Abstract:

Nursing education focuses on both theoretical and clinical components of nursing practice in order to prepare learners for entry into the profession. As practicum settings become more challenging, learners are faced with the need to demonstrate competency in increasingly complex patient situations. Clinical judgment, or the "interpretation or conclusion about a patient's needs, concerns, or health problems, and the decision to take action (or not), use or modify standard approaches, or improvise new ones as deemed appropriate by the patient's response" (Tanner, 2006, p. 204) is seen as a lynchpin of effective nursing practice and is most often cited as a factor in student inability to meet practicum requirements. Unfortunately, when students struggle in the clinical setting with clinical judgment, oftentimes clinical remediation practices are unavailable or clinical instructors have no time to focus on clinical remediation and limited training in how to do so (Camp & Legge, 2018). Evidence-based options for remediation in relation to nursing practicum performance challenges, including the use of simulation-based education (SBE), have been slow to develop (Camp & Legge, 2018; Custer, 2016). SBE as a means of remediation to provide nursing students with the opportunity to strengthen their nursing skills is an underexplored method for remediating and reinforcing nursing practice requirements (McCaughey & Traynor, 2010; Ryall et al., 2016; and Ward-Smith, 2008). Given that SBE has been shown to support nursing students to transfer theoretical knowledge to clinical situations, thereby improving their clinical judgement (Lynn & Twigg, 2011), nursing clinical remediation approaches employing SBE warrant further development and evaluation. This presentation focuses on the development of the Clinical Judgment Coaching Method (CJCM) as a means of providing targeted, evidence-based remediation for nursing students experiencing challenges in practicum experiences. The overall goal of the CJCM is to assess the student’s clinical judgment and provide support and strategies that enable the student to improve clinical judgment skills. At the same time, the coaching framework helps to build student confidence and competence. The development of the CJCM is one mechanism through which SBE can be used effectively for practicum-based nursing education remediation that identifies gaps in nursing student knowledge, practice, and clinical judgment, while at the same time supporting learners in real time to address those gaps.

Keywords:

Coaching, education, nursing, simulation.