Do prelicensure nursing students' backgrounds impact what they notice and interpret about patients?

Background: Academic educators are challenged to foster the development of clinical judgment in diverse learners. The impact of nursing students' backgrounds on clinical judgment has not previously been studied. Aims: 1. Determine what identifiable background variables influence what students notice and how they interpret what is noticed; 2. Identify some implications for pedagogical approaches that may foster clinical judgment development among diverse learners. Sample: Prelicensure/preregistration students, representing three international English-speaking programs in 3 countries, comprised the sample (N = 532). All were enrolled in the first course in which perioperative content was taught. Data collection: An online learning activity was designed to elicit responses to a simulated case study of an expert nurse role model caring for an older adult patient experiencing delirium several days post-operatively. Data analysis: Dyads of coders did three rounds of coding. Logistic and multinomial logistic regression models used background variables to look for patterns in student responses. Findings: The data strongly suggest that background variables impact clinical judgment, however, not in interpretable patterns. Conclusion: Nurse educators must acknowledge that prelicensure students' backgrounds impact their clinical judgment and assist them to learn to think like nurses.