新人看護師の臨床判断における経験と期待される能力：スコーピングレビュー

Experience and Required Abilities of New Graduate Nurses in Clinical Judgment: A Scoping Review

要旨

　目的：新人看護師の臨床判断に関する文献を包括的にレビューし，臨床判断の経験および期待される臨床判断能力を明らかにする．

　方法：PRISMA-ScRに基づくスコーピングレビューを実施した．PubMed，CINAHLなどのデータベースを使用し，一般病棟での新人看護師の臨床判断に関する研究を対象とした．

　結果：15件の文献が採用され，新人看護師の臨床判断の経験として，【患者が表出する反応への臨床判断】【看護ケア実施場面での臨床判断】【安全をまもる場面での臨床判断】【臨床判断のための情報収集と報告】が抽出された．期待される臨床判断能力は，立場や役割により水準が異なった．

　結論：新人看護師の臨床判断の経験と期待される能力が明らかになり，現実的で段階的な教育設計への示唆が得られた．今後は多角的手法による発達段階の解明と，発達段階に応じた具体的指標の開発が必要である．

　Objective: This study aimed to comprehensively review literature on clinical judgment among new graduate nurses and clarify their experiences and expected competencies in clinical judgment.

　Methods: A scoping review was conducted following the PRISMA-ScR. Literature searches were performed using databases, such as PubMed and CINAHL, targeting studies on clinical judgment among new graduate nurses in general hospital wards.

　Results: Fifteen studies were included in the analysis. Four categories of clinical judgment experiences were identified: [Clinical judgment for patient-expressed responses], [Clinical judgment in nursing care implementation], [Clinical judgment for safety protection], and [Information gathering and reporting for clinical judgment]. Expected competencies included patient information gathering, needs assessment, and appropriate intervention selection, although expectation levels varied by organizational position and roles.

　Conclusions: This review clarified experiences and expected competencies of clinical judgment among new graduate nurses, providing insights for realistic and progressive educational program design. Future research requires detailed investigation of developmental stages through multifaceted approaches and development of specific indicators according to these developmental stages.