Factors Affecting the Development of Clinical Judgment in Nursing Students: A Systematic Review

Document Type : Review Article

Authors

1 Student Research Committee, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

2 Professor, Nursing and Midwifery Care Research Center, and Medical Sciences Education Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

10.22038/nnj.2025.91926.1521

Abstract

Background and Aims: Accurate clinical judgment is an essential skill for nurses, enabling them to provide safe and effective patient care. This study aimed to identify factors influencing clinical judgment among nursing students.
Materials and Methods: This systematic review was conducted in accordance with PRISMA guidelines. Searches were performed in PubMed, Web of Science, and Scopus databases for studies published between 2015 and 2025. Inclusion criteria comprised cross-sectional and analytical studies involving nursing students that examined factors affecting clinical judgment. Study quality was assessed using the STROBE tool.
Results: Of 132 initially identified articles, 14 studies were included in the final analysis. Factors influencing clinical judgment were classified into three main categories: (1) individual student characteristics, including critical thinking, problem-solving skills, metacognitive regulation, emotional intelligence, and personality traits; (2) environmental/situational factors, including clinical learning environment quality, task complexity, time pressure, and workload; (3) educational/organizational factors, including curriculum, teaching methods, simulation, and professional support.
Conclusion: The development of clinical judgment requires a comprehensive approach that simultaneously addresses individual characteristics, environmental context, and educational policies. Revision of nursing education programs and increased use of simulation-based education are essential.

Keywords

References

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Navid No
Volume 28, Issue 96
March 2026
Pages 88-103

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