2. Active learning with Cue Cards Incorporate clinical judgment for at least every 15 minutes of class. Open a Davis Advantage Clinical Judgment assignment in class, focusing on the electronic health record (EHR). § Place students in groups of 2-4 and ask them to review the components of the EHR and query each other using the 6 Cue Cards. • Fundamental students: Focus on Recognize and Analyze Cues initially. Roll out additional cards as the semester progresses and students build confidence, knowledge, and understanding. • Advanced students: Challenge them to apply all 6 Cue Cards within a group, or have them work independently through the process, comparing their answers with their peers. When students are periodically asked to work independently on clinical judgment application, it provides formative assessment of their learning. Early weakness identification and intervention can improve student success. • Lab: Provide skills in an EHR format, including medication records, provider orders, lab reports, or nursing notes. Have students discuss the entries, applying clinical judgment before performing a skill. Embed concerning conflicts, such as hypokalemia for a patient prescribed a nasogastric tube to suction to generate discussion. • Simulation: Before starting the simulation, allow students time to review the EHR and discuss questions from the 6 Cue Cards. Add the context of time pressure by giving students a pre-specified and limited amount to time to preform this analysis. • Clinical: Ask students to apply the 6 Cue Cards to the EHR of the patient who they cared for in clinical, discussing with the nurse mentor, instructor, or in post-conference. Select a client case from the text, ebook or Davis Advantage Clinical Judgment Cases. § Deliver a handoff report to the class. Perform this verbally or as a pre-recorded audio file. § Role model a nurse at the bedside with rate of delivery and use of medical terms. Allow students to use the Cue Cards to discuss afterwards. • Fundamental students: Provide a basic handoff report of a client in a long-term or skilled care facility, questioning students using the 6 Cue Cards as an entire class. Isolate each step of clinical judgment, explaining what it means. Debrief by explaining how a nurse thinks with each Cue Card. Nursing students need to develop a deep understanding of how a nurse thinks in order to apply clinical judgment. • Advanced students: Provide a comprehensive handoff report with multiple patients, requiring prioritization, or have the students develop and deliver the handoff report to a peer, based on a Clinical Judgment Case. • Lab: Provide some context to the skill, offering the patient’s background in the handoff report. Have students apply the 6 Cue Cards before practicing the skill. Using context will add realism and support clinical judgment thinking. • Simulation: Before starting the simulation, allow students time to analyze the handoff report and apply the 6 components of clinical judgment. Push students to identify priorities and delegation of care. • Clinical: Ask students to apply the 6 Cue Cards after receiving the shift handoff report and before providing care. Query students mid-shift about what has changed since the initial handoff report, framing the discussion around the 6 Cue Cards. 3. Assessment of learning with Cue Cards Provide clinical faculty with a set of Cue Cards. § Educate them on how to query students by asking questions from each card throughout the shift when receiving a report or assisting with a skill. • Fundamental students: Ask 1-2 questions, focusing on recognizing and analyzing cues at the start of the semester. Progress to all 6 Cue Cards as the semester progresses. • Advanced students: Facilitate students in self-reflection of clinical judgment through journaling. § Divide the class into 6 groups, providing them with a Next Gen NCLEX test item template. Have each group develop a test item that is focused on their assigned step of the Clinical Judgment Cue Cards. A text or ebook case, or Davis Advantage Clinical Judgment Case can be used as the patient. Learn More! Visit FADavis.com/NextGen or contact us at Hello@FADavis.com
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