Evaluating Collective Competence to Promote Safe, Effective Care
First Place Winner

Background/Introduction: New graduate competency in clinical judgment is imperative to safe, effective nursing care. In practice, nurses often use clinical reasoning and judgment collaboratively to make decisions in complex patient situations. Collective competence, the effective achievement of a desired outcome by a health care team, is influenced by individual nurse confidence and competence. New graduate nurse delivery of safe, quality care requires that nursing education teach and assess both individual and collective competence in clinical reasoning and judgment in practice-relevant situations.

Purpose: This study explored facilitators and barriers to collective competence and the relationship among individual student confidence, perceived clinical judgment competence, and collective competence of student teams in 141 senior baccalaureate-level pre-licensure nursing students during a team-based simulation.

Methods or Processes/Procedures: A mixed methods pre- and post-test design using a 24-item pre-survey and a 28-item post-survey based on the National Council of State Boards of Nursing's Clinical Judgment Measurement Model (NCSBN-CJMM) assessed individual student confidence and perceptions of clinical judgment competence before and after a team-based simulation. Observation of team dynamics and task completion assessed collective competence and student perception of learning.

Results: Analysis is underway for this study. An initial cross-sectional study using a 26-item post-simulation survey based on the NCSBN-CJMM (? 0.86) and observation identified closed-loop communication and role assignment as facilitators, and lack of confidence and perceived competence with Layer 3 and 4 of the NCSBN-CJMM as barriers. The current study was conducted with a subsequent student cohort.

Limitations: The study includes students from only one school, but compares outcomes to the previous pilot study.

Conclusions/Implications for Practice: The results of this study will promote academic and practice educators’ ability to design and implement strategies for teaching and assessing collective competence in teams of students and new graduate nurses.

Lacey Cross
MSN, FNP-BC

Biography

Lacey Cross, MSN, FNP-BC, CPN, is an Instructor of Nursing at Vanderbilt University School of Nursing in Nashville, TN. She has a specific scholarly interest in facilitating and evaluating clinical judgment ability in nursing students, especially through simulation experiences. In collaboration with her co-authors, she developed an innovative simulation experience for senior baccalaureate-level nursing students that was designed to allow students the opportunity to demonstrate their clinical judgment ability in a team-based setting.

Email: lacey.e.cross.1@vanderbilt.edu

Co-Author(s)
Angela Weaver, MSN, CPNP-PC, CNE
Mary Ann Jessee, PhD, RN