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Doctoral Dissertation Defense
of
Laurie Robinson

For the degree of

Doctor of Philosophy
Curriculum and Instruction

Exploring Clinical Judgement Development in Early Prelicensure Nursing Students Using NCJMM Modeled Case Studies: A Two Manuscript Dissertation

March 26, 2025
2:00–4:00 P.M.
MACC Annex 272

Exploring Clinical Judgement Development in Early Prelicensure Nursing Students Using NCJMM Modeled Case Studies: A Two Manuscript Dissertation

The purpose of this two-manuscript dissertation explores first semester nursing students’ experiences with NCJMM-modeled case studies in their Health Assessment lab prior to entering the clinical environment. Participants completed six case studies and a pretest/posttest throughout the semester and identified which step of the clinical judgment process was hardest through reflections and Likert scoring. The intervention group’s pretest/posttest scores were also compared to the control group that experienced traditional lab curriculum. 

Findings indicated that students being introduced to the NCJMM find steps that deal with deciding how to care for their patients were the hardest in their reflections. However, comparing their perceived hardest step to their actual performance on the pretest/posttest, students scored highest on the step they perceived was the hardest. This may indicate that students cannot identify what concepts they struggle with and an approach to teaching that addresses both perceived difficulty and actual performance weaknesses could give the students a more well-rounded understanding of their clinical judgment development. 

When comparing posttest scores on the intervention group with the control group, no significant differences were found in scores. This could indicate that as students are entering the program multiple different learning activities could be used to begin to develop student’s clinical judgment. More research needs to be done to address whether exposure to a clinical judgment process early in the nursing program affects clinical judgment development as students continue though the program.