Content Analysis of Experience of Nursing Students in Clinical Judgment during Nursing Practicum

간호학생의 임상적 판단 경험에 관한 내용분석

  • Suh, Yeon-Ok (Department of Nursing, Soonchunhyang University) ;
  • Ahn, Yang-Heui (Department of Nursing, College of Medicine, Yonsei University Wonju) ;
  • Park, Kyung-Sook (Department of Nursing, Chung-Ang University)
  • 서연옥 (순천향대학교 간호학과) ;
  • 안양희 (연세대학교 원주의과대학 간호학과) ;
  • 박경숙 (중앙대학교 간호학과)
  • Received : 2009.02.16
  • Accepted : 2009.04.14
  • Published : 2009.04.30

Abstract

Purpose: To describe the lived experience of nursing students when faced with clinical judgment in a nursing practicum at the hospital. Methods: A descriptive research design was utilized. Participants were 79 students in the clinical practicum. Participant consent was obtained for ethical protection. Data were collected from August to December 2007 using a semi-structured questionnaire. Content analysis was utilized for data analysis. Results: Two categories and 5 themes were extracted from the data for 'difficult' and 'easy' clinical judgments. For the student category, the two themes were 'knowledge' and 'skill', while the three themes for the clinical education environment category were, 'judgment of clinical symptoms and signs', 'differences between theory and practice' and 'human relationships'. For coping, 2 categories and 5 themes were extracted for the difficult clinical judgment situation, while one category and one theme were found for the easy clinical judgment situation. Conclusion: To develop students' clinical judgment, there is need to develop the method of clinical skills using simulation in clinical teaching. For future research, a study on factors affecting clinical judgment of nursing students in hospitals is needed.

Keywords

References

  1. Ahn, Y. H. (2004). Critical thinking and the standards of nursing education. J Educ Eval Health Prof, 1(1), 99-106. https://doi.org/10.3352/jeehp.2004.1.1.99
  2. Brykczynski, K. A. (1999). An interpretive study describing the clinical judgment of nurse practitioners. Scholarly Inq Nurs Pract, 13(2), 141-166.
  3. Chase, S. K. (1995). The social context of critical care clinical judgment. Heart Lung, 24(2), 154-162. https://doi.org/10.1016/S0147-9563(05)80010-X
  4. Facione, P. A., & Facione, N. C. (1994). The California Critical Thinking Skills Test(CCTST): Form A and form B test manual. Millbrae, CA: California Academic Press.
  5. Facione, N. C., Facione, P. A., & Sanchez, C. A. (1994). Critical thinking disposition as a measure of competent clinical judgment: The development of the California critical thinking disposition inventory. J Nurs Educ, 33(8), 345-350.
  6. Fesler-Birch, D. M. (2005). Critical thinking and patient outcomes: A review. Nurs Outlook, 53(2), 59-65. https://doi.org/10.1016/j.outlook.2004.11.005
  7. Forneris, S. G., & Peden-McAlpine, C. (2007). Evaluation of a reflective learning intervention to improve critical thinking in novice nurses. J Adv Nurs, 57(4), 410-421. https://doi.org/10.1111/j.1365-2648.2007.04120.x
  8. Gordon, M., Murphy, C., Candee, D., & Hiltunen, E. (1994). Clinical judgement: An integrated model. ANS Adv Nurs Sci, 16(4), 55-70.
  9. Hwang, Y. Y. (2005). The study of the nursing students lived experience of clinical practice nursing of elderly patients. J Korean Acad Soc Nurs Educ, 11(1), 73-81.
  10. Kang, Y. S., Cho, H., Roh, Y. S., Boo, E. H., & Ahn, K. H. (2006). The effects of cooperative clinical nursing education program on the competency and satisfaction of nursing students in clinical practice. J Korean Acad Soc Nurs Educ, 12(1), 13-20.
  11. Kim, J. H., Moon, S. Y., Lee, J. E., & Lim, M. L. (2001). A research on the interactions in practice of the nurse's college students in the nursing college. J Korean Acad Soc Nurs Educ, 7(2), 207-216.
  12. Kim, Y. H. (2002). Nursing students' performance and confidence in basic nursing skills after the completion of clinical practice - focused on basic nursing skills of low performance. Unpublished master's thesis, Keimyung University, Daegu.
  13. Krippendorff, K. (2003). Content analysis: An introduction to its methodology (2nd ed.). Thousand Oaks, CA: Sage Publications, Inc.
  14. Kwon, I. S., Lee, G. E., Kim, G. D., Kim, Y. H., Park, K. M., Park, H. S., Sohn, S. K., Lee, W. S., Jang, K. S., & Chung, B. Y. (2006). Development of a critical disposition scale for nursing students. J Korean Acad Nurs, 36(6), 950-958.
  15. Lasater, K. (2007-a). High-fidelity simulation and the development of clinical judgment: Students' experiences. J Nurs Educ, 46(6), 269-276.
  16. Lasater, K. (2007-b). Clinical judgment development: Using simulation to create an assessment rubric. J Nurs Educ, 46(11), 496-503.
  17. Lee, S. O., Eom, M. R., & Lee, J. H. (2007). Use of simulation in nursing education. J Korean Acad Soc Nurs Educ, 13(1), 90-94.
  18. McCarthy, P., Schuster, P., Zehr, P., & McDougal, D. (1999). Evaluation of critical thinking in a baccalaureate nursing program. J Nurs Educ, 38(3), 142-144.
  19. Moon, M. S. (1998). Nursing students' initial clinical experience. J Korean Acad Soc Nurs Educ, 4(1), 15-27.
  20. Park, M. Y. (2001). Nursing students' stress and anger experience in the clinical setting. J Korean Acad Soc Nurs Educ, 7(1), 7-21.
  21. Riddell, T. (2007). Critical assumptions: Thinking critically about critical thinking. J Nurs Educ, 46(3), 121-126.
  22. Shin, K. R., Ha, J. Y., & Kim, K. H. (2005). A longitudinal study of critical thinking dispositions & critical thinking skills in baccalaureate nursing students. J Korean Acad Nurs, 35(2), 382-389.
  23. Shin, Y. H., Hur, H. K., Park, S. M., Song, H. Y., & Kim, G. Y. (2007). Development of an integrated clinical nursing practice course for improvement of nursing competency among nursing students. J Korean Acad Soc Nurs Educ, 13(1), 32-40.
  24. Stillman, P. L., Swanson, D. B., Case, S., McCahan, L., & Nelson, V. (1990). An assessment of clinical skills of fourth year students at four New England medical schools. Acad Med, 65(5), 320-326. https://doi.org/10.1097/00001888-199005000-00013
  25. Tanner, C. A. (2006). Thinking like a nurse: A research-based model of clinical judgment in nursing. J Nurs Educ, 45(6), 204-211.
  26. Yang, J. J., & Park, M. Y. (2004). The relationship of clinical competency and self-directed learning in nursing students. J Korean Acad Soc Nurs Educ, 10(2), 271-277.