Flipping the script: Assessing clinical judgement in student-led clinical evaluation

Introduction and background: Strong clinical judgement and reflective thinking and practice are imperative to make safe, ethical clinical decisions, particularly in today’s complex healthcare environment. Yet clinical judgement and underlying thinking are challenging to assess in post-licensure specialty nursing clinical education due to their complexity and invisibility.Methods: Problem: Clinical evaluation can be subjective, based on observed behaviours rather than on assessment of thinking processes and clinical judgement underlying students’ clinical decisions and actions. Approach: The BCIT Clinical Evaluation Tool (CET) and Evaluation Process (CET-EP) were developed using a shared accountability approach that shifts responsibility for demonstration of learning from instructor/preceptor to student, and facilitates the reflective thinking and practice necessary to develop clinical judgment.Conclusions: Use of this CET-EP in post-licensure specialty certificate programs has assisted instructors, preceptors, and students to reach insights into learners’ thinking, tailor learning interventions, and promote reflective practice, as well as provided greater objectivity in clinical evaluation.