• Title/Summary/Keyword: Clinical judgement

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Reliability and Validity of the Clinical Judgment Rubric on Simulation Practice with a Post-operative Rehabilitation Case (수술 후 재활 사례에 적용한 임상 판단력 평가도구의 신뢰도 및 타당도)

  • Oh, Hye Kyung
    • The Korean Journal of Rehabilitation Nursing
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    • v.18 no.2
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    • pp.145-152
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    • 2015
  • Purpose: The purpose of this study was to evaluate the reliability and validity of the clinical judgement rubric on simulation practice with a post-operative rehabilitation case. Methods: Methodological study design was used to evaluate the reliability and validity of the clinical judgement rubric on simulation practice. The participants were 35 students in a college of nursing. Results: There were showed reliability and validity of the clinical judgement rubric on simulation practice with a post-operative rehabilitation case. In terms of internal consistency, the Cronbach's ${\alpha}$ for all columns was .821. Factor analysis showed that planning, intervention and evaluation domains with Eigen values of 69.87% were bound, unlike the original tool where four factors including noticing, interpretation, responding and reflecting domains were bound. Convergent validity was established by the correlation between the total clinical judgement score and critical thinking disposition before and after simulation practice. Discriminative validity was established by the correlation between the total clinical judgement score and simulation effectiveness score. Conclusion: The findings of this study suggested that clinical judgement rubric on simulation practice is reliable. Repeated studies are needed to objectively evaluate the clinical judgement rubric of simulation practice for applying various clinical situations.

Development and Effects of Simulation Educational Program for Nursing Students (간호대학생들을 위한 시뮬레이션 교육프로그램 개발 및 적용효과)

  • Im, Kyung Ja;Yang, Bok Sun;Kim, Yoon Lee
    • Journal of Digital Convergence
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    • v.16 no.2
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    • pp.203-213
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    • 2018
  • Purpose. This study was conducted to identify effects of the high fidelity simulation for nursing students. Methods. A non-equivalent quasi-experimental design was used to experimental group (N=43) and control group (N=39) for 8 weeks, 5 times from September 26 to November 9, 2013. Clinical performance was measured by using standardized patients. Critical thinking was measured through the questionnaire and clinical judgement was measured through observation by Lasater's rubric. Results. Clinical performance (F=211.15, p<.001), critical thinking (t=3.00, p<.004) and clinical judgement (t=7.60, p<.001) were significantly higher in experimental group with simulation education program than control group. Conclusion. Simulation education program were effective to improve clinical performance, critical thinking disposition and clinical judgement for nursing students.

The Study of the Sham Acupuncture for Double Blind (이중맹검을 위한 Sham Acupuncture에 대한 임상연구)

  • Lim, Jeong-A;Seo, Jung-Chul;Lee, Eun-Yong;Lee, Hyang-Sook;Moon, Hyung-Cheol;Choi, Sun-Mi;Hwang, Woo-Joon;Cho, Nam-Geun;Kim, Sung-Chul
    • Journal of Acupuncture Research
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    • v.23 no.5
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    • pp.127-144
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    • 2006
  • Background and Purpose : Though there were many clinical studies of acupuncture effects they didn't have appropriate control group. So we didn't say it was true acupuncture effect, though subjects in clinical study improved. To investigate the possibility of sham acupuncture application, we examined how well subjects distinguished real acupuncture from sham acupuncture. Methods : We investigate the possibility of sham acupuncture application as the following 3 kinds of methods. 1. The public (n=60) and Oriental Medicine Doctors (n=20) looked at the appearance of acupuncture and then were treated with randomly allocated acupuncture and judged it as real or sham. 2. The public (n=60) and Oriental Medicine doctors (n=20) were treated with randomly allocated acupuncture, then they looked at the appearance of acupuncture and judged it as real or sham. 3. The public (n=60) were treated with randomly allocated acupuncture (right-real-left-sham), (right-sham-left-real), (left-real-right-sham), (left-sham-right-real), then they judged it as real or sham. Results : 1. When the public (n=60) looked at the acupuncture appearance, the correct judgement ratio was 63.3%. After they were treated with acupuncture, the correct judgement ratio was 50.0%. 2. When Oriental Medicine doctors (n=20) looked at the acupuncture appearance, the correct judgement ratio was 25.0%. After they were treated with acupuncture, the correct judgement ratio was 45.0%. 3. When the public (n=60) were treated with acupuncture, the correct judgement ratio was 50.0%. After they looked at the acupuncture appearance, the correct judgement ratio was 63.3%. 4. When Oriental Medicine doctors (n=20) were treated with acupuncture, the correct judgement ratio was 65.5%. After they looked at the acupuncture appearance, the correct judgement ratio was 65.0%. 5. After the public (n=60) were treated with randomly allocated sham or real acupuncture as (right-real-left-sham), (right-sham-left-real), (left-real-right-sham), or (left-sham-right-real). the correct judgement ratio was 66.7% in looking at the acupuncture appearance group, and in not looking at 60.0%. Conclusion : These results indicated that Kim Sham Acupuncture could apply to the double blind clinical study of acupuncture effect. And more continuous studies are needed on Sham Acupuncture apparatus.

