Clinical Decision-making

Course Details

Course Number
Section Number
Fall 2010
Dillard College of Business Administration
Classroom Number
Days & Times

Mondays 3:00pm to 5:50 pm

Dr. Robin Lockhart (view Profile)

Course Attachments


Course Objectives

1.  Apply the theories and concepts learned throughout the program to clinical situations.

2.  Utilize problem-solving approaches in recognizing and meeting patient care needs.

3.  Apply clinical judgment skills in the coordination of patient care.

4.  Implement the nursing role of coordinator of care.

5.  Integrate effective communication, research, and teaching-learning principles in coordinating patient care.

6.  Evaluate effective and non-effective nursing interventions in providing care to patients.

7.  Examine the legal, ethical, cultural, economic, and spiritual issues related to the care of patients.

Course Expectations

Weekly quizzes (Average of 6 highest scores)


Exams (3 at 10% each)

30 %

Competency Transcript

20 %  

HESI Exit Exam





Required Textbooks/Materials


Curriculum Test Code Senior 2 Level, Elsevier: ISBN: 2818390029796


Recommended Textbooks / Materials:








Evolve Reach Comprehensive Review for the NCLEX-RN Examination 2e





Frye’s 3300 Nursing Bullets for NCLEX-RX






Prioritization, Delegation & Assignment





NCLEX-RN 250 New Format Questions




Additional Course Requirements:


1.         Students must maintain satisfactory health as determined by the total faculty consensus.


2.         Clinical performance, campus and/or clinical laboratory, are evaluated. Students are expected to pass both clinical and classroom components of the course. Failure in either one will constitute failure in the course. A course average of at least 74% is required to successfully complete this course.


3.         Students must maintain a current immunization record on file at the Vinson Health Clinic plus proof of a current CPR card, validated Health Insurance and paid Liability Insurance on file with the Wilson School of Nursing secretary during the entire semester. In order to attend class or clinical experiences, each student MUST comply with each of these requirements. 


4.         Four function calculators are allowed during exams. The use of programmable calculators, statistical or graphing calculators and calculators stored on personal data assistant devices are NOT allowed. In addition, sharing a calculator with another student is NOT allowed. Calculators may not make a discernable noise during use.


5.         Students are to notify the course coordinator either by phone or e-mail prior to administration of exams and the competency transcript if the student is unable to attend the administration of these assignments. Failure to comply with this requirement could result in a grade of “0” for the exam or assignment.


6.         Faculty reserve the right to make changes at anytime to this syllabus.


7.         Students will be held accountable for all communications sent by faculty via the course’s WebCT site; therefore, you will be expected to check the site for announcements, assignments, messages, etc. daily. Faculty asks that students use the discussion board or clinical group sites as a means to make a specific request, ask for content clarification, to submit clinical dates…and so forth…rather than using our school/work email addresses.

Grading Standards









64- and below



There will be no rounding of grades.

Course Content:

Weekly Quizzes:

1.         Eight weekly quizzes will be given over the semester.

2.         Weekly quizzes can only be taken during class at the time of administration. There will be no “make up” quizzes.

3.         The two lowest scores on the quizzes will be dropped and the average of the 6 highest scores will be calculated into the overall course score.

4.         Each quiz will consist of 5 dosage calculation problems and one clinical scenario problem.

5.         Weekly quizzes are to reflect the student’s individual effort, therefore collaboration will be considered academic dishonesty.


1.         Three exams will be given over the semester. The dates for these exams are: September 20, 2010; October 1, 2010; and November 1, 2010.

2.         Missed exams can be taken on the make-up exam dates (October 15, 2010 and December 3, 2010 at 1300) providing the student adequately and appropriately notified the course coordinator prior to the administration of the exam that he/she would be absent for the exam.

3.         The exams will consist of clinical scenario problems including problems that might include dosage calculations.

4.         Textbooks and notes maybe used during these exams.

5.         Patient reviews and case studies are available through the Curriculum Test Code to prepare students for this exam.

6.         The exams will be graded using the rubric below.

7.         Exams are to reflect the student’s individual effort, therefore collaboration will be considered academic dishonesty.

Exam and Competency Transcript Grading Rubric






Client safety

Answers place client at a severe risk of harm.





0 points

Answers place client at some risk of harm but other factors included provide some protection from harm.


25 points

Answers maintain client safety.





30 points


Message is incomprehensible.



0 points

Difficult to read but message is understandable.


5 points

Communicates ideas clearly.



10 points

Clinical reasoning

Answers are non-therapeutic and lack evidence of decision-making


0 points

Answers lack evidence of decision-making or are non-therapeutic.



25 points

Answers demonstrate decision-making leading to therapeutic interventions.


30 points

Evidence-based care

Answers are opinion-based and not supported by the evidence.



0 points

Answers are primarily opinion but would be supported by the evidence if used.


25 points

Answers demonstrate use of evidence-based guidelines, textbooks and clinical guides.


30 points

HESI Exam:

1.         The HESI Exit Exam will be administered three times over the semester. The dates for administration are:  September 17, 2010; October 15, 2010; and November 29, 2010.

