# Effects of Hybrid Education Sequence on Learning Outcomes for Clinical Judgement Development in Nursing Students in the Developing Phase of Readiness

## TL;DR

This study found that the order of hybrid class components did not affect nursing students' clinical judgment skills or learning outcomes.

## Contribution

The study provides new evidence on the sequence effects of hybrid education for clinical judgment in nursing.

## Key findings

- No differences were found between groups in baseline characteristics.
- The sequence of hybrid class components did not affect LCJR scores or learning goals.
- Results suggest that the order of simulation and lecture in hybrid classes is not critical for learning outcomes.

## Abstract

This study aimed to determine the effects of the sequence of a hybrid class on learning outcomes for clinical judgment development in nursing students.

This was a quasi-randomized controlled trial. The study participants consisted of 85 second-year nursing university students. The class was conducted in a hybrid format consisting of a simulation of providing nursing care to a patient with diabetes and an on-demand lecture on blood sugar regulation, insulin secretion, and action. The Japanese version of the Lasater Clinical Judgment Rubric (LCJR) was used to evaluate participants’ clinical judgment. The Shapiro-Wilk test confirmed non-normal distribution for all items. The Mann-Whitney U test compared groups with a significance level of p < 0.05. This study was based on the “Development and Validation of Guidelines for Reporting Evidence-Based Practice Educational Interventions and Teaching.”

No differences were found between the groups at baseline. No differences were found between the groups in achievement based on the LCJR items, total scores, or learning goals after the hybrid class.

The results suggest that the sequence of simulations and on-demand lectures for clinical judgment development did not affect LCJR scores or learning goal achievement following a hybrid class.