Clinical reasoning in experienced nurses
ABSTRACT As an essential component of nursing practice, clinical reasoning is used to assimilate information, analyze data, and make decisions regarding patient care. Little is known about the reasoning strategies of experienced nurses who are not yet experts. This qualitative descriptive study explored the cognitive strategies used by experienced nurses as they considered assessment findings of assigned patients. To date, few studies of nurses' clinical reasoning have been conducted in a practice setting during actual patient care. A small group research design was employed using the think-aloud (TA) method with protocol analysis. A total of 15 experienced nurses were asked to "think aloud" about patient assessment findings. Data were audiotaped, transcribed, and analyzed using the three steps of protocol analysis. The results suggest that experienced nurses used a conceptual language to reason about assessment findings and used heuristics to reason more quickly and efficiently.
Physiotherapy Canada 05/2015; · 0.61 Impact Factor
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ABSTRACT: OBJECTIVE: To propose new criteria for expert selection for validation studies in nursing in Brazil. METHODS: (a) Literature review on terms related to expertise and criteria for expert selection; and (b) development of new consensus criteria for expert selection and consensus building. RESULTS: Definitions for the terms novice, advanced beginner, competent, proficient , and expert were found. In the second phase, criteria to rank the experts (junior, senior, and master) were developed and validated according to a score of 5–20. CONCLUSION AND IMPLICATIONS FOR NURSING PRACTICE: The new criteria valued clinical experience over academic experience. The use of these criteria by researchers in the country should reduce uncertainties, difficulties, and limitations imposed by the modification/current adaptation of already existing criteria. OBJETIVO: Propor novos critérios para seleção de experts para estudos de validação em enfermagem no Brasil. METODOS: (a) Revisão de literatura sobre termos relacionados a expertise e critérios de seleção de experts; (b) elaboração e consenso quanto a novos critérios para seleção de experts. RESULTADOS: Encontraram-se definições para principiante, principiante avancado, competente, proficiente e perito. Foram elaborados critérios classificando os experts em júnior, master e sênior, de acordo com escore de 5 a 20. CONCLUSÃO E IMPLICAÇÕES PARA A PRÁTICA CLÍNICA: Os novos critérios valorizaram experiência clínica sobre a acadêmica. O uso desses critérios por pesquisadores no país deve diminuir incertezas, dificuldades e limitações impostas pela modificação/adaptação de critérios já existentes. Validation studies have been used for the development of nursing science. These studies expose the true value of what they intend to measure, enabling the inference of how much the obtained results represent or not the truth (Polit & Beck, 2014). These results are essential for the improvement of diagnoses, interventions, and outcomes classificaInternational Journal of Nursing Terminologies and Classifications 03/2015; n/a(n/a):n/a. DOI:10.1111/2047-3095.12089 · 0.90 Impact Factor
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ABSTRACT: The study aims to gain an understanding of the concept of decision making as it relates to the nurse practice environment. Rodgers' evolutionary method on concept analysis was used as a framework for the study of the concept. Articles from 1952 to 2014 were reviewed from PsycINFO, Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), JSTOR, PubMed, and Science Direct. Findings suggest that decision making in the nurse practice environment is a complex process, integral to the nursing profession. The definition of decision making, and the attributes, antecedents, and consequences, are discussed. Contextual factors that influence the process are also discussed. An exemplar is presented to illustrate the concept. Decision making in the nurse practice environment is a dynamic conceptual process that may affect patient outcomes. Nurses need to call upon ways of knowing to make sound decisions and should be self-reflective in order to develop the process further in the professional arena. The need for further research is discussed. © 2015 Wiley Periodicals, Inc.Nursing Forum 02/2015; DOI:10.1111/nuf.12119