Abstract

Background: Providing safe patient care requires strong clinical judgement skills (American Association of Colleges of Nursing (AACN), 2021); however, developing and assessing clinical judgement in undergraduate students has been difficult (Dickison et al., 2019). The Lasater Clinical Judgment Rubric (LCJR) has been found to be valid and reliable in assessing clinical judgment development over time (Adamson et al., 2012), but at present has not been adapted as a self-evaluation tool. The LCJR was originally intended to define clinical judgment with consistent terms and monitor student performance over time (Lasater & Nielsen, 2024).

Method: With the permission of Dr. Kathie Lasater, a pilot study was conducted to adapt the LCJR as a self-assessment tool in a midwestern undergraduate nursing program. The adapted tool was administered to 111 senior students at three points in the final year of the program. In the senior year, students were exposed to a variety of clinical, simulation, and didactic learning strategies, including some form of case-based learning (CBL). Students were asked to rate themselves on a scale of 1-4 in the four facets of the LCJR (noticing, interpreting, responding and reflecting).

Results: The self-assessment data was correlated with student performance in the associated courses and with NCLEX success. The data demonstrated significant results in perceived student growth of clinical judgment skills over the course of their senior year. Interestingly, students who had a course grade of an A or B consistently rated themselves higher in clinical judgment competencies than students who had a course grade of a C. Previous research has described inconsistencies between self-assessment and actual performance (Hadid, 2017).

Conclusion: The LCJR as a self-assessment tool can provide additional data to support clinical judgment competency development. As students identify areas of weakness, programs can tailor review practices to target specific clinical judgment skills. This tool may be beneficial as nursing programs transition to competency based education, as this self-assessment practice can provide data-driven interventions to address gaps in performance.

Notes

Reference list included in attached slide deck.

Description

Using the adapted Lasater Clinical Judgment Rubric (LCJR) as a self-assessment tool assisted faculty and students in recognizing gaps and strengths in clinical judgment competencies. The adapted tool will be reviewed and made available to participants. Methods for implementation will be addressed to assist educators in identifying strategies for the classroom, clinical, or simulation spaces. A special focus on case-based learning platforms will be incorporated.

Author Details

Bev A. Wilgenbusch, EdD, MSN, BSN; Victoria Jurevic, DNP; Britt Cole Archibald, DNP; Alexis Zehler, MSN; Caitlin Jeanmougin, DNP; Katy Gilb, MSN

Note: Author names are listed in the order supplied in the Sigma event system, not the slide deck.

Sigma Membership

Alpha

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Pilot/Exploratory Study

Keywords:

Teaching and Learning Strategies, Competence, Nursing Education, Advances in Education, Clinical Competence, Lasater Clinical Judgment Rubric

Conference Name

48th Biennial Convention

Conference Host

Sigma Theta Tau International

Conference Location

Indianapolis, Indiana, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2025-12-04

Click on the above link to access the slide deck.

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Use of the Lasater Clinical Judgment Rubric to Self-Identify Gaps in Clinical Judgment Competencies

Indianapolis, Indiana, USA

Background: Providing safe patient care requires strong clinical judgement skills (American Association of Colleges of Nursing (AACN), 2021); however, developing and assessing clinical judgement in undergraduate students has been difficult (Dickison et al., 2019). The Lasater Clinical Judgment Rubric (LCJR) has been found to be valid and reliable in assessing clinical judgment development over time (Adamson et al., 2012), but at present has not been adapted as a self-evaluation tool. The LCJR was originally intended to define clinical judgment with consistent terms and monitor student performance over time (Lasater & Nielsen, 2024).

Method: With the permission of Dr. Kathie Lasater, a pilot study was conducted to adapt the LCJR as a self-assessment tool in a midwestern undergraduate nursing program. The adapted tool was administered to 111 senior students at three points in the final year of the program. In the senior year, students were exposed to a variety of clinical, simulation, and didactic learning strategies, including some form of case-based learning (CBL). Students were asked to rate themselves on a scale of 1-4 in the four facets of the LCJR (noticing, interpreting, responding and reflecting).

Results: The self-assessment data was correlated with student performance in the associated courses and with NCLEX success. The data demonstrated significant results in perceived student growth of clinical judgment skills over the course of their senior year. Interestingly, students who had a course grade of an A or B consistently rated themselves higher in clinical judgment competencies than students who had a course grade of a C. Previous research has described inconsistencies between self-assessment and actual performance (Hadid, 2017).

Conclusion: The LCJR as a self-assessment tool can provide additional data to support clinical judgment competency development. As students identify areas of weakness, programs can tailor review practices to target specific clinical judgment skills. This tool may be beneficial as nursing programs transition to competency based education, as this self-assessment practice can provide data-driven interventions to address gaps in performance.