• 한국산업융합학회 논문집
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• 제22권6호
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• pp.721-727
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• 2019

The purpose of this study is to investigate the relationship between clinical judgment and nursing performance based on myocardial infarction simulation applied to nursing students. Method: 39 fourth grade nursing students participated in this explanatory study with sampling of accommodations. The Lasater Clinical Judgment Rubric has been used in self-reported clinical trials and satisfaction with judging practices. Data were analyzed by descriptive statistics, t-test and Pearson's correlation coefficient using SPSS WIN 19. Results: Scenarios with myocardial infarction were scored by self-reported clinical judgment. Total mean score of clinical judgment and total mean value of clinical judgment is 4.17 ± 0.80. Correlation Between Variables After Simulation Practice is highly significant for providing positive clinical judgment and satisfaction with nursing performance. Conclusion: The simulation-based practice associated with adult nursing in myocardial infarction was useful for clinical judgment and nursing performance satisfaction, which improved the core basic skills of nursing students.

• International Journal of Contents
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• 제14권2호
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• pp.35-40
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• 2018

The purpose of this study is to investigate the effects of debriefing using Lasater's Clinical Judgment Rubric to study nursing students' academic self-efficacy, clinical performance, and clinical judgment. The experiment group was subjected to debriefing by applying the Clinical Judgment Rubric, while general debriefing was applied to the control group. The results of the study are as follows: Clinical judgment scores were improved after debriefing for both groups, significantly higher for students in the experimental group compared to the control group. However, there was no significant difference between the two groups in academic self-efficacy or clinical performance. In conclusion, the debriefing based on the Clinical Judgment Rubric used in this study proved to be effective in improving the clinical judgment of nursing students.

• 한국간호교육학회지
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• 제23권3호
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• pp.330-340
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• 2017

Purpose: This study was conducted to explore the relationship between simulation-based clinical judgment and performance ability for tracheal suction in nursing students. Methods: With a convenience sampling, 207 nursing students participated in this descriptive study. Lasater clinical judgment rubric was used for self-reported clinical judgment in addition to observe the skill of tracheal suction using a checklist. Data were analyzed by descriptive statistics, t-test and Pearson's correlation coefficients using the SPSS/WIN 22. Results: A scenario with pneumonia patient was developed to observe the skill of tracheal suction during simulation-based practices. Then self-reported clinical judgment was scored. The mean score of total sum of clinical judgment, total mean of clinical judgment, and performance skill were $36.44{\pm}4.82$, $13.44{\pm}1.71$, and $42.32{\pm}5.05$, respectively. Statistically, students having good skills in suction showed significant differences in clinical judgment of interpreting (p=.031) compared to students having fair skills. Conclusion: The results of this study show that a structured debriefing method utilizing Lasater clinical judgment rubric is helpful. Also, simulation-based practice related to adult nursing in the respiratory system was useful for increasing the core basic skills among nursing students.

• 한국콘텐츠학회논문지
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• 제17권11호
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• pp.577-587
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• 2017

본 연구의 목적은 시뮬레이션 실습교육이 간호대학생의 임상판단력, 자신감, 임상수행능력에 영향을 미치는 효과를 파악하고자 실시되었으며 단일군 사전-사후 실험연구이다. 연구 대상자는 S지역에 소재한 간호학과 2학년 시뮬레이션 실습교과목을 수강한 45명의 학생으로 자료는 설문지를 이용하여 시뮬레이션 실습교육 전 후에 수집되었다. 연구결과 임상판단력, 자신감, 임상수행능력 모두가 통계적으로 유의미하게 향상되었다. 그러므로 시뮬레이션 실습교육이 간호대학생의 임상판단력과 자신감, 임상수행능력에 미치는 긍정적인 효과를 확인하였다. 추후 임상판단력, 자신감, 임상수행능력을 향상시킬 수 있는 시뮬레이션 실습교육의 모듈 개발 및 효과를 검증할 수 있는 연구가 필요하다고 사료된다.

• 성인간호학회지
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• 제25권5호
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• pp.574-584
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• 2013

Purpose: The purpose of this study was to evaluate the effects of a simulation based clinical reasoning practice program on clinical competence in nursing students. The program was based on the theoretical frameworks of simulation models and experiential learning theory. Methods: The program consisted of eight scenarios which includes three main symptoms (abdominal pain, changes in mental status, dyspnea), for improvement of clinical competencies in nursing students. A nonequivalent control group pretest-posttest design was used for evaluation of the effects of the program. Fifty-two junior nursing students in Y University participated in the experimental group (n=25) or control group (n=27). Critical thinking was measured using a self-administered questionnaire. Clinical judgment and clinical performance were measured by a rater using the Rubric. Descriptive analysis, t-test, Mann-Whitney U, Wilcoxon signed rank test was used for data analyses. Results: Clinical judgment and clinical performance increased in the experimental group, but there were no significant differences in critical thinking. Conclusion: Results indicate that the program developed in this study is a useful strategy to enhance clinical judgment and clinical performance in nursing students. However, the program did not significantly enhance critical thinking disposition, and further study is needed to measure integrated clinical competence including critical thinking skills.

