Thesis (M.S.)--Boston University

Indiana University-Purdue University Indianapolis (IUPUI) / Clinical judgment provides the basis for nurses’ actions and is essential for the provision of safe nursing care. Tanner’s Clinical Judgment Model and its associated instrument, the Lasater Clinical Judgment Rubric (LCJR) have been used in the discipline of nursing, yet it is unclear if scores on the rubric actually translate to the completion of an indicated nursing action. This is important because clinical judgment involves identifying and responding to patient situations through nursing action, and then evaluation of such actions. The purpose of this observational study was to explore the relationship between clinical judgment, as measured by the LCJR, and the completion of an indicated nursing action, as measured by a nursing action form. The clinical judgment and completion of an indicated nursing action was measured in 92 participant students at a Midwestern university school of nursing who were enrolled in an adult medical/surgical nursing course that included simulation and debriefing during which scoring occurred. This study explored whether clinical judgment, as measured by the LCJR, was related to the completion of an indicated nursing action. In addition, this study evaluated whether Responding, as measured by the LCJR was related to the completion of an indicated nursing action. The data revealed that a very weak relationship was present between clinical judgment, as measured by the LCJR, and the completion of an indicated nursing action; however, these findings were not statistically significant. The data also revealed that a very weak relationship was present between the dimension Responding, and the completion of an indicated nursing action; however, these findings were also not statistically significant. This study expands upon previous clinical judgment research in nursing and identifies a need for additional methods of evaluating clinical judgment in baccalaureate nursing students including action appraisal so that deficiencies are established and targeted for improvement.

Thesis (M.S.)--Boston University

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Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2999-01-01

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<p> Simulation based learning (SBL) is pedagogical method poised to innovate nursing educational approaches. Yet, despite a growing body of research into SBL, limited investigation exists regarding assumptions and beliefs that underpin SBL pedagogy. Even though key simulation design characteristics exist, the particular methods nurse educators use to operationalize simulation design characteristics and how these choices are viewed from the perspective of nursing students is unknown. Without understanding what motivates educators to design simulations as they do, it is difficult to interpret the evidence that exists to support chosen methods. Through the exploration of perspectives (points-of-view), underlying beliefs can be uncovered. Educators readily share their points-of-view on simulation design both formally (in literature) and informally (ordinary conversations). These conversations portray the subjectivity surrounding simulation design and become a vehicle for exploration. The purpose of this study was to describe and compare nurse educators' and nursing students' perspectives about operationalizing design characteristics within educational simulations. The National League for Nursing-Jeffries Simulation Framework guided this study by identifying the interaction of teacher, student, and educational practices on the five design characteristics (objectives, student support, problem solving, fidelity, and debriefing). It was from this interaction that perspectives were investigated. A Q-methodological approach was employed to investigate the subjectivity inherent in perspectives. Derived from 392 opinions on simulation design, a 60-statement Q-sample was rank-ordered into a quasi-normal distribution grid by 44 nurse educators and 45 nursing students recruited from two national organizations. Factor analysis and participants' explanations for statement placement contributed to factor interpretation. Factor analysis revealed nurse educators share a common, overriding <i>Facilitate the Discovery</i> perspective about operationalizing simulation design. Two secondary bipolar factors revealed that even though educators share a common perspective, there exist aspects of simulation design held in opposition regarding student role assignment and how far to let students struggle including when and if to stop a simulation. Factor analysis revealed nursing students hold five distinct and uniquely personal perspectives labeled <i>Let Me Show You, Stand By Me, The Agony of Defeat, Let Me Think it Through,</i> and <i> I'm Engaging and So Should You.</i> Second-order factor analysis revealed nurse educators share similar aspects of thinking with four of the five nursing students' perspectives. Results suggest ongoing and sustained educational development along with time for nurse educators to reflect on and clarify their perspective about simulation design is essential. Educators need to emotionally prepare and support nursing students prior to and during simulation activities. Further educational research is needed on how operationalizing simulation design characteristics differ based on a SBL activity with either a formative or a summative purpose.</p>

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

Thesis (M.S.)--Boston University