High-fidelity simulation: Assessment of student nurses' team achievements of clinical judgment

• There is a research gap between nursing students' team achievements and theoretical and personal characteristics using HFS.
• For attaining high team achievements in clinical judgment the majority in the team should theoretically be “high performing”.
• A single theoretically knowledgeable student seems to have difficulty achieving team high scores in clinical judgment in HFS.
• Previous experiences of observation and HFS seem impact on students' clinical judgment the most.
• Tanner's model, Lasater's clinical judgment rubric and Dewey's philosophy seem useful to spot breakdowns in clinical judgment.

Nursing educators have the challenge of preparing nursing students to handle complex patient care situations in real life, but much remains unknown about the ability to make clinical judgments. In this study, high-fidelity simulation (HFS) was used at a Swedish university to find answers about pre-licensure nursing students' success in clinical judgment in terms of team ability and relationships with theoretical achievements, and personal and scenario circumstances. The matrix Lasater Clinical Judgment Rubric (LCJR) was used to analyze and score the students' ability in teams to notice, interpret and respond to complex care situations. Overall, the results showed the student teams in their first meeting with HFS in a complex care situation achieved low clinical judgment points; most teams were in the stages of Beginning and Developing. For attaining high team achievements the majority of the students in the team should theoretically be “high performance”. Being observers and having HFS experience before nursing education was significant too. However, age, health care experience, and assistant nurse degrees were of secondary importance. Further research at universities regionally, nationally, and internationally is needed.