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New Graduate Nurse Experiences in Clinical Judgment: What Academic and Practice Educators Need to Know
Janet Lusk Monagle1, Kathie Lasater, Sydnee Stoyles
1About the Authors Janet Lusk Monagle, PhD, RN, CNE, is an associate professor, Endicott College, Beverly, Massachusetts. Kathie Lasater, EdD, RN, ANEF, FAAN, is a professor, Oregon Health & Science University, Portland, Oregon. Sydnee Stoyles, MBST, MAT, is a senior research assistant, Oregon Health & Science University. Nathan Dieckmann, PhD, is an associate professor, Oregon Health & Science University. The research team gratefully acknowledges the funding support of this study from Beta Psi Chapter of Sigma Theta Tau International. In addition, the research team acknowledges the permission granted from the development team of Jennifer Newton, Amanda Henderson, Judith Greaves, Christine Ossenberg, Katherine Cook, and Brian Jolly for use of the Clinical Workplace Learning Culture tool. For more information, contact Dr. Monagle at jmmonagle@icloud.com.
Aim:
The aim of the study was to determine if use of a structured reflection exercise using a clinical judgment framework would result in more practice-ready new graduate nurses (NGNs).
Background:
Clinical judgment is a critical skill for all nurses, yet it is identified as a deficit in NGNs.
Method:
Seventy-four NGNs in two groups participated in this mixed-methods study in their first year in practice. Scores from two quantitative measures were collected for all participants. The Lasater Clinical Judgment Rubric framed the structured intervention.
Results:
Although the quantitative data showed no significant differences between the groups, use of the reflection exercise indicated a positive impact on NGNs. Qualitative data revealed four themes that present challenges for preparation of NGNs: enhancing communication, finding interprofessional support, responding to complexity of care, and appreciating the role of the nurse.
Conclusion:
Implications provide guidance for academic and practice educators to smooth the transition into practice.
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