• 중환자간호학회지
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• 제16권2호
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• pp.42-53
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• 2023

Purpose : This retrospective mixed-methods study aimed to explore key considerations for designing effective simulated education in nursing, focusing specifically on the recognition and response to deteriorating patients. Methods : Quantitative and qualitative data were analyzed to assess the clinical judgment and performance of the nursing students. Descriptive statistics were used to analyze quantitative data related to prior knowledge, simulation satisfaction, clinical judgment, and nursing performance during deteriorating patient simulations. Qualitative content analysis was conducted for the reflective journal entries of the participants. Results : Quantitative analysis showed that most participants demonstrated a "being skillful" level of clinical judgment (33.1%) in effective response. At the beginner level, clinical judgment varied across effective noticing(39.7-82.8%), effective interpretating(77.6-82.8%), effective responding(3.4-86.2%), and effective reflecting(90.0-95.4%). Nursing performance in assessing patient respiration or SpO2 after request from a physician ranged from 46.6-48.3%. Qualitative analysis indicated that 48.5% of the participants anticipated a deteriorating condition and initiated appropriate actions, while 70% noticed patient unresponsiveness for the first time. Conclusion : To design an effective simulation program for identifying and addressing deteriorating patient care, a framework for observation and interpretation is essential, along with regular simulated training. It is important to design and assess simulation programs and to conduct thorough interviews with nursing students to gain insight into their clinical decision-making.

• 대한간호학회지
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• 제47권6호
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• pp.842-853
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• 2017

Purpose: This study was conducted to identify effects of debriefing based on the clinical judgment model for nursing students on their knowledge, skill performance, clinical judgment, self-confidence and learner satisfaction during simulation based end-of-life care (ELC) education. Methods: Simulation based ELC education was developed in six steps as follows: selection of learning subjects and objects, development of learning tools, a trial run of simulation-based education, students' skill training, and evaluators' training. Forty-eight senior nursing students (25 in the experimental group and 23 in the control group) participated in the simulation-based ELC education using a high-fidelity simulator. Debriefing based on the clinical judgment was compared with the usual debriefing. Results: ANCOVA showed that there were differences in knowledge (F=4.81, p=.034), skill performance (F=68.33, p<.001), clinical judgment (F=18.33, p<.001) and self-confidence (F=4.85, p=.033), but no difference in satisfaction (t=-0.38, p=.704) between the experimental and control groups. Conclusion: This study found that debriefing based on the clinical judgement model is effective for supporting nursing students for reflecting on clinical judgment and improving their diverse competencies in complex clinical settings such as ELC.

• 대한간호학회지
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• 제48권5호
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• pp.588-600
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• 2018

Purpose: The purpose of this study was to test a model of nursing competencies of nursing simulation learners. The conceptual model was based on the theory of Jeffries's simulaton theory. Methods: Data collection was conducted in October 2017 for 310 students from two nursing universities in Kyungbuk area for 20 days. Data analysis methods were covariance structure analysis using SPSS 21.0 and AMOS 22.0 statistical programs. Results: The hypothetical model was a good fit for the data. The model fit indices were comparative fit index=.97, normed fit index=.94, Tucker-Lewis Index=.97, root mean square error of approximation=.44, and standardized root mean square residual=.04. Teacher factors were directly related to simulation design characteristics, and it was confirmed that the curriculum, classroom operation and teaching method of the instructors were important factors. Learner factors were found to have a direct effect on nursing competence, self-confidence, and clinical performance that belong to nursing capacity. In particular, the results of this study indicate that the simulation design characteristics have a partial mediating effect on learner factors and clinical performance, and a complete mediating effect on learner factors and clinical judgment ability. Conclusion: In order to improve the learner's clinical performance and clinical judgment ability, it is necessary to conduct practical training through nursing simulation besides preparing the learner and the educator.

• Child Health Nursing Research
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• 제21권2호
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• pp.160-167
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• 2015

Purpose: This study was done to evaluate the Lasater Clinical Judgement Rubric for use with Korean nursing students. Methods: A methodological study was used to validate the rubric developed by Lasater to assess clinical judgment during nursing simulation. Participants were 34 nursing students at K University in Seoul. Between February and May, 2012, analysis was done of 91 video clips recording performance during simulation. Results: Findings showed reliability and validity of the rubric. For internal consistency, Cronbach's ${\alpha}$ score was .884 and intraclass correlation coefficient was .839, which established reliability. The rubric was validated using the exploratory factor analysis and content validity. The content validity score was 83%, establishing the appropriateness and readiness of the tool. Factor analysis showed that noticing, responding, and reflecting domains had Eigen values of 2.669, 1.991, and 2.912, respectively and were bound, but unlike the original tool in which four factors noticing, interpretation, responding, and reflecting domains were bound. Conclusion: Results of the study indicate that the rubric shows acceptable reliability and validity in Korean nursing students. This evaluation tool for nursing simulation allows nursing faculty to objectively evaluate students' clinical judgment as well as students to reflect on their clinical judgment process during simulation.

• 중환자간호학회지
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• 제5권2호
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• pp.15-27
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• 2012

Purpose: To evaluate the applicability of Lasater Clinical Judgment Rubric (LCJR) as an evaluation tool for hypoglycemia simulation practicum on Korean nursing students. Methods: The methodological study was done to evaluate the reliability and validity of the LCJR. Based on Benner's 4 levels of nursing grading rubric, ten items of the LCJR was evaluated for interrater reliability and internal consistency. The content validity was tested by eight experts and concurrent validity was done by Clark (2006)'s clinical simulation grading rubric. Fifty five video-taped cases of senior nursing students in Y University were used for the reliability and concurrent validity of the LCJR. Results: The interrater reliability was r=.90 (p<.001); Kendall tau b=.87 (p <.001), and Cronbach's alpha was .90. A value of item content validity index of the LCJR was .97 and correlation coefficient between the LCJR and Clark's instrument was .90 (p<.001). The mean (${\pm}SD$) of the nursing students' clinical judgment was 2.04 (${\pm}50$). Conclusion: The LCJR is a useful tool to examine the simulation performance evaluation for improving competency among nursing students. The results indicated that the LCJR may provide valuable information regarding clinical judgment of nursing students and thus, suggested to use to develop a simulation-based education program.