What is the role of a nurse educator? Many say that a nurse educator “teaches students to be nurses,” while others say “preparing students to pass the NCLEX exam,” but the job is much grander than that. The role and responsibility of a nurse educator is to create safe, competent, and practice-ready nurses. This encompasses the need to impart knowledge and experience, facilitate learning, and mentor each student to consistently apply clinical judgment as a way of thinking. Are nursing graduates practice ready? Significant research has been published in the last decade that shows a deterioration in entry level competency of novice nurses entering practice. A publication by Kavanagh & Sharpnack (2021) measured that only 9% of new graduates met this minimal level of preparation. As an educator it is emotionally distressing, but as a consumer of health care it is terrifying! Creating Practice-Ready Nurses TIPS & TRICKS FOR NURSE EDUCATORS Karin J. Sherrill, MSN, RN, CNE, ANEF, FAADN
Novice Nurses Meeting Entry Level Competency
Del Bueno (2005)
Kavanagh & Szweda (2017)
Kavanagh & Szweda (2021)
How do I know if my students are progressing in clinical judgment decision making? Using terminology from Patricia Benner’s Novice to Expert model (1982), the process of clinical judgment occurs over time with exposure and experience. Here’s an example of how this progression occurs. It is not possible to become an “expert” of clinical judgment as a nursing student. This level of competency occurs with one or more years of exposure to clinical experiences. Our goal as educators is for students to obtain proficiency by graduation.
Advanced Beginner
Competent
Novice
Proficient
Progression Towards the Development
§ Gain baseline
§ Identify cause and effect. § Make association between cues. § Begin to differentiate between abnormal and critical. § Begin to anticipate needs and problems.
§ Able to apply
§ Proficient with cue recognition and analysis. § Struggle with process of prioritization. § Identify adequate
knowledge and recognize obvious cues.
clinical judgment. § Lack confidence. § Know when to seek guidance. § Safe practitioner.
§ Differentiate
between normal and abnormal.
of Clinical Judgment
outcome measures.
Expert... Comes Later
How Davis Advantage can help Sprinkle and spread clinical judgment everywhere Ideas for your classroom
Challenge students with initiating Davis Advantage Clinical Judgment assignments as a part of classroom preparation. For example, ask them to apply the NCSBN’s Clinical Judgment Measurement Model, layer 3 (https://www.nclex.com/clinical- judgment-measurement-model.page) to a clinical example in their textbook readings. Review the assignments as a class. Support students in developing clinical imagination. Create opportunities for students to explore the multiple facets of a patient’s situation by placing the student imaginatively into the real world of clinical practice. Use of images attached to Davis Advantage case studies helps. Present material using EHR forms to create realism. Eliminate narrative presentation of clinical situations, including medication math and skill teaching. A health care provider’s order form, medication administration record, intake/output, or vital sign flow sheet can make all the difference. Use Davis Advantage Clinical Judgment cases to bring a patient to class. Facilitate small group or entire class application. Expand the case by holding a classroom debate on whether the patient is acute, chronic, stable, unstable, and what care can be delegated to other members of the health care team. Ask students to delineate the priority care to be performed in the first 5 minutes, 1 hour, or by the end of the shift. Give the class a verbal handoff report on 4 patients in the Davis Advantage Clinical Judgment cases. Have them work to prioritize which patient should be seen first and why. Assign a Davis Advantage Clinical Judgment case and have students work in small groups to build a Next Gen-style test item. Provide them with the template and format. Davis Advantage is built using concepts of andragogy, metacognition, and clinical judgment application. Customer feedback supports the value of high-level thinking in the transformation of students into practice-ready nurses. Learn More! Visit FADavis.com/NextGen or email us at Hello@FADavis.com References Benner, P. (1982). From Novice to Expert. American Journal of Nursing 82 (3), 402-407. DelBueno, D. (2005). A crisis in critical thinking. Nursing Education Perspectives , 26, 278-283. Kavanaugh, J., Szweda, C. (2017). A crisis in competency: The strategic and ethical imperative to assessing new graduate nurses’ clinical reasoning. Nurse Education Perspectives , 38, 57-62. Kavanaugh, J., Sharpneck, P.A. (2021). Crisis in competency: A defining moment in nursing education. Online Journal of Issues in Nursing , 26 (1), Manuscript 2. NCSBN: Clinical Judgment Measurement Model: A Framework to Measure Clinical Judgment & Decision Making. https://www.nclex.com/clinical-judgment- measurement-model.page About the Author Karin Sherrill, MSN, RN, CNE, ANEF, FAADN has been a nurse educator for over 30 years. She works as a nursing education consultant, supporting faculty in creating better nurses. “The inclusion of adaptive learning technology and comprehensive assessment resources further enhance students’ understanding and application of nursing fundamentals. I highly recommend Davis Advantage as a robust instructional tool that supports student success in the field of nursing.” —Elizabeth Hughes, Rasmussen University
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