Elevating Clinical Judgment Skills in Dedicated Education Units

Background/Introduction: Although dedicated education units (DEUs) were first established to tackle nurse and nursing faculty shortages, they are also an innovative approach that bridges the classroom/practice gap in nursing education. However, studies show that new graduate nurses lack clinical judgment skills necessary for optimal patient care. DEUs allow time for higher-order thinking through nursing faculty and staff nurse collaboration. This academic-practice partnership provides students with opportunities to discuss, practice, and evaluate their decision-making abilities.

Purpose: The purpose of this project was to integrate high level thinking into clinical courses. DEUs afford nursing faculty the time to help students focus on developing vital clinical judgment and decision-making skills necessary for safe patient care.

Methods or Processes/Procedures: Faculty incorporate the National Council of State Boards of Nursing (NCSBN) Clinical Judgment Model (CJM) while meeting with each student during the clinical day. Students and faculty discuss cues (recognizing and analyzing) and development of priority hypotheses (nursing diagnoses). Students share their thought process for generating solutions. Actions and evaluation criteria are also addressed. Students then complete care maps that incorporate the CJM.

Results: Students in DEUs report increased critical thinking confidence. Nurses report student practice, professionalism, and judgment skills development. Nursing unit managers note that graduate nurses with DEU clinical experience transition well into their new roles demonstrating clinical judgment and decision-making skills.

Limitations: High nurse/patient ratios challenge even experienced nurses to facilitate students’ growth in “connecting the dots.”

Conclusions/Implications for Practice: Studies show that DEUs foster new graduates’ transitions into competent and prepared nurses by strengthening students' clinical judgment and decision-making skills. Despite the current hardship in many clinical settings, it is important that the DEU model continues to provide the supportive clinical environment to best prepare future nurses for practice. Additional studies would further analyze and evaluate students' clinical judgment and decision-making skills while in the DEU setting.

Cheryl Honeycutt
MSN, RN, CNE

Biography

Cheryl Honeycutt is a Senior Lecturer in the Undergraduate School of Nursing at Old Dominion University, Virginia Beach, VA. She is the Course Coordinator for Foundational Concepts and Adult Health II Clinical courses in the pre-licensure program and is the Course Coordinator for Introduction to Professional Development for Baccalaureate Nursing in the RN/BSN post-licensure program. As co-chair of the Dedicated Education Unit (DEU) Task Force, she has developed and maintained multiple DEUs in the Hampton Roads area.
She earned her BSN from George Mason University and her MSN at Old Dominion University. Her nursing clinical experience includes ICU, PACU, Urgent Care and Telephone Triage. Ms. Honeycutt currently serves as Co-Chair to the Admissions and Continuance Committee, and is a member of the Simulation Committee, Interprofessional Education Committee, and ODU’s Sigma chapter Epsilon Chi.

Email: choneycu@odu.edu

Co-Author(s)
Christine Sump, DNP, MSN, RN, CNE