Lasater Clinical Judgment Rubric Research Articles

The second European evidence-based consensus on the diagnosis and management of Crohn's disease (part 4)

Pediatric clinical facilities have become oversaturated and increasingly restrictive, limiting student exposure to acutely ill children. It is imperative to find alternative methods to provide opportunities for students to work with high-acuity patients, which assist in developing clinical judgment. The sample consisted of participants including 234 students enrolled in child health in a baccalaureate nursing degree program.This repeated measures pilot study used the Lasater Clinical Judgment Rubric to evaluate the effect of a virtual simulation on students' self-perceived clinical judgment skills.Improved clinical judgment was illustrated by students' ability to obtain minimal simulation scores in fewer attempts. Student self-perception of clinical judgment abilities was demonstrated by improved clinical judgment scores. Study results show statistically significant findings in attempts and in student self-perception of their clinical judgment abilities.Findings suggest that virtual simulation is beneficial to student learning and the development of clinical judgment skills.

Clinical judgment: The last frontier for evaluation

Nursing educators and preceptors often find it difficult to evaluate prelicensure students’ clinical judgment development. Clinical judgment is critical to excellent patient care decisions and outcomes. The Lasater Clinical Judgment Rubric, a validated, evidence-based clinical judgment rubric, is described as a tool that offers a common language for students, nurse educators, and preceptors and a trajectory for students’ clinical judgment development. The rubric has been used to provide feedback for reflective journals and a means for self-evaluation in addition to a guide for formulating higher level thought questions to shape students’ thinking like a nurse.

High-Fidelity Nursing Simulation: Impact on Student Self-Confidence and Clinical Competence

Development of safe nursing practice in entry-level nursing students requires special consideration from nurse educators. The paucity of data supporting high-fidelity patient simulation effectiveness in this population informed the development of a quasi-experimental, quantitative study of the relationship between simulation and student self-confidence and clinical competence. Moreover, the study reports a novel approach to measuring self-confidence and competence of entry-level nursing students. Fifty-three baccalaureate students, enrolled in either a traditional or simulation-enhanced laboratory, participated during their first clinical rotation. Student self-confidence and faculty perception of student clinical competence were measured using selected scale items of the Lasater Clinical Judgment Rubric. The results indicated an overall improvement in self-confidence and competence across the semester, however, simulation did not significantly enhance these caring attributes. The study highlights the need for further examination of teaching strategies developed to promote the transfer of self-confidence and competence from the laboratory to the clinical setting.

A collaborative project to apply and evaluate the clinical judgment model through simulation.

As use of simulations increases in nursing education, nurse educators are challenged to evaluate students' clinical judgment skills. The purpose of this article is to describe faculty development in the use of the Lasater Clinical Judgment Rubric (LCJR); faculty application of LCJR in evaluating students' clinical judgment skills during a simulation scenario; and faculty and students' perception transference from the simulation to the clinical setting.Tanner's Clinical Judgment Model was used in an assigned adult health simulation. Quantitative and qualitative data were collected from faculty and student evaluations and students' reflective statements. Findings support the importance of simulation's contribution to clinical judgment development. However, more work remains to improve the integration of clinical judgment and use of a conceptual framework and evidence-based rubric. For long-term change, both faculty and students need ongoing practice and encouragement in applying the clinical judgment framework to clinical and simulation experiences. For application of the model, a recommendation is to incorporate the clinical judgment language into course syllabi, course assignments, and evaluations.

Evaluation of the Lasater Clinical Judgment Rubric

Clinical judgment is an elusive concept that educators struggle to present and assess. Benner's seminal work in 1984 and continuing work in 1996 of novice to expert along with Tanner's continuing work on clinical judgment provides a model of “thinking in action” that focuses on four phases: noticing, interpreting, responding, and reflecting. This model served as the basis for the Lasater Clinical Judgment Rubric (LCJR) that was developed to evaluate a single patient encounter requiring clinical judgment using simulation.

Reflective Journaling for Clinical Judgment Development and Evaluation

Reflective journaling is a strategy used often in clinical education to gain insight into students' clinical thinking; however, studies indicate that students may benefit from guided reflections. Numerous tools have been used to structure student reflection with varying results. This article describes the outcomes from using the Guide for Reflection based on Tanner's Clinical Judgment Model. The Lasater Clinical Judgment Rubric, created from the Model, is used to evaluate development of clinical judgment and provides language to communicate about clinical thinking with students. Senior immersion course competencies, also developed with language from Tanner's Clinical Judgment Model,offer a comprehensive package that fosters students' clinical judgment development, faculty-student communication about clinical judgment, and evaluation of students' clinical thinking.