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辅导对护生临床判断力的影响:一项准实验研究。

The impact of tutoring on nursing students' clinical judgment: A quasi-experimental study.

作者信息

Davis Beena, Anderson Jeffrey, Gonzales Mildred

机构信息

School of Nursing, Los Angeles County College of Nursing & Allied Health, Los Angeles, California, USA.

出版信息

Worldviews Evid Based Nurs. 2023 Oct;20(5):492-499. doi: 10.1111/wvn.12674. Epub 2023 Aug 11.

Abstract

BACKGROUND

Nurses' lack of clinical judgment often leads to adverse patient outcomes due to failure to recognize clinical deterioration, intervene, and manage complications. Teaching clinical judgment through a nursing process can help nursing students provide safe and competent patient care with improved health outcomes and to pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN).

AIMS

The aim of this study was to examine the effect of tutoring on clinical judgment of undergraduate nursing students utilizing Lasater's Clinical Judgment Rubric (LCJR). This study also compared the clinical judgment of male and female nursing students and students from different semester levels.

METHODS

This quasi-experimental study utilized a single group pretest, posttest design. A convenience sample of n = 40 undergraduate nursing students from the Los Angeles County College of Nursing and Allied Health participated in the study. The participants underwent a pretest simulation, four sessions of the Clinical Judgment Model (CJM)-based tutoring, and a posttest simulation.

RESULTS

The posttest clinical judgment scores (35.70 ± 3.6) were significantly different from the pretest scores (25.78 ± 5.20). The tutoring had a significant effect on the clinical judgment of nursing students t(39) = -11.64, n = 40, p < .001, at 95% CI of the mean difference.

LINKING EVIDENCE TO ACTION

Enhancing nursing students' clinical judgment is crucial to provide high-quality, safe patient care with improved health outcomes. The CJM-based tutoring is an effective strategy for developing clinical judgment in nursing students. This new teaching approach can train students to critically think, develop clinical judgment, and prepare for the complex healthcare environment. Therefore, nurse educators should focus on integrating clinical judgment into the prelicensure nursing program curriculum as a priority.

摘要

背景

护士缺乏临床判断力常常因未能识别临床病情恶化、进行干预和处理并发症而导致不良患者结局。通过护理程序教授临床判断力有助于护理专业学生提供安全且胜任的患者护理,改善健康结局,并通过美国国家执业护士执照考试(NCLEX-RN)。

目的

本研究的目的是检验利用拉萨特临床判断量表(LCJR)对本科护理专业学生临床判断力进行辅导的效果。本研究还比较了男女护理专业学生以及不同学期水平学生的临床判断力。

方法

本准实验研究采用单组前测、后测设计。从洛杉矶县护理与联合健康学院选取了n = 40名本科护理专业学生作为便利样本参与研究。参与者接受了一次前测模拟、四节基于临床判断模型(CJM)的辅导课程以及一次后测模拟。

结果

后测临床判断分数(35.70 ± 3.6)与前测分数(25.78 ± 5.20)有显著差异。辅导对护理专业学生的临床判断力有显著影响,t(39) = -11.64,n = 40,p <.001,平均差异的95%置信区间。

将证据与行动联系起来

增强护理专业学生的临床判断力对于提供高质量、安全的患者护理以及改善健康结局至关重要。基于CJM的辅导是培养护理专业学生临床判断力的有效策略。这种新的教学方法可以训练学生进行批判性思考、培养临床判断力,并为复杂的医疗环境做好准备。因此,护士教育工作者应优先将临床判断力融入执照前护理课程中。

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