Exploring clinical judgment ability in second-degree baccalaureate of science nursing students: A mixed methods study

Abstract

BackgroundAs they have not yet embarked on clinical practice, most students who already have a bachelor's degree but require a bachelor's degree in nursing occasionally perceive the educator's instruction on clinical situations as abstract and challenging for making accurate clinical judgments. ObjectivesThis study aims to implement a clinical judgment model and case scenarios in classroom teaching to evaluate improvements in students' clinical judgment and critical thinking abilities. DesignA mixed-method design. SettingA second-degree Bachelor of Science in Nursing at a university in Taiwan. ParticipantsFirst-year undergraduate nursing students. MethodsThis mixed-methods study featured a survey at the beginning and end of a course, followed by one-on-one online interviews. A purposive sample of sophomore nursing students was recruited from a university in northern Taiwan between March 2020 and May 2021. Semi-structured interviews were conducted after a preliminary analysis of the collected quantitative data. ResultsIn total, 48 participants completed the study questionnaire, and 20 were interviewed. The results show that the students' ability to make clinical judgment and identify individual health problems from case scenarios significantly improved after completing the course. However, critical thinking did not differ significantly after the course. Qualitative data analysis revealed three key themes relevant to the participants' learning experiences: (1) establishing the context of clinical judgment, (2) building a bridge between basic medical science and clinical nursing, and (3) having a broader perspective. ConclusionsIncorporating clinical judgment measurement model and case scenarios in the curriculum may benefit second-degree Bachelor of Science in Nursing students who have not yet begun their clinical practice. Additionally, the result provides educators with valuable learning goals and evaluation strategies in the classroom and clinical practice.