Clinical judgment in reflective journals of prelicensure nursing students.

Clinical judgment is an essential skill needed by RNs. Employers expect new graduate nurses to enter the work-force with established clinical judgment skills. Therefore, nurse educators must ensure that prelicensure nursing students develop clinical judgment before graduation. This qualitative, interpretive description study reviewed the reflective journals of 30 prelicensure nursing students who participated in four progressive high-fidelity simulation (HFS) scenarios during a medical-surgical nursing course. Eight themes were identified in the reflective journals: (a) expectations about the patient, (b) recognition of a focused assessment, (c) interpretation of medications, laboratory data, and diagnostics, (d) communication with the patient, (e) collaboration and interprofessionalism, (f) prioritizing interventions, (g) skillfulness with interventions, and (h) incorporation of skills and information into real patient situations. This study indicated that reflective journaling following progressive HFS scenarios may be an effective teaching-learning strategy to assist prelicensure nursing students in the development of clinical judgment.