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Effects of the Lasater's Clinical Rubric of Debriefing in Advanced Cardiovascular Life Support Training (전문심폐소생술 교육에 Lasater의 임상판단 루브릭을 적용한 디브리핑의 효과)

  • Eun, Young;Bang, Sul-yeong
    • The Journal of the Korea Contents Association
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    • v.16 no.4
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    • pp.516-527
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    • 2016
  • The purpose of this study was to test the effects of the Lasater's debriefing on critical thinking disposition, problem- solving skills and clinical judgement of nursing students. The study design was a nonequivalent control group non synchronized design. The subjects were 60 students for 12 groups. They were randomly assigned to the experimental group (n=30) or control group (n=30). Critical thinking and problem-solving skills were measured using a self-administered questionnaire. Clinical judgement was measured by a Lasater's clinical judgement rubric. The Results of the study was : After Lasater's debriefing, the level of students' critical thinking, problem-solving skills and clinical judgment in experimental group were higher than the level of control group. Through this experiment the rubric of Lasater debriefing is an effective tool for clinical judgment, therefore we know that the future of simulation training is needed to use the Lasater's clinical judgement rubric of debriefing in simulation training.

The Effect of Debriefing using Reflective Questions and Writing in Simulation Training - Post Operative Care of Abdominal Surgery (시뮬레이션 교육에서 성찰질문과 글쓰기를 이용한 디브리핑의 효과 - 복부수술 후 환자 간호에서)

  • Bang, SulYeong;Eun, Young
    • The Journal of Korean Academic Society of Nursing Education
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    • v.23 no.4
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    • pp.463-473
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    • 2017
  • Purpose: The purposes of study was to evaluate the effect of debriefing using reflection questions and writing on the critical thinking disposition, self-efficacy, and clinical judgement ability in simulation of post-operative care of abdominal surgery. Methods: The research method was a nonequivalent control group no-synchronized design. The study period was from August 22 to 30, 2016. The subjects were comprised of 34 people in the experimental group and 36 in the control group. In a simulation session for post-operative care of abdominal surgery, the treatment of the experimental group was to debrief for 30 minutes using Lasater's reflection questions and writing. For the control group, a typical debriefing was conducted in the same environment. Results: Critical thinking disposition, self-efficacy, and clinical judgement were significantly higher in the experimental group than the control group. Conclusion: To enhance the critical thinking disposition, self-efficacy, and clinical judgement of nursing students in simulation, it is recommended to debrief using reflection questions and writing.

The Reliability and Validity of the Lasater Clinical Judgement Rubric in Korean Nursing Students (임상판단 평가도구의 신뢰도 및 타당도 검증)

  • Shim, Kaka;Shin, Hyunsook
    • Child Health Nursing Research
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    • v.21 no.2
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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.

Effect of Ethics Education on Nurse덕s Moral Judgement (윤리교육이 간호사의 도덕판단에 미치는 영향)

  • 김용순
    • Journal of Korean Academy of Nursing
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    • v.30 no.1
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    • pp.183-193
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    • 2000
  • This main purpose of this study was to assess the effects of two different types of ethics education on the moral judgement of clinical nurses. One type was free discussions among nurses with given specific moral issues and the other type was discussions guided by experts on specific moral issues. The study employed a quasi-experimental, nonequivalent pre test-post test design using two different control groups. The conceptual framework of the study was derived from the Kohlberg′s Moral Development Theory (1969) and the Greipp′s Ethical Decision-Making Model (1992). The data was collected during the period of October 14 through December 15, 1998. Sample consists of 32 nurses working in the ICU who met research criteria. 16 nurses were assigned to the free discussion group and 16 nurses to the group for the guided discussion with experts group. For the pre-test, the DIT which was developed by Rest (1984) and JAND by Ketefian (1998) were used with some modification by the author. After the education, only JAND was used to assess the changes in moral judgement. The collected data was analysed using SPSS PC program. The findings are as follows: 1. There was no significant difference between two groups in their general characteristics. Only difference which was statistically significant between two groups was that realistic score on Case 3/Medical Research and Autopsy was higher in the free discussion group. 2. Hypothesis 1: "There will be a difference on the moral judgement of nurses before and after they receive an ethics education". This hypothesis was supported partially. Those who had low scores on moral judgement before the education tended to have higher scores after the education on the same issues. And, after the education, the nurses tend to give lower scores on the dilemmas they had experienced frequently at work; while giving higher scores on those dilemmas they had no prior experience. 3. Hypothesis 2: "The effect of education may differ depended upon the moral development index [P(%)] score of nurses". The effect of education was different depend on moral development level. The group who′s P(%) scores was low at the pretest has higher scores in realistic moral judgement after the education, while the groups with middle or high P(%) scores went down after the education. These changes were statistically significant in some cases, thus, the Hypothesis 2 was partially supported 4. Hypothesis 3: "The method of ethics education will have different effects on the moral judgement of nurses". Even though several nurses attended the guided discussion stated that the education program broadend their perspectives the difference between two groups was not significant and this hypothesis was not supported. In conclusion, both types of ethics education had helped the nurses to acquire the skills to deal some nursing dilemmas. The effects of ethics education may differ according to the moral development index - P(%) score. However, because of some of the limitations of this study, mainly small sample size, short term education, unable to control other variables which may affect moral judgement of nurses, further research is warranted.er research is warranted.

