# Impact of Simulation-based Learning and Previous Academic Achievement on Clinical Judgment in Nursing Students

## TL;DR

This study explores how simulation-based learning and prior academic performance influence clinical judgment skills in nursing students.

## Contribution

The study identifies specific academic and simulation-based factors that impact clinical judgment dimensions in nursing education.

## Key findings

- Achievement in physical assessment, critical thinking, and nursing processes from prior subjects significantly affects LCJR scores.
- Simulation learning objectives, particularly gathering information and expectation to initial grasp, influence clinical judgment dimensions.
- Emphasizing these areas in nursing education may improve students' clinical judgment skills.

## Abstract

Clinical judgment is crucial for nurses because it directly impacts patient safety and outcomes. Simulation is an effective strategy for teaching clinical reasoning and judgment. This study investigated the relationship between simulation performance and foundational knowledge from previous academic subjects, as measured by clinical judgment performance on the Lasater Clinical Judgment Rubric (LCJR). This study aimed to determine the impact of simulation-based learning and previous academic achievement on LCJR scores among nursing students.

In this cross-sectional quantitative study, a questionnaire was administered to second-year undergraduate nursing students (n = 85) after they completed simulation-based learning. The questionnaire captured self-assessed achievement levels related to the simulation’s learning objectives and previous academic subjects. Statistical analysis included normality tests, Cronbach’s α, Spearman’s correlation, and multiple regression, with simulation and subject achievement as independent variables and LCJR scores as the dependent variable.

Achievement of learning objective 3 (the “expectation to initial grasp”) within the simulation, along with self-reported achievement in physical assessment, critical thinking, and nursing processes from previous academic subjects, significantly affected the LCJR total score and the “Interpreting” dimension. Physical assessment, critical thinking, and nursing processes also significantly impacted the LCJR “Noticing” dimension. Achievement of learning objective 1 (“Gathering information from electronic medical records”) and learning objective 3 affected the LCJR “Responding.”

The achievement of physical assessment, critical thinking, and nursing process in the previous academic subjects affected the total LCJR scores and the scores of Noticing and Interpreting. Emphasizing these areas of nursing education may enhance the students’ clinical judgment skills.