703 - The Key to Unlocking Clinical Judgment Lies in Our Values

• Do I value learning over performance?
• What is my goal when I teach? Is it helping students pass? Is it helping students learn?
• Do my objectives/learning outcomes reflect my goal?
• Do my actions/teaching reflect my goal?
• Does my evaluation/testing reflect my goal?
• Am I teaching content or am I teaching students?

These are the questions we will ponder as we discuss our values as educators and how these values directly impact the development of clinical judgment in our nursing students.

Our primary, secondary, and higher education systems are set up to value a grade over all else, including learning. If you get an A, you pass and are labeled the “smart child.” If you get all A’s, you will be given a scholarship. If you outperform your peers, you will be awarded a coveted internship. There is no acknowledgment, except perhaps the label “high-risk,” for the student who failed a course but learned from it and turned it around to become the most empathetic and knowledgeable caregiver in the group; maybe even the student with the best clinical judgment!

What does it take to build CJ? Aren’t we, as nurse educators, asking ourselves that every day? NCSBN has given us a CJ measurement model. We can use it to assess and evaluate our students, but does the model itself develop CJ? Of course not. It is our job as nurses and educators to assist our students with their clinical decision-making and ultimately their CJ. What do we do to assist our students with developing CJ?

We must provide opportunities for deliberate practice. We must provide targeted and timely feedback. We need to provide instructional scaffolding and allow time for reflection. All of these strategies are part of formative assessment. As a matter of fact, most of these strategies have been directly linked to the development and improvement of CJ.

If we do not provide opportunities for practice or opportunities for failure, we often teach students that memorization equals learning, the get it, spit it, forget it method. We know this method does not work because it is not teaching students how to think. We often say as nurse educators, “think like a nurse.” Think like a nurse literally means using your CJ to make the appropriate decision for your patient! Are we teaching our students to think like a nurse? If we are, then we are valuing learning over performance, utilizing formative assessment, and developing CJ. If we can't say for certain that we do this, then we need to re-examine our values as educators.