THE APPLICATION OF CASE-BASED LEARNING ON THE DEVELOPMENT OF CLINICAL JUDGMENT SKILLS IN UNDERGRADUATE NURSING STUDENTS

Abstract

One of the key attributes of professional nurses is the skill of clinical judgment. In recent years, there has been significant attention paid to new nurse’s readiness for practice and their ability to reason through unique clinical situations. This attention is driven by issues of safety and the increased complexity when providing nursing care. While clinical judgment skills are a key component of nursing practice, they have proven to be difficult to develop and assess. Because of this difficulty, educators have engaged in a variety of instructional approaches and assessment strategies to better understand how clinical judgment is taught and captured. To both facilitate and assess clinical judgment, instructional and assessment strategies like case-based learning (CBL) and the Lasater Clinical Judgment Rubric (LCJR) have been considered in different contexts, but not together. These approaches have been supported through various studies but have not been studied in tandem for impact or student interest. A descriptive study was conducted to appreciate the impact of an abbreviated CBL intervention on clinical judgment competencies, as well as to better understand how participants perceive CBL as an instructional strategy. Quantitative data collection instruments included a pretest and posttest, the modified LCJR data, and responses to Likert-style items on a questionnaire. Qualitative data was collected through open-ended items on the questionnaire. The results demonstrated a statistically significant difference between the pretest and posttest, suggesting that CBL strategies can positively impact knowledge and clinical judgment skills. The modified LCJR data did not show a statistically significant overall difference between cases. However, considering the brevity of the intervention, this was not entirely surprising. It was interesting to note that the LCJR can be modified and applied to CBL strategies, with the ability to provide quantitative data to the abstract concept of clinical judgment. Participants overwhelmingly found the CBL experience enjoyable and valuable to their learning experiences.