Extending Tanner's framework: the digital clinical judgment model for nursing education

Clinical judgment is a core competency across healthcare professions and is commonly conceptualized through Tanner's model, which incorporates four phases of clinical judgment: noticing, interpreting, responding and reflecting. While Tanner's framework has informed assessment and reflection tools, less attention has been paid to how clinical judgment can be facilitated through pedagogical design in digital and blended learning environments.

This article presents the new Digital Clinical Judgment Model (DCJM), a pedagogical model developed to support the teaching and learning of clinical judgment in digital nursing education.

The DCJM was developed using an iterative conceptual synthesis of Tanner's Clinical Judgment Model, educational theories of sociocultural learning, scaffolding and deep learning, as well as from empirical insights into digital nursing education obtained during the COVID-19 pandemic.

The DCJM integrates Tanner's four phases of clinical judgment within three interrelated layers of support: pedagogical structure, social and emotional support and technological support. This approach outlines design conditions that enable meaningful engagement in clinical judgment across digital, blended and practice-based learning contexts.

Clinical judgment should be supported through the design of learning environments rather than an outcome to be assessed. This new approach represents a pedagogical rather than an evaluative perspective.

As a conceptually grounded pedagogical model, the DCJM offers educators a theoretically informed and practically applicable framework for designing learning environments that support the development of clinical judgment in contemporary nursing education. Further empirical research is needed to determine its usefulness in practice and its impact on student learning and educational design.