Designing Simulation Scenarios to Enhance Nursing Students’ Clinical Judgment: A Qualitative Study

Abstract

Clinical judgment is the cognitive process that emerges from critical thinking or clinical reasoning that affects patient safety. For example, not noticing clients’ deterioration signs while making a clinical judgment may cause inaction errors. Therefore, nursing students must have sound clinical judgment before entering professional nursing practice. Simulation-based learning has become a vital pedagogy used widely to develop students’ clinical judgment. However, to date, simulation-based learning in Thailand has focused on theoretical content and clinical practices rather than the development of cognitive ability. Nursing instructors are vital in developing the thinking process of nursing students. Therefore, a deep understanding of nursing instructors’ perspectives on the essential components of designing a simulation scenario for enhancing clinical judgment among nursing students remains important. This qualitative descriptive study aimed to explore the critical components in the design characteristics of nursing simulation scenarios for improving nursing students’ clinical judgment based on the perception of nursing instructors. Participants were 23 nursing instructors purposively selected from a nursing college in Thailand. Data were collected during March 2021 in focus group discussions with all participants, then five participants with simulation-based learning expertise undertook individual in-depth interviews. Data were analyzed using content analysis. From the findings, four themes emerged: 1) fostering instructor support, 2) recognizing students’ strengths, 3) enhancing specificity in scenarios, and 4) promoting cognitive development. Nursing instructors can apply the findings in creating simulation-based activities to develop their clinical judgment to support nursing students’ cognitive processes. Such actions will help to ensure patient safety and quality of care.