Assistant Professor TCU Brock, Texas, United States
Abstract :
Background: Newly graduated nurses’ clinical judgment (CJ) is declining. Although observing simulations significantly improves CJ, the gains are inconsistent over time. Learners’ ability impacts their knowledge, thinking and approach to simulation observations. Implementing the pre-briefing standard ensures more universal simulation preparation. A gap exists investigating how observer pre-briefing impacts CJ.
Methods: This study aims to describe how pre-briefing methods impact observers’ CJ. Guided by the NLN/Jeffries Simulation Theory, a quasi-experimental study was performed using a mixed factorial design. Junior-level learners first completed either traditional (n=61) or observer-specific pre-briefing (n=35). Traditional pre-briefing included learners creating their own situation, background problem list, planned assessment, and recommend priorities after reviewing patient information sheets. Observer-specific pre-briefing added viewing videos of an expert nurse describing the simulated patient’s situation, background problems, assessments, and recommended priorities. Learners then observed an expert-modeled simulation and responded to 11 CJ prompts, scored using the Lasater CJ Rubric. Pre-briefing, simulation observations, and CJ prompts were completed for eight scenarios. Two-way mixed ANOVAs compared how pre-briefing methods impact CJ over time.
Results: CJ outcomes were influenced by pre-briefing method and time F(5.47, 514.154)=20.206, p<.001, ηp2=.177. Both pre-briefing types improved CJ, but observer-specific pre-briefing led to significantly higher scores in seven scenarios.
Conclusion: Implementing observer-specific pre-briefing elevates simulation observations and promotes more consistent CJ outcomes. Aligning observers’ pre-briefing with the Healthcare Simulation Standards of Best Practice for Pre-briefing supports learners identifying salient cues, interpreting patient priorities, and anticipating patient needs— essential steps in closing the CJ gap among newly graduated nurses.
Please include a short summary of your presentation that highlights why an attendee would want to participate in your session.: Discover how providing observer-specific pre-briefing transforms simulation observations into a powerful tool for clinical judgment development. This session will help simulationist elevate simulation observations by aligning to the Healthcare Simulation Standard of Best Practice for Pre-briefing. Learn how to apply this method in your program to better prepare nurses’ clinical judgment.
Learning Objectives:
Upon completion, participants will be able to describe what is currently known about observers’ clinical judgment.
Upon completion, participants will be able to identify how pre-briefing impacts simulation observers’ clinical judgment
Upon completion, participants will be able to describe strategies for applying the Healthcare Simulation Standards of Best Practice: Pre-briefing to their simulation/ program area of work or practice with observers.
