How Expert Nurse Faculty Teach Cue Recognition

ABSTRACTThe purpose of this project was to discover how expert nurse faculty teach noticing and cue recognition skills to undergraduate nursing students. The current health care environment is complex, requiring new nurses to apply sound clinical judgment for safe patient care. New nurses often struggle with the first phase of clinical judgment, which includes noticing or cue recognition. Nurse educators often say that they teach clinical judgment skills, however specific guidelines to accomplish this task are limited. This study employed a qualitative exploratory descriptive design. Expert nursing faculty (N=18) from across the USA were nominated by peers and participated in semistructured interviews in person or via webinar. Interviews were recorded, transcribed, verified, and then coded using open and axial coding procedures in a grounded theory approach. Themes were confirmed by three educators with experience in teaching clinical judgment. Fifteen themes emerged. Faculty employed a variety of methods to teach cue recognition skills. In the clinical setting, faculty reported using orientation to the environment, Socratic questioning, role modeling, guidance in cue collection, and open discussion. Faculty teaching in simulation settings reported manipulating cues to reflect real time consequences of missing cues and manipulating cues based on best available evidence related to the scenarios. Authentic clinical environments and human patient simulation provide opportunities for undergraduate nursing students to learn cue recognition and noticing skills. However, students need the support of nurse educators to guide their learning and maintain overall safety. Expert nurse faculty possess a wealth of knowledge in how to teach clinical judgment. Nurse educators reported using methods suitable across settings and methods specific to clinical or simulation settings. The methods and strategies that expert nurse educators reported for supporting students in clinical judgment can be used to build and refine professional development programs for novice and continuing nurse educators.