Using the NCSBN Clinical Judgement Measurement Model as a Framework to Introduce Clinical Judgement and Promote Retention of Learning Among Medical/Surgical Nursing Students in Clinical Simulation

Abstract: The National Council State Boards of Nursing (NCSBN) Clinical Judgement Measurement Model (CJMM) clarifies the process by which students develop clinical judgement. This innovative model was introduced in medical/surgical clinical simulation to increase retention of learning in psychomotor skills and to introduce the cognitive operations required to acquire clinical judgement. We used the framework for the CJMM to develop Student Performance Behaviors (SBPs).

To accomplish this, 4 Clinical Simulation Experiences (CSEs) were held once a day over 6 weeks. The CSEs involved 2 patients, in one room, cared for by 2 teams of 2 junior nursing students each. All simulations lasted 2-3 hours with medication administration, recognizing /analyzing cues for problems, prioritizing hypotheses, calling a provider, taking actions, and evaluating outcomes. Each scenario had specific SPBs for each cognitive operation and skills/safety action. The percentage of students who successfully completed each SPB was calculated. Seventy-five percent successful completion for each SPB was considered an effective result.

The skills/safety SPBs of platelet administration, hanging I.V. fluids, and hanging I.V. piggyback medications were 100% successfully completed. Hanging blood and performing sterile dressings were less than 75% successful. Noting a cue, generating a hypothesis/solution led to an independent action (i.e., glucometer/SSI). This is a cognitive operative labeled a CHS-A. These occurred in all 28 scenarios and had 100% achievement of SPBs. This poster will detail the inclusion of CJMM into clinical simulation to quantify medical/surgical nursing student’s success in comprehending clinical judgement and which areas need repetition as they progress through the program.