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

Table 1. LCJR Frequency Distribution Table.

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

						n=85
	Exemplary n (%)	Accomplished n (%)	Developing n (%)	Beginning n (%)	Mean (SD)	Median [IQR]
Effective noticing involves:
Focused observation	2(2.35)	39 (45.88)	44 (51.76)	0 (0)	2.51 (0.55)	2 [2-3]
Recognizing deviations from expected patterns	2 (2.35)	37 (43.53)	44 (51.76)	2 (2.35)	2.46 (0.59)	2 [2-3]
Information seeking	2 (2.35)	34 (40.00)	49 (57.65)	0 (0)	2.45 (0.55)	2 [2-3]
Effective interpreting involves:
Prioritizing data	3 (3.53)	36 (42.35)	46 (54.12)	0 (0)	2.49 (0.57)	2 [2-3]
Making sense of data	2 (2.35)	27 (31.76)	56 (65.88)	0 (0)	2.36 (0.53)	2 [2-3]
Effective responding involves:
Calm, confident manner	1(1.18)	27 (31.76)	53 (62.35)	4 (4.71)	2.29 (0.57)	2 [2-3]
Clear communication	4 (4.71)	36 (42.35)	42 (49.41)	3 (3.53)	2.48 (0.65)	2 [2-3]
Well-planned intervention/flexibility	1 (1.18)	27 (31.76)	55 (64.71)	2 (2.35)	2.32 (0.54)	2 [2-3]
Being skillful	0 (0)	22 (25.88)	60 (70.59)	3 (3.53)	2.22 (0.50)	2 [2-3]
Effective reflecting involves:
Evaluation/Self-analysis	2 (2.35)	31 (36.47)	51 (60.00)	1 (1.18)	2.40 (0.56)	2 [2-3]
Commitment to improvement	1 (1.18)	28 (32.94)	56 (65.88)	0 (0)	2.35 (0.50)	2 [2-3]

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Table 2. Achievement Level of Simulation-based Learning and Previous Academic Subjects.

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

		n = 85
Achievment level in simulation-based learning (n = 85)		Median [IQR]
Learning Objective 1: [Pre-assignment] Demonstrate the ability to gather relevant information from electronic medical records.		6 [5-7]
Learning Objective 2: Demonstrate an understanding of the anatomy and physiology necessary for clinical judgment.		6 [5-7]
Learning Objective 3: Anticipate the patient’s condition, prioritize observations, and develop an initial understanding.		6 [5-7]
Learning Objective 4: Interpret information obtained through observation and respond appropriately, including using the I-SBAR report and providing nursing assistance.		6 [5-7]
Learning Objective 5: [Post-assignment] Reflect on outcomes and recognize the clinical judgment process.		6 [5-7]
Achievement level of previous academic subjects		Median [IQR]
Specialized foundational subjects	Anatomy and physiology I, II	6 [5-7]
	General Therapeutics	6 [5-7]
	Pathophysiology	6 [5-7]
	Disease Therapy I, II, III	6 [5-7]
Specialty field	Assist of activities of daily living life	7 [6-8]
	Physical Assessment	6 [5-7]
	Nurse’s role in helping examination and treatment	6 [5-7]
	Critical Thinking and the Nursing Process	6 [5-7]

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Table 3. Relationship between the Achievement Levels of Simulation-based Learning and Previous Academic Subjects for LCJR (Total Score and Four Phases).

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

					n = 85
	Item	Total LCJR	Noticing	Interpreting	Responding	Reflecting
Achievement levels in simulation-based learning	Learning Objective 1: [Pre-assignment] Demonstrate the ability to gather relevant information from electronic medical records.	0.255 *	0.335 **	0.237 *	0.192	0.220 *
	Learning Objective 2: Demonstrate an understanding of the anatomy and physiology necessary for clinical judgment.	0.311 **	0.302 **	0.284 **	0.289 **	0.322 **
	Learning Objective 3: Anticipate the patient’s condition, prioritize observations, and develop an initial understanding.	0.433 ***	0.439 ***	0.382 **	0.402 ***	0.381 ***
	Learning Objective 4: Interpret information obtained through observation and respond appropriately, including using the I-SBAR report and providing nursing assistance.	0.397 ***	0.402 ***	0.331 **	0.392 ***	0.351 **
	Learning Objective 5: [Post-assignment] Reflect on outcomes and recognize the clinical judgment process.	0.396 ***	0.429 ***	0.330 **	0.366 ***	0.342 **
	Item	Total LCJR	Awareness	Interpretation	Reaction	Reflection
Achievement levels in previous academic subjects	Anatomy and physiology I, II	0.291 **	0.314 **	0.249 *	0.279 **	0.310 **
	General Therapeutics	0.317 **	0.297 **	0.217 *	0.370 ***	0.348 **
	Pathophysiology	0.263 *	0.262 *	0.227 *	0.295 **	0.273 *
	Disease Therapy I, II, III	0.353 ***	0.33 **	0.241 *	0.394 ***	0.384 ***
	Assist of activities of daily living life	0.377 **	0.373 ***	0.345 *	0.379 ***	0.385 **
	Physical Assessment	0.419 ***	0.415 ***	0.386 **	0.428 ***	0.413 ***
	Nurse’s role in helping examination and treatment	0.369 **	0.389 ***	0.314 *	0.399 ***	0.374 ***
	Critical Thinking and the Nursing Process	0.247 *	0.246 *	0.182	0.250 *	0.270 *

