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Evolving the Assessment of Clinical Judgment: An Individual or Collective Competency?
Janelle M Delle1, Lacey Cross, Angela Weaver
1Assistant Professor of Nursing (Dr Delle), Instructor (Mss Cross and Weaver), and Assistant Dean for Academics, Generalist Nursing Practice (Dr Jessee), Vanderbilt University School of Nursing, Nashville, Tennessee.
Nurse Educator
|February 2, 2023
Summary
Effective nursing teamwork relies on clear communication and defined roles. Student nurses
Area of Science:
- Nursing Education
- Teamwork and Collaboration
- Clinical Judgment Development
Background:
- Nurses' individual confidence and clinical judgment competence are crucial for effective team management of patient care.
- Collective competence in nursing teams is essential for optimal patient care delivery.
- Understanding facilitators and barriers to collective competence is vital for improving team performance.
Purpose of the Study:
- To identify individual and team-based factors influencing collective competence among nursing students.
- To explore facilitators and barriers to collective competence in a simulated team environment.
- To assess the impact of simulation on prelicensure nursing students' team performance.
Main Methods:
- Cross-sectional study utilizing a 26-item survey based on the National Council of State Boards of Nursing (NCSBN)-Clinical Judgment Measurement Model (CJMM).
- Survey assessed individual student confidence and perceived clinical judgment competence.
- Team dynamics and task completion were observed to evaluate collective competence.
Main Results:
- Closed-loop communication and clear role assignment facilitated collective competence.
- Absence of closed-loop communication and role assignment acted as barriers.
- Lack of student confidence and perceived competence in advanced CJMM layers (3 and 4) were identified barriers.
Conclusions:
- Team-based simulation is an effective strategy for evaluating collective clinical judgment competence in nursing students.
- Targeted interventions addressing communication, role clarity, and confidence building can enhance team performance.
- Simulation provides a valuable platform for developing and assessing essential teamwork skills in future nurses.
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