Clinical Decision Cards Promote Clinical Judgment in Nursing Students
Allowing students to practice for when the unexpected happens is an essential skill of a nurse educator.
I'm a massive fan of clinical. I love working with students at the bedside and connecting theory and practice. However, I've had occasions where my day went according to plan. My students had stable patients who improved, with no unforeseen complications, and were moving toward discharge. When patients are stable, what can you add clinical judgment to the day?
Building opportunity for clinical decision-making is critical
Clinical time is valuable, and adding the Clinical Decision Cards is a fantastic way to build more clinical judgment opportunities.
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. There are 27 different critical patient assessment findings possible.
How to Implement:
1. Students pick a card containing abnormal assessment findings or clinical red flags.
2. 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. Next, 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.
After receiving the cards in the mail, have your students prepare for a typical patient care day. They should complete assessments, give medications, and have completed their documentation. Then, throw them a curveball. Have them draw a clinical decision card.
Once they have their abnormal assessment finding, they can create a care plan based on this data. A digital download of a care planning template is included with the purchase of a deck. The template uses assessment, diagnosis, planning, intervention, and evaluation. But you could also use your school’s clinical paperwork as well.
Add this deck to your teaching toolkit!
Help your students practice making decisions 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.
About the Cards:
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 in the pocket of your lab jacket as you prepare for the clinical day.
Best for:
This activity was designed for rotations in acute care. But instructors can use it in outpatient settings or home health as well.
Variations:
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.
Start Building Clinical Decision Cards into your teaching practice
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 Card.
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.