Clinical Judgment and Informatics: Encoding Simulations Using the Omaha System

Background: Clinical judgment is a critical nursing competency. Unfolding case study is a pedagogy used to develop clinical judgment. The Omaha System is an accepted taxonomy for standardizing nursing documentation. Method: An unfolding case study was developed from a simulation scenario by encoding 33 nursing interventions with the Omaha System, then developed multiple true-false response items which were sent electronically in survey format to prelicensure baccalaureate nursing students. Differences between identified essential and distractor interventions were evaluated. Results: Participants (n = 101) identified correct interventions (M = 74.6%, standard deviation [SD] = 12%). A paired t-test indicated the percentage of correctly identified essential interventions (M = 78%, SD = 18.7%) was significantly higher than distractor interventions (M = 67%, SD = 18%). Discussion: Nursing students can identify appropriate interventions using the Omaha System, demonstrating potential to extend highly effective and low-cost learning experiences using unfolding case study and multiple true-false response items.