Tanner: Clinical Judgement Model Flashcards
Which 3 aspects are central to influencing how nurses notice, respond, and reflect?
- Nurses background
- Situational context
- Relationship with pt
TRUE OR FALSE:
The complexity of clinical judgement is due to the ambiguity of situations that is typically full of complicated disease implications that patients struggle to live with.
FALSE
The complexity of clinical judgement is due to the ambiguity of situations that is typically full of VALUE CONFLICTS and COMPETING INTERESTS of individuals, as well as other complicated factors.
Good clinical judgement in nursing requires understanding of both the disease (patho) and the _________ (pt view of symptoms and suffering).
Illness experience
1 - Clinical judgement are influenced more by __________ than the situation’s objective data.
Five conclusions of Tanner:
what the nurse brings to the situation
their philosophical perspectives; values/ethics; knowledge; intuition - or lack thereof; etc.
2 - Sound clinical judgement rests, to some degree, on knowing the pt and their ______, and _____ with their concerns.
Five conclusions of Tanner:
Responses; engagement
What are the 4 aspects of the clinical judgement model?
- Noticing
- Interpreting
- Responding
- Reflecting
The process by which nurses make their judgement, including creating alternatives and weighing them against evidence, choosing what’s appropriate and those engaged, practical reasoning patterns.
What am I?
Clinical reasoning (Tanner)
3 - Clinical judgments are influenced by the _____ of the situation and the ______ of the nursing unit.
Five conclusions of Tanner:
Context; culture
4 - Nurses use a variety of ____ _____ alone or in combination for decision-making.
Five conclusions of Tanner:
Reasoning patterns
Which of the five are NOT one of the reasoning patterns discussed by Tanner?
a. Intuition
b. Analytic processes
c. Narrative thinking
d. Detective work (modus-operandi)
e. Creative thinking
e. creative thinking
Analytic processes is a reasoning pattern used by….
a. involved family members
b. disengaged physicians
c. novice nurses
d. acute care patients
c. novice nurses
Intuition is often characterized by ______
a. immediate apprehension
b. emotional intelligence
c. a “gut feeling”
a. immediate apprehension
often intuition is a result of having a previous similar experience; it’s a result of recognizing a pattern
5 - Reflection on practice is often triggered by _________ in clinical judgment. It is critical in developing clinical ______ and improving clinical ______.
Five conclusions of Tanner:
breakdown ;
knowledge ;
reasoning
Name 5 factors that influence nurses’ noticing.
- KNOWLEDGE of particular pt
- nurse’s VISION of excellent practice
- VALUES r/t pt situation
- WORKPLACE CULTURE and patterns of care
- COMPLEXITY of work environment
When noticing, factors like background, context, and relationship with pt, along with expectations for the pt shape the nurse’s ___________
initial grasp
Nurse’s noticing/initial grasp triggers ______, which allows the nurse to interpret and respond to the situation.
a. intuition
b. clinical reasoning
c. reasoning patterns
c. reasoning patterns
such as analytic, intuitive or narrative!
TRUE OR FALSE:
The act of assessing and intervening (interpreting and responding) both SUPPORT AND IS A RESULT OF clinical reasoning.
True
What are the two types of Reflection according to Tanner’s clinical judgment model?
Reflection-IN-action
(nurse ability to “read”/assess/recognize pt response to interventions and adjust appropriately)
Reflection-ON-action
(the “bigger picture”; developing clinical knowledge and capacity for clinical judgment in future situations)
SATA:
Reflection-on-action completes the clinical judgment cycle and…
a. requires a sense of responsibility
b. allows nurses to “read” their patients
c. requires knowledge outcomes
d. contributes to ongoing knowledge and clinical judgment development
A, C, D
“Noticing” is about… (3)
- Observations
- Knowledge
- Nurses experiences
