NSG 298 Unit 8 error pattern portfolio example

Three Named Patterns, Each Testable, and the Evidence For and Against Them: An Error Pattern Portfolio at the End of Twelve Weeks of Review

Student Name

Department of Nursing, Herzing University

NSG 298: Review of Nursing Concepts

Instructor Name

March 5, 2026

Three Named Patterns, Each Testable, and the Evidence For and Against Them: An Error Pattern Portfolio at the End of Twelve Weeks of Review

The Findings

Pattern 1: When a situation includes an abnormal number and an unexplained change in a person, I choose the number, even when the change is the more dangerous finding.

Pattern 2: When a sequence includes both a protective action, such as calling for help or keeping a line open, and an assessment, I put the assessment first.

Pattern 3: I read past qualifiers such as "first," "immediate," or "most important," and answer the question of what is concerning rather than what must be done now.

A fourth pattern, dropping units in calculations, was found early and appears to have been corrected; its evidence is summarized at the end.

Each pattern is written so that it could be shown to be wrong: if a new set of items contains many chances to make the error and I do not make it, the pattern is either gone or was never real.

Pattern 1: Evidence

For: Unit 1, Item 1, where I chose the patient with a glucose of 190 over the restless patient after surgery; Unit 4, Entry 2, where the concept of mental-state change as an early warning had to be named explicitly; four misses in management of care between weeks 1 and 5 recorded in the gap map (Unit 5) with the same shape.

Against: in weeks 6 to 8, management of care rose from 73% to 79% on 48 items, and only one recent miss had this shape.

Status: probably weakening. The clinical judgment model separates recognizing cues from analyzing them (Dickison et al., 2019); this pattern was a failure to treat a behavioral change as a cue at all, and naming it seems to have helped.

Pattern 2: Evidence

For: Unit 2, Rows A and B, assessing before protecting access and before calling for help; four recent misses in physiological adaptation and maternal-newborn items (Unit 6).

Against: Unit 2, Row D, where my order matched; the unit's delegation items, where I did not delay handing off routine work.

Status: still active. It appears in emergencies more than in routine care, which suggests it is tied to a habit of wanting more information before acting. That habit is useful in stable situations and costly in unstable ones.

Pattern 3: Evidence

For: Unit 1, Item 5, the chest tube item; six of the 31 misses in weeks 6 to 8 turned on a qualifier (Unit 6); two qualifier errors in the week 12 timed set.

Against: the qualifier drill in session 9-3 (Unit 7), where I missed only 2 of 25 items when circling the qualifier first.

Status: active under time pressure, controlled when I slow down. The drill result suggests the fix works when used, and the timed-set errors suggest I stop using it when rushed.

Pattern 4, Corrected: Dropped Units

Unit 3 traced four calculation errors to lines where I stopped writing units. After I began writing units on every line, one calculation error appeared in 12 items in weeks 6 to 8, and none in the 10 calculations in session 11-1. The pattern is recorded as corrected, with the caution that the numbers are small.

Patterns Considered and Rejected

Two other patterns were proposed during the term and rejected on the evidence. The first was that I do poorly on pharmacology because I do not know the drugs. The breakdowns showed that most pharmacology misses involved drugs I could describe correctly; the errors were in recognizing a risk, which belongs to Pattern 1 and to the dropped-units pattern, not to missing knowledge. The second was that I do poorly on long items. When the week 12 timed set was sorted by item length, my accuracy on the longest third was the same as on the shortest third. Both rejected patterns are kept in the portfolio so that the three that remain can be seen to have survived a test that others failed.

What the Portfolio Changes

The three active patterns share a root: acting on the most familiar or most striking feature of a situation rather than on the feature the situation asks about. That is a reading habit more than a knowledge gap, which is why practice by content category alone did not fix it. The remaining weeks before the licensure examination will use two habits: circling the qualifier before reading the options, and asking "what could harm this patient soonest?" before choosing. Noticing and interpreting are the steps where these patterns begin, in the model of clinical judgment taught in this program (Tanner, 2006). Practice will continue to be spaced and mixed across categories (Dunlosky et al., 2013), and each pattern will be retested on a fresh set of 30 items two weeks before the examination.

References

Dickison, P., Haerling, K. A., & Lasater, K. (2019). Integrating the National Council of State Boards of Nursing clinical judgment model into nursing educational frameworks. Journal of Nursing Education, 58(2), 72-78. https://doi.org/10.3928/01484834-20190122-03

Dunlosky, J., Rawson, K. A., Marsh, E. J., Nathan, M. J., & Willingham, D. T. (2013). Improving students' learning with effective learning techniques: Promising directions from cognitive and educational psychology. Psychological Science in the Public Interest, 14(1), 4-58. https://doi.org/10.1177/1529100612453266

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