Lasater clinical judgment rubric reliability for scoring clinical judgment after observing asynchronous simulation...

Area of Science:

• Nursing Education
• Healthcare Simulation
• Clinical Judgment Assessment

Background:

• The Lasater Clinical Judgment Rubric (LCJR) is validated for in-person simulations and reflections.
• A gap exists in evaluating clinical judgment using LCJR with asynchronous simulation observations.

Purpose of the Study:

• To determine the reliability, feasibility, and usability of the LCJR for scoring written reflections after asynchronous simulation video observation.
• To assess the LCJR's effectiveness in a novel educational context.

Main Methods:

• A one-group descriptive design was employed with pre-licensure, junior-level bachelor's nursing learners.
• Participants observed expert-modeled asynchronous simulation videos and completed written reflections scored with LCJR.
• Reliability was assessed via internal consistency (Cronbach's alpha) and interrater reliability (Cohen's kappa, Gwet's AC). Feasibility and usability were measured by completion times and learner surveys.

Main Results:

• Reliability measures showed acceptable to excellent agreement (Cohen's kappa cumulative = 0.58, Gwet's AC cumulative = 0.74).
• Internal consistency ranged from 0.51 to 0.72 (Cronbach's alpha).
• Learners spent an average of 28.32 minutes per video, and raters spent 4.85 minutes per response, indicating feasibility. Learners reported the activity as usable.

Conclusions:

• The LCJR is a reliable tool for assessing clinical judgment in asynchronous, expert-modeled simulations.
• The learning activity is logistically feasible for both learners and faculty within reasonable timeframes.
• Nurse educators can confidently use this approach to evaluate and track the development of observer clinical judgment.