Date of Award

8-16-2024

Document Type

Open Access Dissertation

Department

Educational Studies

First Advisor

William Morris

Abstract

Clinical judgment is a priority nursing skill to ensure the delivery of safe and effective nursing care. New graduate nurses and nursing students lack the clinical judgment skills that are necessary for entry-level nursing practice. Nurse educators must therefore implement teaching strategies that facilitate clinical judgment. This study evaluated the clinical judgment of undergraduate nursing students after the implementation of multimedia case studies related to the concept of perfusion. Two research questions guided this study: (a) in what ways do undergraduate nursing students demonstrate clinical judgment after completing a series of perfusion-related multimedia case studies and (b) to what extent do undergraduate nursing students’ perceptions of clinical judgment change after the completion of perfusion-related multimedia case studies?

This study utilized a convergent mixed methods approach with 34 undergraduate nursing students who engaged in four weeks of multimedia case-based learning related to the concept of perfusion. Quantitative data was collected during two nursing simulations and analyzed with the Lasater Clinical Judgment Rubric (LCJR) using descriptive statistics and a Wilcoxon signed-rank test. A statistically significant (p = 0.005) increase was noted in the subscale of interpreting from the pre-intervention score (M = 4.545, SD = 1.969) to the post-intervention score (M = 5.864, SD = 1.583). The other subscales of the LCJR did not demonstrate a significant difference.

Qualitative data obtained during a pre-intervention and post-intervention clinical care reflection was analyzed against predetermined keys through a process of deductive analysis to evaluate clinical judgment. Four participants were noted to have improved clinical judgment, while two participants’ clinical judgment stayed the same and two participants’ clinical judgment decreased.

Qualitative data obtained from a semi-structured interview was analyzed using inductive analysis to reveal three themes: 1) noticing patient data, 2) interpreting patient data, and 2) responding to the situation. During the interview, participants displayed sound clinical judgment in each of the five aspects of the LCJR. Participants found that the case studies promoted clinical judgment by increasing familiarity with course content, stimulating deeper connections, and providing opportunities for extra practice. These findings support the use of multimedia CBL as a strategy to promote clinical judgment within nursing education.

Rights

© 2024, Macy Jenette Bennett

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