Examining the relationship between clinical judgment and nursing action in baccalaureate nursing students

Abstract

Clinical judgment provides the basis for nurses’ actions and is essential for the provision of safe nursing care. Tanner’s Clinical Judgment Model and its associated instrument, the Lasater Clinical Judgment Rubric (LCJR) have been used in the discipline of nursing, yet it is unclear if scores on the rubric actually translate to the completion of an indicated nursing action. This is important because clinical judgment involves identifying and responding to patient situations through nursing action, and then evaluation of such actions. The purpose of this observational study was to explore the relationship between clinical judgment, as measured by the LCJR, and the completion of an indicated nursing action, as measured by a nursing action form. The clinical judgment and completion of an indicated nursing action was measured in 92 participant students at a Midwestern university school of nursing who were enrolled in an adult medical/surgical nursing course that included simulation and debriefing during which scoring occurred. This study explored whether clinical judgment, as measured by the LCJR, was related to the completion of an indicated nursing action. In addition, this study evaluated whether Responding, as measured by the LCJR was related to the completion of an indicated nursing action. The data revealed that a very weak relationship was present between clinical judgment, as measured by the LCJR, and the completion of an indicated nursing action; however, these findings were not statistically significant. The data also revealed that a very weak relationship was present between the dimension Responding, and the completion of an indicated nursing action; however, these findings were also not statistically significant. This study expands upon previous clinical judgment research in nursing and identifies a need for additional methods of evaluating clinical judgment in baccalaureate nursing students including action appraisal so that deficiencies are established and targeted for improvement.