Abstract
The competency of clinical judgment in new nurses leading to safe practice has declined. The integrated clinical education theory posits discourse with meaningful feedback between nurse educators and pre-licensure students during clinical experiences enhances the development of clinical judgment. Quantitative evidence is needed for efficacy of clinical teaching using discourse with meaningful feedback. The hypothesis for this study was implementation of discourse with meaningful feedback between the academic nurse educator and the pre-licensure student nurse in direct patient care will improve the development of clinical judgment in students compared to the development of clinical judgment in students exposed to other clinical teaching practices. An explanatory sequential mixed methods design was used. The quantitative phase was a quasi-experimental pretest-posttest control group design using a convenience sample. The qualitative phase followed a narrative approach to provide deeper understanding of quantitative results. Academic nurse educators measured clinical judgment in students on the first and last day of clinical. Educators in the intervention group used discourse with meaningful feedback during the clinical course. The control group educators used their own teaching practices. A repeated measure analysis of covariance (RM-ANCOVA) was used to assess differences in clinical judgment development. Intervention educators participated in a focus group following collection of posttest scores. Results showed a significant mean difference in the Total LCJR scores with a large effect size with discourse and meaningful feedback. Key facets in the study intervention were consistent use of a clinical judgment model and providing space for students to think and reflect.
Date of publication
Fall 10-30-2025
Document Type
Dissertation
Language
english
Persistent identifier
http://hdl.handle.net/10950/4914
Committee members
Dr. Belinda Deal, Dr. Kevin Gosselin, Dr. Janice I. Hooper
Degree
Doctor of Philosophy in Nursing
Recommended Citation
Jackson, Annissa C., "Developing Clinical Judgment in Nursing Students Using Discourse with Meaningful Feedback, Explanatory Mixed Methods Design" (2025). Nursing Theses and Dissertations. Paper 156.
http://hdl.handle.net/10950/4914