A framework to support preceptors’ evaluation and development of new nurses’ clinical judgment

• Preceptors value an objective framework to guide discussion of thinking about nursing care.
• A clinical judgment framework can support teaching strategies and feedback to new nurses.
• A framework for orientation supports evaluation and tracking of new graduate nurses’ progress.

In today’s complex, fast-paced world of hospital nursing, new graduate nurses do not have well-developed clinical judgment skills. Nurse preceptors are charged with bridging the gap between new graduates’ learning in school and their autonomous practice as RNs. In one large, urban medical center in the U.S., a clinical judgment model and rubric were used as a framework for a new evaluation and orientation process. Preceptors of new graduate nurses who had used the former and new processes described their experiences using the framework. The findings indicated that having a structured framework provided objective ways to evaluate and help develop new graduate nurses’ clinical judgment. It is hypothesized that academic clinical supervisors may find such a framework useful to prepare students for transition to practice.