Clinical Judgements Flashcards
What are three definitions of “critical thinking”?
Purposeful thinking - considering all information before arriving at tentative conclusion.
Exploring with an open mind, engaged reasoning.
Deliberative process of generating, analyzing, and evaluating alternatives.
What are four parts of the metaconcept of critical thinking.
Critical analysis
Clinical reasoning
Clinical judgement
Critical reflection
What are the characteristics of critical thinkers?
Habitually inquisitive Avoids oversimplification Being aware of what one doesn’t know Reflective thinker, independent Open-minded in evaluation Honest in identifying personal biases Proactive vs reactive Diligent, focused in inquiry Persistent in seeking results
What are the characteristics of non-critical thinking/limited thinking?
Non-critical thinking characterized by:
Relying on thoughts of others
Emotion in place of reason
Limited reasoning – blinded by one dominant idea or point of view
What are the 5 steps of Benner’s “Novice to Expert” progression?
Novice Advanced Beginner Competent Proficient Expert
What occurs during the “novice” stage of Benner’s Novice to Expert progression?
Context-free rules
Textbook principles
Practice guided by theory
What occurs during the “advanced beginner” stage of Benner’s Novice to Expert progression?
Clinical situations are seen as sets of tasks
Use standards of care, procedures etc (rules based practice)
Distracted by the need to establish competence
What occurs during the “competent” stage of Benner’s Novice to Expert progression?
Ability to anticipate the likely course of events
Focus switches to clinical situation from task orientation
Holistic orientation
Priority setting is deliberate
What occurs during the “proficient” stage of Benner’s Novice to Expert progression?
Able to read and respond to situations appropriately
Moves from use of quantitative measures to patient particulars to guide judgments
Flexible and responsive to changing situations.
What occurs during the “expert” stage of Benner’s Novice to Expert progression?
Increased intuitive links for each situation
Attends to context and environment
Organization and priority setting do not show up as focal points
What are the four components of critical thinking? (Brookfield 1987)
- Identifying / challenging assumptions
- Understanding the importance of context
- Exploring and imagining alternatives
- Reflecting with an open mind
What is “clinical judgement”?
Clinical judgement “refers to the (reasoning) process by which nurses reach their clinical judgements by choosing what to observe, interpreting the observations and takin appropriate actions by modifying approaches and improvising new ones for patients needs. Responsibility” (Adapted from Tanner, 1998)
What does clinical judgement require?
Requires an ability to critically think.
Requires weighing evidence against expectation, norm, or standard.
What does clinical judgement include?
Includes “thinking-in-action” skills of noticing, interpreting, responding, and “reflection-in-action”
What are six factors influencing clinical judgement?
Nurse’s background Context Relationship with patient Initial grasp of situation Reasoning ability Practical knowledge