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A Reliability Study on the Auditory-perceptual Evaluation of Parkinsonian Dysarthria (파킨슨증으로 인한 마비말장애의 청지각적 평가에 대한 신뢰도 연구)

  • Kim, Hyang-Hee;Lee, Mi-Sook;Kim, Sun-Woo;Lee, Won-Yong
    • Speech Sciences
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    • v.11 no.4
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    • pp.129-141
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    • 2004
  • An auditory-perceptual evaluation has long been utilized in assessing dysarthric speech. The process involves subjective judgement and the results might vary depending on clinical experiences or training of listeners. This study aimed to investigate reliability of the auditory-perceptual evaluation of 22 multi -dimensional variables on 6 patients with Parkinsonian speech disorders. Listeners were divided into two groups: one consisted of 6 speech therapists with clinical experiences for three years or more, and the other 6 graduate students without any previous clinical background. The results showed that the former evaluated dysarthric speech with higher inter-rater and intra-rater reliabilities than the latter. Furthermore, such speech variables as 'precise consonant: 'speech intelligibility: and 'SMR regularity' were more influenced than others by clinical experiences. We, therefore, postulated that a reliable auditory-perceptual evaluation of dysarthric speech may require adequate amount of clinical training of listeners.

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A Review for Concept Clarification of Critical Thinking, Clinical Reasoning, and Clinical Judgment in Nursing Education (간호교육에서의 비판적 사고, 임상적 추론, 임상적 판단 개념의 고찰)

  • Lee, Dongsuk;Park, Jiyeon
    • The Journal of Korean Academic Society of Nursing Education
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    • v.25 no.3
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    • pp.378-387
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    • 2019
  • Purpose: This article is a comprehensive review for concept clarification of critical thinking, clinical reasoning, and clinical judgment, which still lack a consensus and are of mixed use. Methods: Norris's method of concept clarification was used to review concepts that have no clear definition or conceptualization yet. Results: This review summarized literature from various disciplines, classified each concept based on similarities and differences, and provided hypothetic conceptual schema. Conclusion: Clinical reasoning and clinical judgment are clinical situation specific concepts, while critical thinking is a concept applied in general situations. Critical thinking is a broader concept and serves as a foundation for clinical reasoning and clinical judgment. Clinical reasoning precedes clinical judgment. Clinical judgement implies the end point or conclusion of clinical reasoning. Each of critical thinking, clinical reasoning, and clinical judgment is a cognitive and affective process not a psychomotor process. The concept of clinical competency involves action taken after the cognitive processes of clinical reasoning and clinical judgment.

The Effect of Simulation Practice Education on the Clinical Judgment, Self-confidence and Clinical Performance Ability in Nursing Student (시뮬레이션 실습교육이 간호대학생의 임상판단력, 자신감, 임상수행능력에 미치는 효과)

  • Lee, Sook-Keyong
    • The Journal of the Korea Contents Association
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    • v.17 no.11
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    • pp.577-587
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    • 2017
  • The purpose of this study was to test the effects of simulation practice education on clinical judgment, self-confidence, and clinical performance ability of nursing student. This study used a one group, pre-post test design. The subject of this study were 45 second grade nursing students who participated in the simulation practice education. Data were collected before and after the simulation practice education using the questionnaire. As a result of this research, the improvements of the clinical judgment, self-confidence, and clinical performance ability were statistically significant. Therefore, the simulation practice education has a positive effect on nursing students in terms of the clinical judgment, self-confidence, and clinical performance ability.