Sherpath Ch 16: Into to Clinical Judgement Measurement Model Flashcards
Clinical Judgment Measurement Model (CJMM)
Assessment - Recognize Cues
Analysis - Analyze Cues and Prioritize Hypotheses
Planning - Generate Solutions
Implementation - Take Action
Evaluation - Evaluate Outcomes
Internal vs External Contextual Factors that can influence the nurse’s ability to apply clinical judgement skills
Internal contextual factors: education, experience, knowledge, communication, consequences/risks, emotions/perceptions
External contextual factors: distractions, interruptions, time pressures, task complexity, professional autonomy
layers of CJMM
Observation:
Layer 0: Client needs (initiate the process of clinical judgment) and clinical decisions (end the process of clinical judgment)
Cognitive Operations:
Layer 1: Clinical judgment, defined by the observable aspects from layer 0 and the unobservable cognitive aspects of layers 2 and 3
Layer 2: Process related to hypotheses that can be repeated to improve outcomes; three cognitive functions identified (form, refine, and evaluate hypotheses)
Layer 3: Identifies six specific operations to complete each function identified in layer 2, that is, prioritizing hypotheses and generating solutions (operations identified in layer 3) are necessary to refine hypotheses (function identified in layer 2)
Contextual Factors:
Layer 4: Outlines contextual factors that can influence cognitive operations throughout the CJMM.
-not linear progress
Layer 0 of CJMM
observation layer
-clinical needs
-clinical decisions
layer 1 of CJMM
a cognitive layer of the CJMM that reflects clinical judgment as a single entity
layer 2 of CJMM
represents a cyclical, or recurring, process of three cognitive operations: forming hypotheses, refining hypotheses, and evaluating outcomes
layer 3 of CJMM
Recognize and analyze cues (to form hypotheses in layer 2), prioritize hypotheses and generate solutions (to refine hypotheses in layer 2), and take actions and evaluate outcomes (to complete the evaluation process in layer 2)