Clinical Judgment Model-Based Critical Reflection Program for Newly Graduated Nurses: A Nonrandomized Controlled...

Area of Science:

• Nursing Education
• Clinical Skills Development
• Healthcare Professional Training

Background:

• Newly graduated nurses require robust clinical judgment skills for safe patient care.
• Traditional on-site training may not sufficiently develop advanced clinical reasoning.
• The Clinical Judgment Model (CJM) provides a framework for understanding clinical judgment.

Purpose of the Study:

• To evaluate the impact of a critical reflection program on the clinical judgment skills of newly graduated nurses.
• To assess the effectiveness of the Lasater Clinical Judgment Rubric (LCJR) reflective questions within the CJM framework.
• To determine if the intervention improves specific components of clinical judgment, such as noticing and responding.

Main Methods:

• A quasi-experimental design with 153 newly graduated nurses divided into control and experimental groups.
• The experimental group received a critical reflection program alongside standard on-site training and preceptorship.
• Data on clinical judgment and reasoning were collected at baseline, 6 weeks, and 3 months post-intervention.

Main Results:

• The experimental group demonstrated significantly higher scores in overall clinical judgment and the 'noticing' stage at 6 weeks.
• Both groups showed significant improvements in clinical reasoning competence and clinical judgment across all time points.
• A significant difference was observed between groups in the 'responding' stage of clinical judgment from preintervention to 6 weeks.

Conclusions:

• A critical reflection program, grounded in the CJM and LCJR, effectively enhances newly graduated nurses' clinical judgment.
• The intervention shows promise for improving clinical judgment during the early stages of professional adaptation.
• Targeted reflection can accelerate the development of essential nursing skills in novice practitioners.