Implementation of clinical reasoning concepts to improve clinical judgment and self-confidence of nursing students in the clinical setting

Abstract

Introduction: Studies of graduate nurses demonstrate unpreparedness for practice, leaving nursing education programs to examine methods of instruction that support clinical judgment development. Aim: To evaluate effectiveness of active-learning concept-based themes to improve clinical judgment and self-confidence in nursing students. Methods: 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. Results: Improved overall clinical judgment scores were noted by students (t27 = 10.12, p < .001). Overall confidence scores increased (t22 = 3.72, p < .001) while anxiety scores decreased (t22 = -3.28, p < .001). Discussion: Clinical nurse educators should assess and support the development of clinical reasoning skills in nursing students with active learning concepts.