Assessment Strategies Used by Nurse Educators to Evaluate Critical Thinking, Clinical Judgment or Clinical Reasoning in Undergraduate Nursing Students in Clinical Settings: A Scoping Review of the Literature

Abstract

Background: Nursing students in Canada are typically enrolled in a four-year bachelor degree program that provides students with the necessary skills and knowledge to enter a highly demanding and challenging workforce. Strong critical thinking, clinical reasoning, and clinical judgment skills are essential skills for safe nursing practice. Therefore, educational institutes and their mentors are mandated to teach and assess these skills. In addition, nursing programs operate under an apprenticeship model, which entails the fulfillment of practical experience during which students are expected to develop and refine their skills in critical thinking, clinical reasoning, and clinical judgment. Purpose: The purpose of this scoping review of the literature is to assess the available evidence of how higher-level thinking, including critical thinking, clinical reasoning, and clinical judgment are evaluated in undergraduate nursing students in clinical settings. Methods: The inclusion criteria consisted of quantitative research articles published in the last 10 years. Search databases accessed included CINAHL Plus (EBSCO), Medline, and PubMed. Results: Seven articles that fit the inclusion criteria became the focus of this scoping review. Four tools to evaluate higher-thinking processes in clinical settings were located and scrutinized: Lasater Clinical Judgment Rubric (LCJR), Script Concordance Testing, and Yoon’s Critical Thinking Disposition Instrument. Relevance to Practice: The scoping review will provide direction and contextualize future studies that focus on the appraisal of nursing students’ critical thinking, clinical reasoning, and clinical judgment in clinical settings.