Early Prelicensure Nursing Students' Perceptions of Case Studies Through the Lens of the Clinical Judgment Measurement Model.

BACKGROUND: Research indicates new nursing graduates struggle with clinical reasoning, despite some related skill development throughout their education. The question remains, "Could an earlier focus on clinical reasoning in nursing programs enhance nursing students' clinical reasoning?" PURPOSE: This pilot study investigated how first-semester nursing students perceive the use of case studies in clinical reasoning skill development and the perceived benefits of case studies related to the NCSBN Clinical Judgment Measurement Model (NCJMM). METHODS: Case studies and written reflections were introduced to a convenience sample (n = 45) of first-semester nursing students. Qualitative analysis was conducted on written reflections. RESULTS: Students found case studies enhanced their knowledge and prepared them for clinical practice as a nurse. CONCLUSIONS: Findings suggest early introduction of case studies is a meaningful teaching strategy to develop clinical reasoning aligned with the NCJMM.

Measuring Nursing Student Development Through Computer-Based Simulation Activities.

BACKGROUND: New nurse attrition jeopardizes patient safety, devastates career plans, and negatively impacts costs to hospitals and patients. Employers and educators recognize the widening transition-to-practice gap in meeting expectations for practice-ready, resilient nurses. PURPOSE: The purpose of this study was to test the use of computer-based simulation activities (CBSAs) to measure processes in Aller's Development of Decision-Making and Self-Efficacy Model (ADD-SEM). METHODS: BSN students (N = 50) in a multisite, cross-sectional study used CBSAs to provide data on decision making (Virtual Patient Lasater's Clinical Judgment Rubric), psychological capital (Nursing Anxiety and Self-Confidence in Decision-Making Scale©), and reflection. RESULTS: Repeated-measures analysis of variance and reflexive thematic analysis revealed that decision-making (DM) scores were highest in noticing and lowest in interpreting with significant differences in cohorts (DM) (juniors: P < .001; seniors: P = .013) and self-confidence/anxiety ( P < .001). CONCLUSION: The CBSAs are an effective means of measuring student development of DM and psychological capital needed to retain resilient nurses.

Self-doubt in Nursing Students: An Evolutionary Concept Analysis.

Self-doubt may negatively affect the development of prelicensure nursing students as they prepare to become practice-ready members of the workforce. Walker and Avant's method of analysis was used to explore generalized self-doubt as well as within the context of a contemporary nursing education framework: Aller's Development of Decision-Making and Self-Efficacy Model (ADD-SEM). Results indicate that several attributes of generalized self-doubt, as a form of low psychological capital, were consistent with this construct of the ADD-SEM and should be considered as nurse educators strive to ensure new nurses are prepared for the complexity of today's health care systems.

A Contemporary Model for Undergraduate Nursing Education: A Grounded Theory Study.

BACKGROUND: Health care trends including advanced technology, higher patient acuity, and shorter employment orientation have impacted the environment in which new-graduate nurses are entering the workforce. These issues are contributing to new nurses leaving the workforce prematurely. Theoretical foundations for nursing education need to be updated to better prepare graduates for entry into this burdened environment. PURPOSE: The purpose of this study was to explore, from the student perspective, the process of educational development into professional licensure-ready graduates. METHOD: Grounded theory was used to explore the developmental process of undergraduate nursing education. RESULTS: Two simultaneous developmental processes emerged: decision-making and self-doubt/self-efficacy. Early in the nursing program, students made very few patient care decisions and were plagued with self-doubt. As knowledge and experience were gained, decisions became based on patient conditions, self-doubt decreased, self-efficacy emerged, and students relayed increased comfort, confidence, and competence. CONCLUSION: A contemporary nursing education framework has been developed for testing.