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The Challenge of Developing Critical Thinking in New Nurses

Imagine how hard it is for a healthcare organization to know that nurses new to the profession or moving to a new department are qualified and able to provide high quality care. If a nurse has a knowledge deficit that may have an impact on patients, you might not uncover it except by anecdote and after some time. Typically, leadership does not discover that a nurse cannot handle a situation or will fail to recognize change in a patient’s condition until the staffer gets out on the unit. Sometimes that’s too late for a patient who makes a drastic turn for the worse. Most of the time, while new nurses are able to spot dramatic patient changes, subtle yet significant alterations can be harder to diagnose and address. That means patients may have received substandard and unacceptable care until a nurse’s issue with perception is uncovered. Healthcare organizations need to know about nursing care challenges as soon as possible, and preferably before patients experience them.

Piloting HealthStream’s Jane

A nursing educator in charge of her hospital’s nurse training program who was still getting used to her role wanted to be certain that newly hired nurses and nurses transferring to different departments were adequately prepared and able to provide high quality care. During a typical year, she was responsible for ensuring the competency of as many as 40 newly hired nurses as well as 15 ICU nurse trainees. Her organization, a large multi-state healthcare provider with many hospitals and ancillary facilities, did not have an active process for assessing nurse competency, knowledge base, and critical thinking skills. To gain access to some much-needed functionality, the education leader volunteered to pilot HealthStream’s Jane, an IBM Watson-based, artificial intelligence-driven competency assessment system, designed to help healthcare providers assess competency and critical thinking, identify individual deficits in preparation, and then personalize a learning program for all new candidates. In addition, she was especially interested in how Jane assessments can assist preceptors to understand where to focus additional training, coaching, and learning experiences.

An Initial Assessment to Establish a Baseline

One important element in the pilot’s success was preparation. The educator already had a computer room available for trainees; the Jane assessment process typically takes three to four hours of focused computer time. Trainees were assigned the assessment, just as they would be assigned a training course on the organization’s learning management system, the HealthStream Learning Center. According to the educator, the assignment process was “super easy.” Communicating that the goal of this assessment was to establish a baseline of knowledge was key to setting expectations among those being assessed. The new hires were given the assessment at the beginning of their twelve-week training and again at the ten-week mark, allowing two additional weeks after the follow-up assessment for any necessary additional learning to address any critical remaining knowledge gaps.

This blog post is an excerpt from the HealthStream article, Improving Nurse Competency and Critical Thinking Skills in New Hires: An Experience Using Jane. It also includes:

  • Trainee Responses to Jane
  • Using Assessment Results to Guide Training Choices
  • A Valuable Tool for Helping New Hires Who Might Be Struggling
  • A Student Experience That Demonstrates Jane’s Value
  • Making Sure Nurses Are Prepared

Continue reading the full article.

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