Clinical Decision Cards

💡 Instructions and Ideas

You want your clinical days to be rich with learning—full of moments where students connect theory to practice and build confidence in their clinical judgment. But some days, everything goes smoothly.

Patients are stable, complications are minimal, and students go through the motions without much challenge.

On those days, how can you create meaningful opportunities for students to strengthen their clinical judgment?

Helping students prepare for the unexpected is a crucial part of your role as a nurse educator.

The Clinical Decision Cards you have in hand are a fantastic way to build more clinical judgment opportunities.  


Here is how to get started:

  1. Pick a Card

    Students pick a card containing abnormal assessment findings or clinical red flags.

2. Uncover New Clinical Information

Using their assigned patient from clinical, lab or a case study, they imagine caring for them with the new information from the card.

3. Complete a Care Plan

Students create a plan of care based on this new abnormal assessment that includes their nursing interventions, teaching plan or evaluation techniques.

4. Upon Completion

Students have demonstrated clinical judgment and decision-making when presented with abnormal or unexpected findings.

Care Planning Template

You can certainly use your school’s care planning paperwork, but if you need a quick template, feel free to download this care planning template.

More Ideas

1. Rapid Response Relay 🏎️

Divide students into small teams and line them up for a relay. At the front of each line is a clinical decision card turned face-down. One student from each team flips their card and has 60 seconds to:

  • Identify the abnormal finding,

  • Suggest one priority nursing action,

  • Pass it back to their team to add one additional consideration (e.g., related pathophysiology, likely provider orders, or labs to monitor).

Continue the relay until all team members have contributed. Debrief as a class with the most well-rounded or accurate team sharing their rationale.

💡 This adds time pressure and collaboration, making the activity fast-paced and focused on priority setting and teamwork—mirroring real-world clinical urgency.

2. Story Builder: "How Did We Get Here?" 📖

Each small group receives one card. Their task is to work backwards—they must create a short, logical narrative that leads up to the abnormal finding on their card. This includes:

  • The patient’s history or risk factors,

  • Possible missed assessments or red flags,

  • Earlier symptoms or trends that would have signaled the problem.

Bonus: Have each group share their story with the class and have others guess the final assessment finding.

💡 It strengthens students’ ability to connect assessment to etiology, promotes clinical reasoning, and reinforces illness progression.

3. Priority Ladder 🪜

Post 5–6 different cards around the room. Ask students to rotate in small groups and rank each finding on a scale from 1 to 5 based on urgency or priority for action. After everyone rotates, return to each station for a group discussion and compare rankings. Prompt: “What would make this higher or lower priority?”

💡 It practices priority setting, introduces variability in patient context, and invites critical discussion around nuance— which is key NCLEX-level thinking.

4. The “Wrong Chart” Challenge 🚩

Give students a patient scenario (age, diagnosis, vitals, recent labs) that seems stable. Then, introduce a clinical decision card that doesn’t seem to match the picture. Their job: determine whether this card is a documentation error, a sudden change, or a hidden trend—and justify their decision.

Follow-up: Ask what their next action would be (reassess, notify provider, escalate care).

💡 This activity encourages students to question and investigate discrepancies—skills essential in real practice.

5. Clinical Corners ‼️

Designate four corners of the classroom as follows:

  • A: This is a normal finding

  • B: Assess more before acting

  • C: Requires prompt nursing action

  • D: Notify the provider immediately

Shuffle and display one clinical decision card at a time. Students walk to the corner that best matches their clinical judgment. Once everyone chooses a corner, prompt volunteers from each group to explain their reasoning. Then reveal the best clinical approach and discuss subtle differences.

Optional: Occasionally present borderline or context-dependent findings to spark deeper discussion (e.g., "Is this bradycardia okay in a patient with CHF who is taking beta-blockers?").

💡 This adds movement, peer discussion, and real-time decision-making, helping students practice recognizing patterns and defending their clinical choices.

Have you used the clinical decision cards in other creative ways?

Let me know, I would love to hear from you!