar o conhecimento produzido na literatura sobre os instrumentos utilizados para medir o raciocínio diagnóstico em enfermagem. Método: Realizou-se uma revisão integrativa da literatura, em setembro de 2020, as fontes de dados consultadas foram Literatura Latino-Americana e do Caribe em Ciências da Saúde, Scopus Content Overview, Cumulative Index to Nursing and Allied Health Literature, PubMed e Web of Science. Foram selecionados nove artigos para compor a amostra. Em relação aos estudos incluídos, todos eram internacionais (100%) e 44,4% foram do ano de 2019. Os principais delineamentos foram descritivo, prospectivo, transversal e ensaio clínico randomizado. Resultados: Os instrumentos identificados foram: Teste de Concordância de Script (SCTs); Health Sciences Reasoning Test (HSRT); Lasater Clinical Judgment Rubric (LCJR); Creighton Simulation Evaluation Instrument (C-SEI); Nursing Process Skills Checklist; Critical Thinking Disposition Inventory - versão chinesa (CTDI-CV); Teste verdadeiro ou falso e de múltipla escolha; e Jogo de Simulação Virtual. Conclui-se que existem vários instrumentos para medir o raciocínio diagnóstico em enfermagem. Conclusão: O conhecimento desses instrumentos é de suma importância para avaliar e direcionar o ensino dessa importante etapa do processo de enfermagem.

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Clinical judgment and diagnostic reasoning of nursing students in clinical simulation

Cited by 12 publications

References 22 publications

High Fidelity Simulation and the Development of Clinical Judgment in Senior Nursing Students: A Mixed Method Approach

High Fidelity Simulation and the Development of Clinical Judgment in Senior Nursing Students: A Mixed Method Approach

Evaluation of the Accuracy of Nursing Diagnoses Determined by Users of a Clinical Decision Support System

Tecnologias Educacionais No Ensino Do Raciocínio Diagnóstico Em Enfermagem:

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