2.         The student must score at least an 880 on the exam to successfully complete the course. If a score of 880 or higher is not obtained, the course grade for this assignment will be a zero.

3.         Two attempts are included in the cost of the Curriculum Test Code. If the student requires a third attempt, the student will need to pay an additional charge.

4.         Practice tests are available through the Curriculum Test Code for students to prepare for this exam.

5.         The highest weighted conversion score of the exam will be used in calculating the course average as described under evaluation methods.

Competency Transcript:

1.         The competency transcript will be administered on November 22, 2010.

2.         The transcript will be graded using the exam rubric.

3.         The competency transcript consists of 13 clinical scenarios.

4.         Textbooks and notes maybe used during this assignment.

5.         Missed assignment can be taken on the make-up exam date (December 3, 2010 at 1300) providing the student adequately and appropriately notified the course coordinator prior to the administration of the assignment that he/she would be absent for the assignment.

6.         The competency transcript is to reflect the student’s individual effort, therefore collaboration will be considered academic dishonesty.

Submission Format Policy

Note: You may not submit a paper for a grade in this class that already has been (or will be) submitted for a grade in another course, unless you obtain the explicit written permission of me and the other instructor involved in advance.

Late Paper Policy

Plagiarism Policy

Plagiarism is the use of someone else's thoughts, words, ideas, or lines of argument in your own work without appropriate documentation (a parenthetical citation at the end and a listing in "Works Cited")-whether you use that material in a quote, paraphrase, or summary. It is a theft of intellectual property and will not be tolerated, whether intentional or not.

Student Honor Creed

As an MSU Student, I pledge not to lie, cheat, steal, or help anyone else do so."

As students at MSU, we recognize that any great society must be composed of empowered, responsible citizens. We also recognize universities play an important role in helping mold these responsible citizens. We believe students themselves play an important part in developing responsible citizenship by maintaining a community where integrity and honorable character are the norm, not the exception.

Thus, We, the Students of Midwestern State University, resolve to uphold the honor of the University by affirming our commitment to complete academic honesty. We resolve not only to be honest but also to hold our peers accountable for complete honesty in all university matters.

We consider it dishonest to ask for, give, or receive help in examinations or quizzes, to use any unauthorized material in examinations, or to present, as one's own, work or ideas which are not entirely one's own. We recognize that any instructor has the right to expect that all student work is honest, original work. We accept and acknowledge that responsibility for lying, cheating, stealing, plagiarism, and other forms of academic dishonesty fundamentally rests within each individual student.

We expect of ourselves academic integrity, personal professionalism, and ethical character. We appreciate steps taken by University officials to protect the honor of the University against any who would disgrace the MSU student body by violating the spirit of this creed.

Written and adopted by the 2002-2003 MSU Student Senate.

Students with Disabilities

The Americans with Disabilities Act (ADA) is a federal anti-discrimination statute that provides comprehensive civil rights protection for persons with disabilities. Among other things, this legislation requires that all students with disabilities be guaranteed a learning environment that provides for reasonable accommodation of their disabilities. If you believe you have a disability requiring an accommodation, please contact the Disability Support Services in Room 168 of the Clark Student Center, (940) 397-4140.

Safe Zones Statement

The professor considers this classroom to be a place where you will be treated with respect as a human being - regardless of gender, race, ethnicity, national origin, religious affiliation, sexual orientation, political beliefs, age, or ability. Additionally, diversity of thought is appreciated and encouraged, provided you can agree to disagree. It is the professor's expectation that ALL students consider the classroom a safe environment.

Contacting your Instructor

All instructors in the Department have voicemail in their offices and MWSU e-mail addresses. Make sure you add your instructor's phone number and e-mail address to both email and cell phone lists of contacts.

Attendance Requirements

Other Policies

Clinical Content


1.         Each student will be required to complete 60 clinical hours with a preceptor, 12 clinical hours in the simulation lab, 6 clinical orientation hours and 12 hours completing two clinical assignments.

2.         12 hours of precepted clinical experience must be completed by September 28, 2010, 36 hours must be completed by October 26, 2010 and 60 hours must be completed by November 23, 2010.

3.         The student is to work with the preceptor(s) to develop a clinical schedule. That schedule is to be submitted to the Clinical Instructor and written approval received from the Clinical Instructor prior to the student attending any clinical experiences. Failure to receive written approval for the experience will result in rejection of the clinical hours completed. If any changes need to be made to the submitted schedule, the student is to notify the Clinical Instructor in advance of the change being made and receive written approval. If a student must miss a scheduled clinical, then the student is responsible for notifying the preceptor and the Clinical Instructor prior to the scheduled experience.

4.         The student is to complete a Student Clinical Assignment by October 4, 2010 and by November 29, 2010. This assignment is located on WebCT under the Assignment tab. A faculty member will grade the assignment using the rubric posted on WebCT. The completed assignment serves as the student’s mid-term and end-of-course clinical evaluations.

5.         The student is to complete an evaluation of the preceptor using the Assessment Function in WebCT by November 29, 2010.

