Transforming Teaching of Foundational Nursing Skills to Enhance Clinical Reasoning Development: A Proposed Simulation Based Learning Activity

Abstract

Over the past decade nurse educators have been called to transform nursing academia in order to better prepare our future nurses for the tremendous changes in the healthcare environment. The advancing medical technology, aging population, nursing shortages and recent COVID pandemic have provided unique challenges that require complex decision-making abilities. The National Council of State Boards of Nursing (NCSBN) has made significant changes in their licensure examination to accommodate the need to assess vital clinical judgment and decision-making skills in entry level graduate nurses. A model to measure clinical judgment was developed by NCSBN in 2019 to assist faculty in evaluating students beyond textbook nursing knowledge to actively perform and evaluate safe, effective clinical decisions. In order for students to fully grasp the clinical judgment process, faculty need to create active learning opportunities that provide patient context so students can cultivate clinical decision-making skills parallel to clinical knowledge. In nursing curricula, students learn fundamental skills in the first year of their education that provide them with a strong foundation to assess and care for thousands of patients. Transforming how these vital nursing skills are taught from solely performing the psychomotor learning domain to incorporating patient specific scenarios can foster development of clinical reasoning and sound clinical judgment in practice. This article outlines the transformation and redesign of teaching clinical skills to first semester nursing students to enhance clinical reasoning development and a proposed future study of assessing student outcomes using a simulation-based approach.