目的:将当前的评估实践与护士从本科教育到进入实习的临床判断相关的学习成果进行映射。
方法:使用JoannaBriggs研究所指南进行范围审查,并根据系统审查和荟萃分析(PRISMA)的首选报告项目进行报告。
方法:电子数据库-护理和相关健康文献的累积指数(CINAHLComplete;EBSCOhost),EMBASE(Ovid),MEDLINE(Ovid),PsycINFO(Ovid),和WebofScience(社会科学引文索引,引文索引扩展)-使用与护生相关的描述符和关键词的组合,新毕业的护士,临床判断和相关术语(例如,批判性思维,临床推理,临床决策,和解决问题),和评估。
方法:两名评审员独立提取研究特征,对于与临床判断相关的每个结果,这个概念,定义和框架,评估工具,以及评估的数量和时间表。数据采用叙述性和描述性统计方法进行综合。
结果:52项综述研究中的大多数研究检查了学术环境中离散教育干预(76.9%)的结果(78.8%)。只有6项研究(11.5%)涉及新毕业的护士。临床判断(34.6%),批判性思维(26.9%),临床推理(9.6%)是最常见的三个概念。在一项以上的研究中使用了三种评估工具:Lasater临床判断规则(n=22,42.3%),加州批判性思维技能测试(n=9,17.3%),和健康科学推理测试(n=2,3.8%)。11项研究(21.2%)使用了为该研究设计的评估工具。
结论:除了对基本概念的不同理解之外,关于护生和护士临床判断评估的研究很少,特别是从教育到临床实践的纵向评估。虽然有一些关于这一主题的现有研究,需要进一步的研究来建立有效和可靠的临床能力评估方法,在相关时间点将临床判断有效地整合到临床情况中。
OBJECTIVE: To map current assessment practices for learning outcomes related to nurses\' clinical
judgment from undergraduate education to entry to practice.
METHODS: Scoping
review using the Joanna Briggs Institute guidelines and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
METHODS: Electronic databases-Cumulative Index of Nursing and Allied Health Literature (CINAHL Complete; EBSCOhost), EMBASE (Ovid), MEDLINE (Ovid), PsycINFO (Ovid), and Web of Science (Social Sciences Citation Index, Citation Index Expanded)-using a combination of descriptors and keywords related to nursing students, newly graduated nurses, clinical judgment and related terms (e.g., critical thinking, clinical reasoning, clinical decision-making, and problem-solving), and assessment.
METHODS: Two reviewers independently extracted study characteristics and, for each outcome relevant to clinical
judgment, the concept, definition and framework, assessment tool, and the number and schedule of assessments. Data were synthesized narratively and using descriptive statistics.
RESULTS: Most of the 52 reviewed studies examined the outcome of a discrete educational intervention (76.9 %) in academic settings (78.8 %). Only six studies (11.5 %) involved newly graduated nurses. Clinical
judgment (34.6 %), critical thinking (26.9 %), and clinical reasoning (9.6 %) were the three most frequent concepts. Three assessment tools were used in more than one study: the Lasater Clinical
Judgment Rubric (n = 22, 42.3 %), the California Critical Thinking Skills Test (n = 9, 17.3 %), and the Health Science Reasoning Test (n = 2, 3.8 %). Eleven studies (21.2 %) used assessment tools designed for the study.
CONCLUSIONS: In addition to a disparate understanding of underlying concepts, there are minimal published studies on the assessment of nursing students and nurses\' clinical judgment, especially for longitudinal assessment from education to clinical practice. Although there is some existing research on this topic, further studies are necessary to establish valid and reliable clinical competency assessment methods that effectively integrate clinical judgment in clinical situations at relevant time points.