ラサター臨床判断ルーブリック日本語版（LCJR-J）の信頼性と活用可能性の検討

Examining the Reliability and Usability of the Lasater Clinical Judgment Rubric Japanese Version(LCJR-J)

要旨

　目的：ラサター臨床判断ルーブリック日本語版（LCJR-J）の信頼性と活用可能性を検討する．

　方法：学生7名のシミュレーションをLCJR-Jでレーター4名が評価し，レーター間の一致率を算出した．学生は自己評価を行い，学生とレーター間のLCJR-J得点を比較した．活用可能性をグループインタビューし質的帰納的に分析した．

　結果：一致率を算出し，評者間信頼性は許容範囲を示した．LCJR-J得点の有意差は学生とレーター間の「評価・自己分析」以外では認めなかった．活用可能性は学生より【活用によるアドバンテージ】【継続的な学びの過程の可視化】【簡明な評価への志向】【レベルに応じた活用】【ポジティブな表現による学習支援】，レーターより【評価指標としての有用性】【臨床判断の思考の焦点化】【看護実践の開発支援】【臨床シミュレーションの評価】【妥当な評価への志向】を抽出した．

　結論：LCJR-Jの評価は一定の一致率を認め，臨床判断の観点を共有でき，継続的な対話での活用により発達的なルーブリックとして活用可能性を有する．

　Objective: This study examined the reliability and usability of the Lasater Clinical Judgment Rubric Japanese Version(LCJR-J).

　Methods: The simulations of seven students were evaluated by four raters using the LCJR-J, and the rate of agreement between the raters was calculated. The students self-evaluated their simulations, and the LCJR-J scores given by the students and raters were compared. Group interviews were conducted to qualitatively and inductively analyze the LCJR-J's usability.

　Results: Calculating the concordance rate showed that the reliability between raters was within an acceptable range. No significant differences in LCJR-J scores were observed between students and raters, except for "evaluation/self-analysis." Regarding usability, students identified "advantage through utilization," "visualization of the continuous learning process," "inclination toward simple evaluation," "utilization according to level," and "learning support through positive expression." Meanwhile, raters highlighted "usefulness as an evaluation indicator," "focusing on the thought of clinical judgment, " "support of development for nursing practice, " "evaluation of clinical simulation," and "inclination toward valid evaluation."

　Conclusion: The LCJR-J evaluation demonstrates a certain level of concordance, facilitates sharing of clinical judgment perspectives, and has the potential to be used as a developmental rubric through its use in continuous dialogue.