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Clinical judgment and self-efficacy of nurses in sepsis management: The use of clinical simulation
Lilian Regina-de-Carvalho1, Ursula Marcondes-Westin2, Renata Elizabete-Pagotti-da-Fonseca3
1São Carlos Federal University, Brazil.
Introduction:
Sepsis has high mortality and demands prompt intervention. Nurses are key in its management, but knowledge gaps persist. Enhancing clinical judgment and self-efficacy is crucial, and clinical simulation offers a safe, effective strategy for developing these skills, supporting education in healthcare.
Objective:
To evaluate the responses related to self-efficacy and clinical judgment of nurses in the management of sepsis through high-fidelity clinical simulation.
Methods:
A quasi-experimental, pre-and post-test study design was adopted. Self-efficacy, clinical judgment, and knowledge were considered dependent variables, while time and participant role (scenario participant/observer) were treated as covariates. The sample consisted of 28 nurses. Data were transcribed into Microsoft Excel® spreadsheets and analyzed using SAS version 9.4 software.
Results:
After the debriefing session, the mean scores for knowledge, clinical judgment, and self-efficacy increased compared to baseline. Knowledge scores improved from a mean of 9.71 (SD = 2.02) to 12.75 (SD = 1.24). Clinical judgment scores increased from 31.75 (SD = 4.88) to 36.5 (SD = 5.5), and self-efficacy rose from 4.05 (SD = 0.44) to 4.19 (SD = 0.55). Statistically significant differences were found in clinical judgment (p < 0.0001) and knowledge (p < 0.0001) across time points. Participants who actively engaged in the simulation had significantly higher post-simulation clinical judgment (mean = 39.5 vs. 34.83; p = 0.0252) and self-efficacy scores (mean = 4.51 vs. 4.01; p = 0.0269) compared to observers. However, there was no significant difference in post-test knowledge scores between the groups (p = 0.6012). A strong correlation was identified between self-efficacy and clinical judgment. These findings support the effectiveness of simulation-based education in enhancing both clinical judgment and self-efficacy among nurses.
Conclusions:
High-fidelity clinical simulation contributed to the development of nurses' clinical judgment, self-efficacy, and knowledge regarding sepsis management.
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