Clinical Decision Cards Promote Clinical Judgment in Nursing Students
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Helping students prepare for the unexpected is a crucial part of your role as a nurse educator.
You want your clinical days to be rich with learning and full of moments where students connect theory to practice and build confidence in their clinical judgment.
But some days, everything goes smoothly. Patients are stable, complications are minimal, and students go through the motions without much challenge.
On those days, how can you create meaningful opportunities for students to strengthen their clinical judgment?
Intentionally Create Clinical Decision Moments
Clinical time is valuable, and adding a set of Clinical Decision Cards is a fantastic way to create more opportunities for clinical judgment.
These cards are a done-for-you activity! At clinical, students draw a card and find some abnormal assessment data. For example, their patient may develop a change in their level of consciousness, abnormal bleeding, or a critical lab value pops up.
Medical-Surgical - 27 different critical patient assessment findings including abnormal lab values, medication reconciliation misses, and discharge planning.
OB - 25 scenarios specific to prenatal, intrapartum, postpartum, and infant care.
Mental Health - 25 scenarios that include traumatic flashbacks, reports of unusual pain, or patients trying to elope from the unit.
Pediatrics - 25 pediatric-specific scenarios, including medical needs, such as low blood sugar, as well as social or emotional challenges, including an anxious sibling or feeling left out of peer interactions.
How to Use the Clinical Decision Cards to Build Clinical Judgment
1. After receiving the cards in the mail, have your students prepare for a typical patient care day. They should complete assessments, give medications, and complete their documentation.
2. Next, students pick a card containing abnormal assessment findings or clinical red flags. Using their assigned patient from that day, they imagine caring for them with this new information. Examples include:
- The patient complains of shortness of breath.
- The lab calls to report an INR of 3.1
- The doctor puts in discharge orders - prepare to teach
3. Finally, students create a care plan based on the abnormal assessment that includes their nursing interventions.
4. Upon completion, students have demonstrated clinical judgment and decision-making when presented with abnormal or unexpected findings.
Practice clinical judgment based on abnormal assessment findings
This activity is easy to implement because you already have a patient ready! Because students have been assigned a clinical patient, they already have a medical history, medications, and an initial diagnosis. You are just adding some abnormal assessment findings to improve their critical thinking 😉
Nursing students should use the abnormal assessment finding on the clinical decision card as their priority problem. They may have to do creative thinking - e.g., if the card indicates that they developed new abdominal pain, they may have to come up with a probable cause for that on their own. Maybe they decide it is an ileus and then build their care plan from that idea.
These are beautifully illustrated and professionally printed on premium cardstock, just like a deck of playing cards. They arrive in a box that is easy to slip into the pocket of your lab jacket as you prepare for the clinical day.
Applicable Clinical Settings
This activity was designed for rotations in acute care, but instructors can also use it in outpatient settings or home health.
Other decks available include mental health, pediatrics and OB.
How to Use the Decks in Class or Online
In-Person Option
These cards can be utilized in a theory class as well! As a quick-thinking exercise, divide the students into groups and assign them a disease process. For example, if you cover respiratory content, separate the groups into pneumonia, tracheostomy, cystic fibrosis, and COPD. Then, have students choose a card and rapidly decide their priority assessments and interventions based on the abnormal assessment finding. You could play this for multiple rounds or have them develop a detailed care plan around one card.
Virtual Option
This activity could also translate to the online learning environment. For example, rather than having students pick a card, you may just assign them one.
How to Add Clinical Decision Cards to Your Teaching Toolkit
Being at the bedside with students is one of my favorite teaching days. Using simple clinical decision cards can add a layer of critical thinking and is an excellent activity for nursing students in clinical.
Purchase the Clinical Decision Cards.
Students prepare for a typical patient care day.
Once their daily tasks are complete, have them choose a clinical decision card.
Once they have their abnormal assessment finding, they should create a care plan based on these findings.
This activity was designed for rotations in acute care but can be utilized in theory class.
Conclusion
Clinical Decision Cards boost clinical judgment by introducing unexpected assessment findings into students’ clinical days, prompting them to apply theory to practice.
The decks support diverse learning contexts and are suitable for acute care rotations and adaptable for outpatient or theory courses, reinforcing priority setting, reasoning, and confidence when things go wrong at the bedside.
The cards are easy to implement with flexible variations. Students draw cards with abnormal data, then create a care plan. This can be adapted for classroom, team games, rapid rounds, or virtual settings.
Martha Johnson
Martha Johnson, MSN, RN is a nurse educator and the creator of BreakoutRN. She helps nursing faculty build active learning into the classroom and clinical setting, one practical idea at a time, using tools that support clinical judgment, engagement, and real-world nursing practice.
Frequently Asked Questions
How do the Clinical Decision Card decks work?
Each deck includes short, realistic patient changes or complications that students must respond to using the information they already have. Students identify priorities, make clinical decisions, and justify their reasoning. This can be done individually or in small groups, without requiring extra prep for the instructor.
Where can I find additional templates or worksheets to use with these cards?
A care plan template is included with the purchase of a deck. Also, there are additional classroom, lab, and clinical ideas that pair well with the cards HERE.
These additional resources help structure student thinking, guide debriefing, and make it easier to assess learning.
Can I use Clinical Decision Cards in the classroom or online?
Yes! The cards work well in classroom discussions, simulations, post-conference, virtual courses, and even asynchronous discussion posts. You can assign a card, have students respond in writing or discussion, and debrief their decision-making process.
What other active learning tools are available from BreakoutRN?
BreakoutRN offers a growing library of active learning resources, including unfolding case study card decks, clinical decision cards, tabletop case study kits, worksheets, templates, and educator guides designed to strengthen clinical judgment without overwhelming faculty.
Are these activities aligned with real-world nursing practice and entry-level expectations?
Yes! The scenarios are intentionally designed around realistic patient situations and common complications, helping students practice prioritization, clinical reasoning, and safe decision-making that is expected for entry to practice.
Additional Active Learning Ideas & Inspiration
Related product
🩺 Medical Surgical Clinical Decision Cards
$39.00