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Abstract The primary goal of nursing education is to help nursing students learn how to integrate information, think critically, reason effectively, and use clinical evidence to take the most accurate and suitable decisions . Nursing students are significant decision-makers in any developed healthcare system, and evidence suggests sound clinical judgment is important because the judgments made by nurses in practice, influence patient outcomes. Clinical judgment is the relationship between nursing knowledge and how that knowledge applied through intervention, management, and evaluation. As a result, there is a need in nursing education to improve nursing students’ critical thinking, clinical reasoning, and clinical judgment skills on a national and global scale. Clinical judgment skills can be improved by many strategies, Mind mapping is one of them. It has been incorporated with teaching and learning in recent years. It is a method of creating memory links between a topic keyword and an image, color, or other link by combining drawings and words. It highlights the contents’ important points and allowing learners to successfully store and extract information. Mind mapping is also an effective teaching and learning strategy in linking theory and practice and making the nursing process easier for students to learn. The purpose of mapping nursing practice is to help students develop clinical judgment skills; that is through, assessing the patient, gathering information from various literatures, identify relevant points, relate all of the collected information to the care of the patient, and illustrate the information graphically. The aim of this study is to determine the effect of utilizing electronic mind map on nursing students’ clinical judgment skills. Research hypothesis: Nursing students who utilize electronic mind map exhibit higher clinical judgment skills levels than those who do not. Setting: This study was carried out at Medical-Surgical Nursing Department at the Faculty of Nursing, Damanhour University, in addition to the Damanhour Medical National Institute in which the nursing students spent their clinical training. Subjects: The participants consisted of 60 nursing students out of 150 students who were enrolled in the urology rotation during the second semester of the academic year 2021- 2022.The study subjects were randomly allocated into two equal groups the control and the study group, (30) students for each. To accomplish the aim of the current study; two tools were used for data collection; Tool I: Clinical Judgment Skills Rubric: It was adapted by the researcher based on Lasater clinical judgment skills rubric LCJSR (2007) after approval for modifications from the original author. The tool was used to assess the four aspects of clinical judgment: noticing, interpreting, responding, and reflecting. In addition to asheet that contains students‘ personal and academic characteristics such as name, code, age, sex, academic achievement in the first academic year. Tool II: Electronic Mind Map Scoring Rubric: the researcher developed this tool after an extensive review of the literatures (Cañas & Novak, 2014; Coutinho, 2014; Abd- Elhalem, 2016)to measure the performance of nursing students in constructing the electronic mind map. It included organization, comprehensiveness, links, accuracy, and attractiveness. Before conducting the study and after explaining the study aim, approvals were obtained from the Research Ethics Committee (REC) of the Faculty of Nursing, Alexandria University, the Dean and head of the ”Medical-Surgical Nursing Department,” and the head of the ”Information Technology Unit” of the Faculty of Nursing, Damanhur University. Five experts in nursing education and medical-surgical departments from Damanhour and Alexandria universities evaluated the study tools for content validity, and the necessary modifications were made.A pilot study was carried out on six nursing students to assess the clarity and applicability of the tools, the necessary modifications were made and they were excluded from the study subjects. The Cronbach’s Alpha test was used to assess the reliability of study instruments. The tools were dependable, with test scores of 0.76 and 0.71, respectively. This research was carried out in three stages: preparation, implementation, and evalustion. Phase I: Preparation Phase: - During this phase, the researcher prepared herself, content including PowerPoint presentation, Small videos and a case study for the study group training on writing a nursing care plan in the form of an E-mind map, learning environment (IT lap) and student’ channel on the Microsoft team and Whats-App group were created. Phase II: Implementation Phase: - On the first hospital day both groups were distributed randomly to dialysis patients and were instructed to write their first nursing care plan individually by paper- based method (Pretest) and evaluated by using tool I for both groups. - First, the researcher presented the PowerPoint presentation, the small videos for the study group and provided them with the case study data and teach them how to construct a mind map. - Then, on hospital days, both groups were distributed to the urology department patients randomly. - The researcher observed and asked the study group during their interaction with the patients and collection of data by using tool I that contains ten items which are focused observation and information seeking; identify deviations from expected patterns; prioritizing data; making sense of data; calm, confident manner; clear communication, well-planned intervention/flexibility; being skillful; evaluation /selfanalysis; commitment to improvement. - Every student constructed one EMM per week pertaining to the assigned patients (five electronic MMs) in addition to one for posttest. - The contact were established between the researcher and the study group for any question or interpretation via face to face on the day of the hospital, the day of the clinical conference, and the students send the maps on the Microsoft team channel or WhatsApp group and shared them with each other. 4. Evaluation Phase: - Every hospital day the study group received oral and written feedback about their performance and suggestions for improvement based on researcher evaluation of their MM content, their progress and the students’ score in tool II. - On the last hospital day posttest were done for both groups by the evaluation of the last nursing care plan by using tool I for both groups and tool II for study group only. Main results of the current study: There was a high statistical significant difference between the study and the control group after using the E-mind map in relation to their clinical judgment skills (p = 0.000). In addition to the mean change and standard deviation of clinical judgment skills in the study group were reported as 18.17±2.49, while in the control group, it was 3.43±2.11. This substantial difference highlights the effectiveness of the intervention (application of EMM) in the study group. There was a high positive correlation between the mean score of the mind map and the clinical judgment skills among the study group over the course of the intervention. The study findings show that throughout the application of EMMs, there was a significant difference in mean score of the four aspects of clinical judgment in the study group before and after the intervention and consequently in the CJS totally mean score and EMM scores which increased progressively from the first week to the last week. Concerning the control group, the results show that there were no significant changes in the mean scores of the noticing and interpreting aspects over the course of the study. However, the mean scores of the responding and reflecting aspects progressed slightly which may be due to that nursing students exposure to various patients or settings ,made them more experienced, promote their ability to respond appropriately and encourage them to engage in self-reflection. The following recommendations are made based on the current study findings: - EMM strategy should be integrated into the curriculum and online courses. - Nurse educators should use EMM in combination with traditional teaching methods. - Nurse educators should use EMM in constructing courses outline and objectives. - Appropriate infrastructure and updated resources to support the successful EMM strategy implementation and educational process. - Specific time during the clinical rotation to take the opportunities for applying the new technologies that improve clinical judgment skills as EMM strategy. - Determine the effect of EMM strategy on students‘ knowledge retention and academic achievement. - Replication of this study on other nursing specialties to ensure results can widely be generalizable. |