Effects of Case Based Learning and Simulation Based Learning on Students’ Perceptions of Clinical Judgment and Students’Clinical Judgment
Keywords:
Clinical Judgment, Case Based Learning, Simulation Based Learning, Nursing StudentAbstract
Clinical judgment is recognized as a necessary skill for nurses. It is important for developing the performances of professional nurses. Clinical judgment skills need to be initiated when nursing students apply clinical judgment into real practices. The purpose
of this study was to compare clinical judgment perception and clinical judgment skills of the fourth-year nursing students before and after using case based learning (CBL) and simulation based learning (SBL) in the maternal and newborn nursing and midwifery practice.
A quasi-experimental research was designed -a one group with a pretest and posttest design - in clinical practice. The participants consisted of 61 fourth-year nursing students. Data collection was from October to December 2020. The participants were assigned to practice at prenatal care unit, labor and delivery rooms, and postpartum care unit for four weeks. Three CBL lesson plans and five SBL lesson plans were researched using intervention instruments. The measurement instruments consisted of the Thai version of Lasater Clinical Judgment Rubric (T-LCJR) for clinical judgment perception and clinical judgment skill test. The reliabilities of the instruments were 0.88 and 0.71 respectively. The data were analyzed using descriptive statistics and a paired t-test.
The results showed that after using CBL and SBL, there was a significant increase in the mean clinical judgment perception at the .05 level of significance (t = 16.14, Sig = .00). Also, there was a significant increase in the mean clinical judgment skill at the .05 level of significance (t = 6.80, Sig = .00).
In conclusion, CBL and SBL improved the clinical judgment perception and clinical judgment skills of the fourth-year nursing students in maternity nursing and midwifery. Therefore, these teaching methods should be implemented continuously in nursing practicums to strengthen critical thinking skills and clinical judgment skills. These are important skills for being a competent nurse.
References
1. Lapkin S, Fernandez R, Levett-Jones T, Bellchambers H. The Effectiveness of Using Human Patient Simulation Manikins in the Teaching of Clinical Reasoning Skills to Undergraduate Nursing Students: A Systematic Review. JBI Libr Syst Rev. 2010; 8(16):661-694.
2. Tomlinson J. Using Clinical Supervision to Improve the Quality and Safety of Patient Care: A Response to Berwick and Francis. BMC Med Educ. 2015; xx: yy–zz.
3. Hart PL, Brannan JD, Long JM, Maguire MB, Brooks BK, Robley LR. Effectiveness of A Structured Curriculum Focused on Recognition and Response to Acute Patient Deterioration in An Undergraduate BSN Program. Nurse Educ Pract. 2014 Jan; 14(1):30-6.
4. Levett-Jones T, Hoffman K, Dempsey J, Jeong SY, Noble D, Norton CA, Roche J, Hickey N. The 'Five Rights' of Clinical Reasoning: An Educational Model to Enhance Nursing Students' Ability to Identify and Manage Clinically 'at Risk' Patients. Nurse Educ
Today. 2010 Aug; 30(6):515-20.
5. Tanner CA. Thinking like A Nurse: A Research Based Model of Clinical Judgment in Nursing. J Nurs Educ. 2006; 45(6): 204-11.
6. Lasater K. Clinical Judgment: The Last Frontier for Evaluation. Nurs Educ Pract. 2011; 11(2): 86–92.
7. Menezes SS, Corrêa CG, Silva Rde C, Cruz Dde A. Clinical Reasoning in Undergraduate Nursing Education: A Scoping Review. Rev Esc Enferm USP. 2015 Dec; 49(6):1037-44.
Portuguese.
8. Bjørk IT, Berntsen K, Brynildsen G, Hestetun M. Nursing Students' Perceptions of Their Clinical Learning Environment in Placements Outside Traditional Hospital Settings. J Clin Nurs. 2014 Oct; 23(19-20):2958-67.
