Clinical judgment among nursing interns

Abstract

Clinical judgment (CJ) is considered a vital and crucial ability for nurses that can help them to improve their practical or clinical capabilities, particularly in the internship period. Nursing interns pass through a transient period with significant job responsibilities. They face multifaceted issues, dilemmas, and problems that oblige them to use CJ skills. CJ is a talent and clever skill which should be acquired by nursing interns. The current study is a quantitative study that aims to determine CJ knowledge and skills among nursing interns in nursing practice. A descriptive exploratory design was used. A systematic random sample of 150 nursing interns out of 305 was selected and assigned as a survey group. The data was collected in internship training hospitals in Damanhur, Egypt (Damanhur Medical National Institute, El Raee El Saleh, El Farok and Kafer El Dawar Hospitals). One tool was used for data collection, the Clinical Judgment Evaluation Sheet (CJES), which included two parts. The first part was the Clinical Judgment Knowledge Test that was developed by the researchers to collect the necessary data regarding the CJ knowledge needs of nursing interns. The Lasater Clinical Judgment Rubric (LCJR) 2009 was the second part. It was developed based on Tanner’s work in 2006 and included eleven skills in the four phases delineated with CJ developmental skills (noticing, interpreting, responding, and reflecting). Results revealed that the nursing interns have a serious lack of knowledge about the concept of CJ in nursing practice. Additionally, they have a great deficiency in the knowledge about all phases of the CJ process in nursing practice. As well, they suffered from observed insufficiently CJ skills in the nursing practice, respectfully. These findings confirmed that the nursing interns in Damanhur governorate have necessitated to an educational program about CJ knowledge skills. In conclusion, there is an obvious and serious lack of nursing interns’ CJ knowledge and skills in nursing practice in Egypt. Therefore, CJ teaching programs or self-learning references are important for them for developing and improving CJ knowledge and skills. Nurse educators and preceptors should take initiative steps in developing teaching sessions, models, and instructional aides to empower their nursing intern’s students in CJ practice.