208 Concept: Clinical Judgment: topic: clinical reasoning

Question 1

Describe the meaning of critical thinking.

Answer 1

Critical thinking is thinking about your thinking while you are thinking. This is usually with a focus of being more deliberate and active in your thinking to produce better and more analytical thought results. It evaluates the whole pictures and challenges initial conclusions to see if there are alternatives and viewpoints not initially considered.

Question 2

Describe what clinical reasoning is and how it is different than critical thinking?

Answer 2

Clinical reasoning describes the process by which nurses (and other clinicians) collect cues, process the information, come to an understanding of a patient problem or situation, plan and implement interventions, evaluate outcomes, and reflect on and learn from the process.

Clinical reasoning integrates critical thinking and expands upon it to make it relevant to a clinical setting.

Question 3

What are the stages of the clinical reasoning cycle?

Answer 3

1. Consider the patient situation.
2. Collect cues/information.
3. Process information.
4. Identify problems/issues.
5. Establish goal(s).
6. Take action
7. Evaluate outcomes
8. Reflect on process and new learning.

Question 4

What is involved in the clinical reasoning cycle stage of ‘Consider the patient situation’?

Answer 4

Describe or list facts, context, objects or people.

Question 5

What is involved in the clinical reasoning cycle stage of ‘Collect cues/information’’?

Answer 5

Review current info (e.g. handover reports, patient history, patient charts, results of investigations and nursing/medical assessments previously undertaken)

Gather new info (e.g. undertake patient assessment)

Recall knowledge (e.g. physiology, pathophysiology, pharmacology, epidemiology, therapeutics, culture, context of care, ethics, law, etc.)

Question 6

What is involved in the clinical reasoning cycle stage of ‘Process information’’?

Answer 6

Interpret: analyse data to come to an understanding of signs or symptoms. Compare normal vs abnormal.

Discriminate: distinguish relevant from irrelevant information; recognise inconsistencies, narrow down the information to what is most important and recognise gaps in cues collected.

Relate: discover new relationships or patterns; cluster cues together to identify relationships between them.

Infer: make deductions or form opinions that follow logically by interpreting subjective and objective cues; consider alternatives and consequences.

Match current situation to past situations or current patient to past patients (usually an expert thought process)

Predict an outcome (usually an expert thought process)