Integrating Clinical Judgment Into the Entry-Level Nursing: A Confirmatory Factor Analytic Study.

Area of Science:

• Nursing Education
• Psychometrics
• Healthcare Assessment

Background:

• Clinical judgment (CJ) is essential in nursing, involving complex cognitive processes like reasoning and decision-making.
• Assessing CJ is crucial for evaluating nursing competency and the effectiveness of educational interventions.

Purpose of the Study:

• To evaluate the psychometric properties of items designed to measure clinical judgment using the Clinical Judgment Measurement Model (CJMM).
• To determine if NCLEX items effectively assess clinical judgment and if new constructs can be measured.
• To analyze the dimensionality of CJMM-based items within the context of existing NCLEX item bank.

Main Methods:

• Confirmatory Factor Analysis (CFA) was employed to assess the factor structure of CJMM-aligned items.
• The analysis focused on items specifically designed to measure clinical judgment.
• Comparison was made against extant NCLEX items to understand construct measurement.

Main Results:

• Scenarios developed using the CJMM demonstrated a unidimensional structure.
• This suggests that the items consistently measure a single underlying construct of clinical judgment.
• The findings support the validity of the CJMM for measuring clinical judgment.

Conclusions:

• The CJMM-based scenarios possess a unidimensional structure suitable for psychometric scaling.
• These findings indicate that CJMM items can be effectively integrated and scaled with current NCLEX items.
• This supports the continued development and use of the CJMM for assessing nursing clinical judgment.