9. McLean SF. Case-Based Learning and Its Application in Medical and Health-Care Fields: A Review of Worldwide Literature. J Med Educ Curric Dev. 2016 Apr 27; 3: JMECD.S20377.
10. Facione, PA. Critical Thinking: What It Is and Why It Counts. Millbrae, CA: California Academic Press; 2006.
11. Thistlewaite JE, Davies D, Ekeocha S. The Effectiveness of Case Based Learning in Health Professional Education. A BEME Systematic Review. Med Teach. 2012; 34: E421-4412.
12. Brown ST, Kirkpatrick MK, Greer A, Matthias AD, Swanson MS. The Use of Innovative Pedagogies in Nursing Education: An International Perspective. Nurs Educ Perspect. 2009 May-Jun; 30(3):153-8.
13. Bland AJ, Topping A, Wood B. A Concept Analysis of Simulation as A Learning Strategy in The Education of Undergraduate Nursing Students. Nurse Educ Today. 2011 Oct; 31(7):664-70.
14. Cant RP, Cooper SJ. Use of Simulation-Based Learning in Undergraduate Nurse Education: An Umbrella Systematic Review. Nurse Educ Today. 2017 Feb; 49:63-71.
15. Kanhadilok S, Punsumreung T, Pookpan S. The Integrated Clinical Teaching Methods on Reflective Thinking, and Clinical Judgment in 3rd Year Nursing Students in Maternal Infant and Midwife Nursing Practicum Course I.HCU Journal, 2017; 20 (40):87-99.(in Thai)
16. Williams B. Case-Based Learning: A Review of The Literature: Is There Scope for This Educational Paradigm in Pre-Hospital Education? Emerg Med. 2005; 22: 577-81.
17. Jeffries PR. A Framework for Design, Implement, and Evaluation Simulation Used as Teaching Strategies in Nursing. Nurs Educ Perspect, 2005; 26(2):96-103.
18. Punsumreung T, Kanhadilok S. Inchaitep S. The Thai version of Lasater Clinical Judgement Rubric (T-LCJR): Psychometric Properties, JNAE, 2020: 13(1):14-26. (in Thai)
19. Suksawatdiporn P, Pasiphol S, Na-songkhla, J. Development on The Clinical Judgement Test in Obstetric Nursing for Nursing Students. JOPN, 2019; 11(2): 464-473. (in Thai)
20. George D, Mallery M. SPSS for Windows Step by Step: A Simple Guide and Reference, 17.0 update. 10th ed. Boston: Pearson; 2010.
21. Lasater K. High-Fidelity Simulation and The Development of Clinical Judgment: Students' Experiences. J Nurs Educ. 2007 Jun; 46(6):269-76.
22. Pierce VC. Baccalaureate Nursing Student’s Perception of Clinical Judgment and Self-Efficacy Following High-Fidelity Simulation Doctor of Education. The University of Alabama; 2011.
23. Abdou FA, Dogham RS. Effect of Case Based Learning on Internship Critical Care Nursing Students' Clinical Judgment. IOSR-JNHS.2016; 5(5): 15-20.
24. Yuan HB. Williams BA. Man CY. Nursing Students’ clinical Judgment in High-Fidelity Simulation Based Learning: A Quasi- Experimental Study. J Nurs Educ Pract. 2014; 4(5):7-15.
25. Li AM. Simulation-Based Clinical Skill Training to Promote Effective Clinical Learning with Simulation Evaluation Rubrics in Nursing Education. Int J Inf Educ. 2016; 6(3): 237-42.
26. Qi M. Yi Q, Mo M, Huang H, Yang Y. Application of Case-Based Learning in Instructing Clinical Skills on Nursing Undergraduates. Biomed Res.2018; 29 (2): 300-304
27. Watson F, Rebair A. The Art of Noticing: Essential to Nursing Practice. Br J Nurs. 2014 May 22-Jun 11; 23(10):514-7.
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