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Predictors of Nursing Clinical Judgment in Simulation.
Mary Ann Shinnick1, Cristina Cabrera-Mino
1About the Authors Mary Ann Shinnick, PhD, RN, is an associate adjunct professor and director of simulation, University of California Los Angeles School of Nursing, Los Angeles, California. Cristina Cabrera-Mino, BS, RN, was a research associate at the University of California Los Angeles School of Nursing when this research was conducted. The authors acknowledge the efforts of the following research assistants: Christian Cannady, simulation technician, University of California at Los Angeles School of Nursing; Nicole Robbins, simulation technician, University of California at Los Angeles David Geffen School of Medicine; and Cole Nelson. For more information, contact Dr. Shinnick at mshinnic@sonnet.ucla.edu.
This pilot study found that only years of registered nurse (RN) experience predicted better clinical judgment in a simulation. Stress indicators were present but not significant predictors of nursing performance.
Area of Science:
- Nursing Education
- Clinical Judgment Research
- Human Factors in Healthcare
Background:
- Novice and expert nurses' clinical judgment varies significantly.
- Simulation offers a controlled environment to assess nursing skills.
- Stress can impact clinical decision-making in healthcare professionals.
Purpose of the Study:
- To identify predictors of clinical judgment in nurses.
- To explore the relationship between experience, stress, and clinical judgment.
- To evaluate the utility of simulation in assessing nursing expertise.
Main Methods:
- Pilot study involving novice and expert nurses in a simulation.
- Collected data on age, nursing experience, and simulation experience.
- Measured stress using pupil dilation and assessed clinical judgment with the Lasater Clinical Judgment Rubric.
Main Results:
- Stepwise linear regression identified years of registered nurse (RN) experience as the sole significant predictor of clinical judgment.
- Pupil dilation indicated stress during the simulation, but this was not a statistically significant predictor.
- Nursing experience was the only variable correlating with superior performance on the clinical judgment rubric.
Conclusions:
- Years of RN experience is a key factor in developing strong clinical judgment.
- While stress is evident in simulated environments, it does not appear to be a primary determinant of clinical judgment in this cohort.
- Further research with larger sample sizes is warranted to validate these findings.