6.         Clinical instructors will periodically visit the student and his/her preceptor.


Clinical Simulation Lab


1.         Students will complete three clinical simulations at the Regional Simulation Center for a total of 10 hours plus 2 hours for preparation for the first simulation experience.

2.         Students will sign up for three separate visits to the simulation center.

3.         Students will complete assigned readings for the first experience and two clinical hours will be awarded for this assignment.

4.         Students are expected to bring equipment needed to provide patient care and to have the resources they would normally use during a clinical experience.      

5.         Students who are late to the simulation lab will be considered absent. Absences may be rescheduled depending on space availability. If it is not possible to reschedule a simulation experience, the student may elect to complete additional patient care experiences to obtain clinical hours.


Clinical Failure:


1.         Clinical failures are awarded students who fail to meet the objectives of the clinical experience, students who fail to uphold the ANA Practice Standards and the ANA Code of ethics, students who fail to maintain patient safety, and students who fail to complete all of their clinical hours.


2.         Scoring a “0” on any component of the Student Clinical Assignment will constitute clinical failure. If a “0” is scored on any component on the mid-semester submission of the Student Clinical Assignment, the student may improve for the final submission (except if committed sufficient clinical infractions to warrant clinical failure). If a “0” is scored on any component of on the final submission, the student fails the clinical component of the course.


3.         Each student will receive a mid-term and final clinical evaluation of the student’s performance using the Student Clinical Assignment posted on WebCT.


Infractions constituting clinical failure:




Failure of the clinical component of the course occurs when the student receives an unsatisfactory rating in any area of the evaluation tool or does not complete 90 hours of clinical. Absences will be rescheduled at the discretion of the course coordinator. 


Certain behaviors result in an unsatisfactory rating in the professional behavior section of the evaluation rubric.


Three incidents of infractions to the standard of professional behavior to include but not limited to:


  • Arriving to a clinical experience without completing the pre-clinical assignment even if allowed to stay in the clinical
  • Not conforming to the dress code even if allowed to stay in the clinical
  • Not bringing appropriate supplies to the clinical experience even if allowed to stay in the clinical
  • Unprofessional/inappropriate language or gestures
  • Unprofessional/inappropriate behavior such as disrespectful behavior, chewing gum, using tobacco products in non-smoking areas, disruptive behavior, or failure to comply with a written or verbal instruction including reminders to update immunizations and other clinical requirements
  • Arriving late to any clinical site even if allowed to stay in the clinical
  • Non-compliance with the policy to notify the instructor and the agency of a clinical absence prior to the absence or as soon as possible if immediate notification is not possible
  • Leaving the premises without permission from the clinical instructor
  • Failure to complete assignments by the due dates
  • Failure to return from meals or breaks at the assigned time
  • Falsification, omissions, and/or lying about a non-patient care situation
  • Use of a cell phone for calling, texting, e-mailing or receiving calls, texts or e-mails in the clinical area unless given permission by the clinical instructor


Two incidents of infractions to the standard of professional behavior to include but not limited to:


  • Disregarding patient confidentiality without malice or intent to disclose
  • Patient negligence that does not result in patient injury
  • An error in care that does not harm a patient
  • Committing two infractions from the list above as well as one in this list


Infractions to the standard of professional behavior that results in immediate failure of the clinical component of the course to include by not limited to:


  • Administering medications without the direct supervision of a faculty member or preceptor
  • Failing to check two patient identifiers prior to administering medications.
  • The smell of alcohol on the breath
  • Testing positive for illicit drugs or alcohol
  • An error in care or patient negligence that harms a patient
  • Falsification, omissions, and/or lying about a patient care situation
  • Intentionally revealing confidential information
  • Placing self, staff or patient at risk of harm due to abandonment of duties and/or sleeping during clinical experiences
  • Cheating, collusion, plagiarism, or stealing. Cheating/collusion/plagiarism – cheating means intentionally using or attempting to use unauthorized materials, information, or study aids in any academic exercise; collusion means the unauthorized collaboration with another person in preparing work offered for credit; plagiarism means intentionally representing the words or ideas of another as one’s own in any academic exercise.
  • Performing in an unsafe manner.
  • Failure to report a patient care error or incident.
  • Physical or verbal abuse of patients, patient’s family members, faculty or staff

Writing Proficiency Requirement

All students seeking a Bachelor's degree from Midwestern State University must satisfy a writing proficiency requirement once they've 1) passed the 6 hours of Communication Core and and 2) earned 60 hours. You may meet this requirement by passing either the Writing Proficiency Exam or English 2113. Please keep in mind that, once you've earned over 90 hours, you lose the opportunity to take the $25 exam and have no option but to enroll in the three-credit hour course. If you have any questions about the exam, visit the Writing Proficiency Office website at, or call 397-4131.

Campus Carry

Senate Bill 11 passed by the 84th Texas Legislature allows licensed handgun holders to carry concealed handguns on campus, effective August 1, 2016. Areas excluded from concealed carry are appropriately marked, in accordance with state law. For more information regarding campus carry, please refer to the University’s webpage at

If you have questions or concerns, please contact MSU Chief of Police Patrick Coggins at