Abstract

Background: Clinical judgment is crucial for nursing, enabling informed decisions (AACN, 2024). New graduates often lack this skill, emphasizing the need for better training (Monagle et al., 2024). Multi-patient simulations have proven more effective than single-patient scenarios in improving clinical judgment (Namgung et al., 2023).

Methods: Fifty fourth-semester nursing students in a critical care course engaged in a simulated emergency department scenario, requiring patient prioritization with one bed available. Students acted as charge or staff nurses, using QR codes for assessments. Cases included sepsis, myocardial infarction, and cerebrovascular accident, integrating prior coursework. Pre-simulation activities reviewed critical skills like the Glasgow Coma Scale and rhythm identification (McDermott et al., 2021).

Simulation and Debriefing: Students assessed, documented, and advocated for patient prioritization. Debriefing followed the PEARLS Tool for reflection (Bajaj et al., 2018), with collaborative review in the LMS.

Results: Qualitative feedback indicated enhanced critical thinking, collaboration, and assessment. Surveys showed 87% felt more confident in assessment and prioritization, 97% reported improved decision-making, and 90% believed the simulation enhanced readiness for patient care. Ninety-eight percent found the learning environment engaging.

Conclusions: Multi-patient simulations improve nursing students’ clinical judgment, providing realistic critical care training. This approach fosters independent decision-making, boosting confidence and clinical readiness.

Notes

References:

AACN. (n.d.). Clinical judgement concept. ttps://www.aacnnursing.org/essentials/tool-kit/domains-concepts/clinical-judgement

Bajaj, K., Meguerdichian, M., Thoma, B., Huang, S., Eppich, W., & Cheng, A. (2017b). The PEARLS Healthcare debriefing tool. Academic Medicine, 93(2), 336. https://doi.org/10.1097/acm.0000000000002035

McDermott, D. S., Ludlow, J., Horsley, E., & Meakim, C. (2021). Healthcare Simulation Standards of Best PracticeTM Prebriefing: Preparation and Briefing. Clinical Simulation in Nursing, 58, 9–13. https://doi.org/10.1016/j.ecns.2021.08.008

Monagle, J., Jessee, M. A., Nielsen, A., Gonzalez, L., & Lasater, K. (2024). Observed use of clinical judgment among new graduate nurses. The Journal of Continuing Education in Nursing, 1–8. https://doi.org/10.3928/00220124-20240301-07

Namgung, H., Choi, Y., & Kang, J. (2023). Development of a Multiple-Patient Simulation and its Effectiveness in Clinical Judgment and Practice Readiness: A Randomized Controlled Trial. Clinical Simulation in Nursing, 83, 101448. https://doi.org/10.1016/j.ecns.2023.101448

Description

This presentation showcases how multi-patient simulations in an emergency department setting, enhanced by QR code technology for real-time assessments, improve nursing students' clinical judgment. Participants explored how these simulations advance decision-making, critical thinking, and patient prioritization, boosting readiness for real-world critical care.

Author Details

As shown on title slide: Miranda M. Smith, Ed.D, AGACNP-BC; Joseph Chamness, DNP, FNP-C, ENP-C, CNE; Mary Deason, MSN, RN, CHSE

Sigma Membership

Beta Phi at-Large

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Qualitative Research

Keywords:

Acute Care, Simulation, Teaching and Learning Strategies, Clinical Judgement, Novice Nurses, New Graduates

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, 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.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Click on the above link to access the slide deck.

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Enhancing Clinical Judgment Using Simulation with Multiple Patients

Seattle, Washington, USA

Background: Clinical judgment is crucial for nursing, enabling informed decisions (AACN, 2024). New graduates often lack this skill, emphasizing the need for better training (Monagle et al., 2024). Multi-patient simulations have proven more effective than single-patient scenarios in improving clinical judgment (Namgung et al., 2023).

Methods: Fifty fourth-semester nursing students in a critical care course engaged in a simulated emergency department scenario, requiring patient prioritization with one bed available. Students acted as charge or staff nurses, using QR codes for assessments. Cases included sepsis, myocardial infarction, and cerebrovascular accident, integrating prior coursework. Pre-simulation activities reviewed critical skills like the Glasgow Coma Scale and rhythm identification (McDermott et al., 2021).

Simulation and Debriefing: Students assessed, documented, and advocated for patient prioritization. Debriefing followed the PEARLS Tool for reflection (Bajaj et al., 2018), with collaborative review in the LMS.

Results: Qualitative feedback indicated enhanced critical thinking, collaboration, and assessment. Surveys showed 87% felt more confident in assessment and prioritization, 97% reported improved decision-making, and 90% believed the simulation enhanced readiness for patient care. Ninety-eight percent found the learning environment engaging.

Conclusions: Multi-patient simulations improve nursing students’ clinical judgment, providing realistic critical care training. This approach fosters independent decision-making, boosting confidence and clinical readiness.