Forming Meaningful Connections: Development of Clinical Judgement in Beginning Level Student Nurses

Patient safety is the primary consideration of a nurse. The ability to care for patients safely is dependent upon a nurse’s skill in using clinical judgment. The ability to assess, interpret and respond to patient needs. A review of nursing literature reveals that new nurse graduates are ill prepared for the complex demands of practice. Research also reveals a lack of thorough understanding of clinical judgment or how to teach it. The purpose of this study was to develop a theory of clinical judgement development in student nurses to contribute to the current practice of undergraduate nursing education. An action research design was used to discover the process beginning level student nurses used to make clinical judgments in the acute care setting. Self-reflective inquiry was utilized to examine the educational pedagogy employed by faculty during acute care clinical experiences. Observations of student nurses, and audio recordings of all daily activity were collected along with documentary artifacts. Field notes were taken during all experiences and used during the data analysis to help triangulate findings. Data were analyzed for themes and subthemes and a theory of clinical judgment was formed. A model, Forming Meaningful Connections was designed to represent the way the themes, Noticing, Interpreting, Responding and Reflecting integrate with the subthemes. The theory that emerged in the study explains how each category, Noticing, Interpreting and Responding, are demonstrated by beginning level student nurses in clinical practice and how Reflecting contributes to improvement of clinical judgment ability. The theory also explains how clinical faculty contribute to the development of beginning level student nurses. The theory of clinical judgment in beginning level student nurses that emerged from this study will further research of clinical judgement and promote development of educational strategies and clinical teaching practices to improve thinking like a nurse ability