Abstract
Objective:to evaluate the reported performance regarding clinical judgment by undergraduate Nursing students.Method:a cross-sectional study with the application of the Lasater Clinical Judgment Rubric-Brazilian Version in 166 undergraduate Nursing students from a Brazilian public university. The data were analyzed descriptively and analytically (by comparing the level of clinical judgment among students from the initial, intermediate, and concluding groups). The following tests were applied: Chi-square, Fisher’s Exact and Kruskal-Wallis, and a p-value of 0.05 was adopted. The reliability of the global instrument (Cronbach’s alpha) was 0.786.Results:of the 166 students, 65.7% evaluated themselves as proficient in relation to the reported performance on clinical judgment. Of the rubric’s 11 dimensions (focused observation, recognizing deviations from expected patterns, information seeking, prioritizing data, making sense of data, calm and confident manner, clear communication, well-planned intervention/flexibility, being skillful, evaluation/self-analysis, and commitment to improvement), only four groups did not present significant differences among them (p<0.05): focused observation, information seeking, prioritizing data, and calm and confident manner.Conclusion:the performance on clinical judgment reported as proficient was pointed out by 65.7% of the students and a significant statistical difference was verified in seven dimensions, among beginners, intermediate, and concluding students, compatible with the evolution of learning.
Highlights
One of the difficulties in the education of future health professionals is the development of the reasoning process related to clinical judgment for decision-making
With the application of the Lasater Clinical Judgment Rubric (LCJR)-BV in this research, it was noticed that the groups obtained high total scores and that, of the 11 dimensions evaluated in Lasater Clinical Judgment Rubric - Brazilian Version (LCJR-BV) between the groups, seven presented a significant difference: Recognizing deviations from expected patterns; Making sense of data; Communication; Intervention; Being skillful; Evaluation; and Commitment
It is possible to verify the level of development of clinical judgment from the point of view of the students, through the LCJR rubric in its Brazilian version
Summary
One of the difficulties in the education of future health professionals is the development of the reasoning process related to clinical judgment for decision-making. Clinical judgment comprises a conclusion about problems or needs of the individuals, with consequent decision-making about the situation, modifying approaches as necessary, according to the patient’s responses[2]. It consists of four stages, namely: noticing, interpreting, responding, and reflecting. The nurse interprets the data by means of reasoning patterns and determines conducts appropriate to the case. They reflect on the results of the established actions and about their performance during the entire process[2]
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