J Nurs Educ. 2015 Jan;54(1):36-40. doi: 10.3928/01484834-20141224-05. Epub 2014 Dec 24.
Clinical judgment is an essential skill needed by RNs. Employers expect new graduate nurses to enter the work-force with established clinical judgment skills. Therefore, nurse educators must ensure that prelicensure nursing students develop clinical judgment before graduation. This qualitative, interpretive description study reviewed the reflective journals of 30 prelicensure nursing students who participated in four progressive high-fidelity simulation (HFS) scenarios during a medical-surgical nursing course. Eight themes were identified in the reflective journals: (a) expectations about the patient, (b) recognition of a focused assessment, (c) interpretation of medications, laboratory data, and diagnostics, (d) communication with the patient, (e) collaboration and interprofessionalism, (f) prioritizing interventions, (g) skillfulness with interventions, and (h) incorporation of skills and information into real patient situations. This study indicated that reflective journaling following progressive HFS scenarios may be an effective teaching-learning strategy to assist prelicensure nursing students in the development of clinical judgment.
临床判断是注册护士必备的技能。雇主希望新毕业的护士在进入工作岗位时就具备成熟的临床判断技能。因此，护理教育者必须确保在毕业前，准护士学生能够发展临床判断能力。本研究采用定性、阐释描述法，对 30 名参加护理医学课程中 4 个渐进式高保真模拟 (HFS) 情景的准护士学生的反思日志进行了回顾。反思日志中确定了 8 个主题：(a) 对患者的期望；(b) 确定重点评估；(c) 对药物、实验室数据和诊断的解释；(d) 与患者沟通；(e) 协作和跨专业合作；(f) 优先干预措施；(g) 干预措施的熟练程度；(h) 将技能和信息融入真实患者情境。本研究表明，在渐进式 HFS 情景后进行反思日志记录可能是一种有效的教学策略，可帮助准护士学生发展临床判断能力。
