Clinical Judgment Skills Assessment in High Fidelity Simulation: A Comparison Study in Nursing Education

Abstract

Background: In nursing education, self-assessment associated with effective feedback promotes reflective learning, which is crucial for the acquisition of complex skills such as clinical judgment. The Lasater Clinical Judgment Rubric (LCJR) is one of the most frequently used scales for the evaluation of self-assessment among nursing students and it can be used by students and instructors for providing shared clinical judgment feedback. However, too few studies have evaluated its applicability. Objective of the study was to compare the LCJR scores assigned by the instructors with those self-reported by the nursing students to evaluate the students’ self-assessment skills. Methods: A comparative study was conducted in a probabilistic sample of 80 students enrolled in the 3rd year of the Nursing Programme in an Italian University. At the end of the high-fidelity simulation, the students and two instructors completed the LCJR scale. Results: The mean scores reported by instructors and students in the 4 subscales of LCJR were similar. In the 3 subscales, “Interpreting”, “Responding” and “Reflecting”, no significant differences were observed; only in the cognitive domain “Noticing” was a difference at the limit of statistical significance (p = 0.049) observed, with a slightly higher scores reported by instructors. Finally, the mean score of Overall Clinical Judgment of the LCJR scale reported by the instructors was slightly higher than that of the students (p = 0.044). Conclusions: Our results suggest that LCJR provides a common language between students and teachers and increases the training effectiveness of high-fidelity simulation through self-directed and reflective learning.