We’ve all been there as nurse educators.

Students are drained. Faculty are tired after bouncing around like a ping-pong ball for several hours. Everyone is looking at the clock, and everyone just wants to go home.

Then comes post-conference.

It can be tempting to shorten it, rush through it, or simply ask students to share what they did that day. But post-conference is one of the most important parts of the clinical experience because it is where experience becomes meaningful learning.

Without post-conference reflection, students may remember the tasks they completed. They gave medications. They performed an assessment. They changed a dressing. They documented their care.

But nursing practice is about much more than completing tasks.

When students reflect on their thinking, they begin to understand the clinical reasoning processes nurses use to make safe clinical judgments. That makes post-conference an opportunity we don’t want to shortchange.

Why Reflection Matters for Clinical Judgment

Tanner’s practice-informed Clinical Judgment Model was derived from almost 200 studies examining clinical judgment in nursing. It identifies four clinical reasoning processes: 

• Noticing
• Interpreting
• Responding
• Reflecting (Tanner, 2006)

That final process, reflection, is especially relevant to post-conference.

After providing care, students need opportunities to look back and think about their decisions. 

• What did they notice? 
• What did the clinical data mean? 
• What action did they take? 
• How did the patient respond? 
• What might they do differently next time?

This is where experience becomes learning.

Tanner’s clinical reasoning processes also provided a foundation for developing the six cognitive skills measured by the NCSBN Clinical Judgment Measurement Model.

But an important distinction exists between these frameworks. The NCSBN model uses psychometric testing language, including terms such as cues and hypotheses. Tanner’s model uses language more closely connected to nursing practice.

The NCSBN did not intend its measurement model to be taught directly to students. Instead, current evidence-based frameworks such as the nursing process and Tanner’s Clinical Judgment Model should be used to teach clinical judgment (NCSBN).

That means we don’t have to teach nursing through the language of a testing model. We can teach nursing the way nursing is practiced.

Practice the Thinking of Practice

Using Tanner’s Clinical Judgment Model as a guide can give post-conference more structure and purpose.

For noticing, consider asking:

• What clinical data was most important? 
• What was less important? 

For interpreting, move beyond simply identifying relevant data and ask:

• What does this information mean? 
• What patterns do you see? 
• What pieces of data fit together?

Students begin putting the clinical puzzle together rather than viewing assessment findings as isolated pieces.

Then move into responding:

• What is the current nursing priority? 
• What is the priority nursing intervention? 
• What is the desired outcome?

Finally, bring students into patient evaluation, or what Tanner’s CJM refers to as reflection in action:

• Was the desired outcome achieved? 
• Did the patient respond as expected or unexpectedly? 

These questions shift post-conference away from simply discussing what students did and toward exploring how they thought.

Evidence to Support

Condren (2025) found statistically significant improvement in clinical judgment when students used open-ended clinical judgment prompts adapted from a KeithRN worksheet based on Tanner’s model in clinical over the course of a semester. The study also identified statistically significant improvement in NCLEX question test scores.

This study reinforced that preparing students for practice using open-ended reflection questions develops clinical judgment skills that may translate to NCLEX success.

Bring Active Learning Into Post-Conference

Post-conference can also become an opportunity for active learning.

Calcagni et al. (2023) identified statistically significant improvement (p < .001) in clinical judgment over a semester through a process in which students gave an oral presentation of their patient using SBAR. Other students listened, took notes, and asked clarifying questions. Faculty then used the discussion to debrief and incorporate aspects of clinical judgment.

By repeatedly creating learning opportunities that repeatedly practice the thinking of practice, we can strengthen and develop clinical judgment competency.

Ask: Who Is the Priority Patient?

Here is another simple strategy that mirrors what nurses do every day and needs to be practiced.

Have students take turns presenting their patients. After three or four presentations, stop and ask:

Who is the priority patient? Who should the nurse see first, and what clinical data supports that decision?

Now students compare patients, identify relevant clinical data, set priorities, and defend their decisions.

That mirrors the prioritization nurses must make at the beginning of every shift and throughout the day as patient conditions change.

It also moves post-conference beyond recounting individual experiences and lets students learn from the patients other students cared for.

Use Case Studies

Case studies bridge theory and practice by immersing students in realistic clinical complexity, providing repeated opportunities to apply knowledge, strengthen clinical reasoning, transfer learning to new patient situations, and ultimately improve patient outcomes (McLean, 2016). 

Practice the clinical reasoning your students may not receive in clinical, or use patient cases relevant to your clinical setting. KeithRN case studies are unique because they replicate clinical realities; they unfold as a nurse experiences real-world care, integrate vital signs and assessment findings, and use open-ended reflection questions based on Tanner’s CJM.

Go Deeper With Structured Reflection

Reflection can also move beyond clinical decisions to professional growth.

Consider asking students:

• What would you do differently next time?
• What additional knowledge or skills do you need?
• How did this experience affect your feelings or values?
• What will you carry forward and do differently for the next patient you care for?

These questions encourage students to think not only about what happened but also about who they are becoming as nurses.

Closing Thoughts

Post-conference doesn’t have to feel like one more obligation to get through at the end of a long clinical day. It can be the place where the clinical day finally comes together.

Students have cared for patients, collected clinical data, made decisions, communicated with members of the healthcare team, and experienced the uncertainty and complexity of nursing practice. Now we can help them make sense of it.

Before your next clinical, choose one of these strategies and put it to use. Teaching nursing exactly as it is practiced in the real world does more than just prepare students for the NCLEX.

It equips them with the critical clinical judgment needed to safely care for patients who might one day be you or your loved ones!

Recommended Resources

• Using Reflection to Develop Clinical Judgment
• How Do You Spell Clinical Judgment? T-A-N-N-E-R
• Rethinking Tanner’s Clinical Judgment Model: Why Knowing the Patient Must Come Before Noticing

References

American Association of Colleges of Nursing. (2021). The essentials: Core competencies for professional nursing education [Executive summary]. https://www.aacnnursing.org/Portals/0/PDFs/Essentials/Essentials-Executive-Summary.pdf

Calcagni, L., Lindell, D., Weaver, A., & Jackson, M. (2023). Clinical judgment development and assessment in clinical nursing education. Nurse Educator, 48(4), 175–181. https://doi.org/10.1097/NNE.0000000000001357

Condren, T. (2025). Clinical Judgment Development Through Model-Based Reflection in Clinical Nursing Education. Nursing education perspectives. 

National Council of State Boards of Nursing. (n.d.). Clinical judgment measurement model. NCLEX. https://www.nclex.com/clinical-judgment-measurement-model.page

McLean, S. (2016). Case-based learning and its application in medical and health-care fields: A review of worldwide literature. Journal of Medical Education and Curricular Development, 39. doi: 10.4137/JMECD.S20377

Tanner, C. A. (2006). Thinking like a nurse: A research-based model of clinical judgment in nursing. Journal of Nursing Education, 45(6), 204–211. https://doi.org/10.3928/01484834-20060601-04