New Graduate Nurse Experiences in Clinical Judgment: What Academic and Practice Educators Need to Know.

AIM: The aim of the study was to determine if use of a structured reflection exercise using a clinical judgment framework would result in more practice-ready new graduate nurses (NGNs).

BACKGROUND: Clinical judgment is a critical skill for all nurses, yet it is identified as a deficit in NGNs.

METHOD: Seventy-four NGNs in two groups participated in this mixed-methods study in their first year in practice. Scores from two quantitative measures were collected for all participants. The Lasater Clinical Judgment Rubric framed the structured intervention.

RESULTS: Although the quantitative data showed no significant differences between the groups, use of the reflection exercise indicated a positive impact on NGNs. Qualitative data revealed four themes that present challenges for preparation of NGNs: enhancing communication, finding interprofessional support, responding to complexity of care, and appreciating the role of the nurse.

CONCLUSION: Implications provide guidance for academic and practice educators to smooth the transition into practice.