HJAR May/Jun 2026

42 MAY / JUN 2026 I  HEALTHCARE JOURNAL OF ARKANSAS NURSING COLUMN NURSING ing students for clinical practice without hands-on learning. Sadly, in many nurs- ing schools, it’s challenging to obtain true hands-on learning experiences with wound care. Often, it’s the luck of the draw if a student gets a patient with a wound they can assess and provide actual care for. A lack of training experience is very concerning because rates of diabetes, obe- sity, and vascular disease are increasing in Arkansas, and all of those conditions place patients at a high risk for develop- ing non-healing wounds. 1 Since Arkansas is largely rural, many new nurses will find themselves practicing in settings where specialized wound teams aren’t always available, making their individual assess- ment skills and clinical judgment even more critical. One way to ensure our new nurses get opportunities to practice wound care be- fore they are working in the field is by of- fering simulated wound care experiences in the classroom. The value of simulated wound care is heavily supported by liter- ature. A recent study found that simula- tion-based education, including the use of moulage and simulated patients, sig- nificantly enhances students’ wound care knowledge and clinical reasoning. 2 It is also proven that the use of moulage can improve staging accuracy and confidence in wound assessment. 3 An active learning, low-cost wound- building activity to enhance the development of clinical judgment looks like this: Students use a simulated skin mixture, 4 acrylic paints, sand, modeling tools, sponges, and cosmetic supplies such as hair conditioner and colored hair gel to build their own hyper-realistic wounds (see Figures 1 and 2). They can decide for themselves what type of wound to build. Using a reference photo is recommended to ensure accuracy. Once constructed, their peers assess, stage, and develop appropriate care strat- egies for the newly created wounds. Stu- dents can complete the activity while a more traditional lecture is being held. Fac- ulty then facilitates discussion and debrief- ing, encouraging students to use clinical judgment and evidence-based reasoning. During the discussion, students are guid- ed through explaining their assessment findings as well as any intrinsic or extrinsic factors that could affect the overall wound. AS a nursing instructor, I have the privilege of guiding many young students through some of their earliest clinical learning ex- periences, witnessing firsthand the transi- tion from classroom theory to the bedside. However, one of the challenges I continue to observe is the lack of confidence in as- sessing and managing wounds. In many situations, hesitation often stems from the unpredictable nature of clinical rotations; a student’s lack of profi- ciency is not a personal failure but rather a result of a lack of opportunity. These in- consistencies create a “trial by fire” scenar- io once these students enter the workforce, where they are expected to be competent in skin integrity management from day one. Without a controlled environment to practice these high-stakes skills, students often feel overwhelmed by the complexity of real-life wounds. Bringing simulated wound care into the classroom alongside our traditional lec- tures would address this situation. Addressing Gaps in Wound Care Education No matter how many lectures you give, you can never fully prepare nurs- BRIDGING THE CLINICAL GAP: Advancing Clinical Judgment in Future Arkansas Nurses Through Innovative Wound Building