Date of Conferral

2023

Degree

Ph.D.

School

Nursing

Advisor

Janice Long

Abstract

New graduate nurses often lack adequate clinical judgment skills to practice competent nursing care, which may result in increased risk of committing practice errors that threaten patient safety. To mitigate errors in patient safety, industry leaders have called for nursing program improvements in preparation of nursing students’ clinical judgement as they transition to professional practice. Guided by Tanner’s clinical judgment theory, the rural state nursing programs in this study implemented a concept-based curriculum to promote clinical judgment which includes thinking skills, priority setting, and management of care. The purpose of this three-part, quantitative, nonexperimental study was to compare the development of clinical judgment in associate degree nursing students taught using a traditional systems-based curriculum (n=233) and students taught in a new, concept-based shared curriculum (n=278). A quantitative comparative study using ex post facto student data from the ATI-Comprehensive Predictor exam scores in thinking skills, priority setting, and management of care collected at the completion of each of the associate degree programs was analyzed in SPSS using an independent samples t test. The result of this three-part study did not show a significant difference (p>0.05) in thinking skills and priority setting following curriculum change. However, a significant increase in management of care (p<0.05) was seen. Results of this study may contribute to positive social change as the nursing students develop clinical judgment to perform competent and safe nursing practice improving overall patient care. Future research is needed in the evaluation of curriculum change using other methodologies that support the development of clinical judgment.

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