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Table 4. Multiple Regression Analysis with LCJR Total Score as the Dependent Variable.

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

n = 85
Lasater Clinical Judgment Rubric (LCJR) Total Score
		Step 1		Step 2
		β	VIF	β	VIF
	Achievement levels in simulation-based learning
	Learning Objective 1	-1.64	5.335	-1.223	7.776
	Learning Objective 2	0.09	6.36	0.378	9.126
	Learning Objective 3	2.239 *	9.601	3.306 *	9.157
	Learning Objective 4	0.08	8.073	-0.775	9.924
	Learning Objective 5	0.829	9.609	0.353	9.101
	R2	0.28***		0.40***
	Adjusted R2	0.23***		0.30***
	Achievement levels in previous academic subjects
Specialized basic field	Anatomy and physiology I, II			0.314	6.419
	General Therapeutics			0.385	9.091
	Pathophysiology			0.026	9.117
	Disease Therapy I, II, III			1.162	7.441
Specialty field	Assist of activities of daily living life			0.021	8.831
	Physical Assessment			2.483 *	9.713
	Nurse’s role in helping examination and treatment			0.354	8.000
	Critical Thinking and Nursing Process			1.740 *	4.768

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Table 5. Multiple Regression Analysis with LCJR’s “Noticing,” “Interpreting,” “Responding,” and “Reflecting,” as Dependent Variables.

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

										n = 85
	Lasater Clinical Judgment Rubric (LCJR) Total Score・4 Phases
	Total Score		Noticing		Interpreting		Responding		Reflecting
Achievement levels in simulation-based learning	β	t	β	t	β	t	β	t	β	t
Learning Objective 1	-1.223	-1.395	-0.303	0.653	-1.223	-1.689	0.784 *	2.064	-0.303	-1.654
Learning Objective 2	0.378	0.377	0.226	-1.155	0.378	1.425	0.205	0.518	0.226	1.076
Learning Objective 3	3.306 *	2.128	0.363	1.426	3.306 *	2.490	0.909 *	2.124	0.363	1.603
Learning Objective 4	-0.775	-0.725	-0.171	-1.452	-0.775	-0.818	0.051	0.121	-0.171	-0.767
Learning Objective 5	0.353	0.332	-0.033	-1.394	0.353	0.026	-0.058	-0.138	-0.033	-0.149
Achievement levels in prior academic subjects
Anatomy and physiology I, II	0.314	0.383	0.147	0.763	0.314	0.701	-0.144	-0.444	0.147	0.859
General Therapeutics	0.026	0.027	0.052	0.905	0.026	0.541	0.338	0.912	0.052	0.267
Pathophysiology	1.162	1.323	0.257	1.485	1.162	0.979	0.328	0.946	0.257	1.403
Disease Therapy I. II. III	0.385	0.412	0.060	1.501	0.385	0.181	-0.065	-0.177	0.06	0.307
Assist of activities of daily living life	0.021	0.022	0.065	0.406	0.021	0.779	-0.083	-0.213	0.065	0.315
Physical Assessment	2.483 *	2.133	0.382 *	2.164	2.483 *	2.009	0.846	1.841	0.382	1.572
Nurse’s role in helping examination and treatment	0.354	0.380	0.038	0.258	0.354	0.066	0.255	0.695	0.038	0.196
Critical Thinking and Nursing Process	1.740 *	2.230	0.223 *	2.123	1.740 *	3.003	0.523	1.696	0.223	1.370
R2	0.41***		0.34***		0.40***		0.41***		0.34**
Adjusted R2	0.30 ***		0.22 ***		0.30***		0.30***		0.22**

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