The Impact of Critical Thinking on Clinical Judgment During Simulation With Senior Nursing Students.

ABSTRACT

AIM: The study examined the impact of critical thinking (CT) on clinical judgment (CJ) during a pediatric Objective Structured Clinical Evaluation (OSCE) with 160 pre-licensure nursing students. BACKGROUND: Educators are called to transform teaching strategies to develop CJ but confusion exists over definitions. METHOD: A descriptive correlational design was used to examine demographics and Tower of Hanoi (TOH) and Health Science Reasoning Test (HSRT) scores. CJ was measured by scores on the Lasater Clinical Judgment Rubric (LCJR) from videotaped OSCEs. RESULTS: Participants were 86 percent female, 42 percent Caucasian, median 23 years, with 49 percent having health care experience. Students averaged seven moves over minimum on the TOH. Average scores were HSRT 25/38 and LCJR 31/44. Statistically significant predictors of CJ were gender, ethnicity, HSRT deduction, and analysis; 11 CT variables accounted for 17 percent of LCJR scores. CONCLUSION: Educators need to utilize/develop innovative teaching strategies addressing CJ predictors.