Tanner's model of clinical judgement

Question 1

4 aspects of the model

in order

Answer 1

1. noticing
2. interpreting
3. responding
4. reflecting

Question 2

noticing

Answer 2

-** expectations** of situation and** initial grasp** (may or may not be explicit)
- about understnding if expectations the nurse has have been met

Question 3

expectations

part of “noticing”

Answer 3

• stem from knowledge of patient and their response
• textbook knowledge
• knowledge from similar experiences

Question 4

factors that shape noticing of a situation

3

Answer 4

context, background, relationship

Question 5

Interpreting

definition

Answer 5

noticing triggers reasoning pattern which yields interpreting in order to respond

Question 6

what interpretation entails

Answer 6

• hypotheses
• when assessments are done to rule out different hypotheses and determine response
• reasoning pattern
• intuitive

Question 7

Responding

bassically part of interpreting

Answer 7

action and outcomes
- reflection in action

Question 8

Reflection

Answer 8

in and on action
- involves responsibility for actions

Question 9

reflection in action

Answer 9

nurses ability to “read” the patient, how the patient is responding, and adjusting based on assessment
- not obvious

Question 10

reflection on action

Answer 10

experience contributes to clinical knowledge and development
- completes the cycle

Question 11

knowledge outcomes

part of reflection

Answer 11

knowing what occured as a result of nursing actions

Question 12

patterns of reasoning depend on

Answer 12

• initial grasp of situation
• demands of the situation
• goals of practice

Question 13

analytic process

a pattern of reasoning

Answer 13

breaks down a situation into its elements
- generation of alternatives and weighing the alternatives with likelihood of achievement
- one approach is diagnositc reasoning

Question 14

analytic processes are typically used when …

Answer 14

• there is a lack of essential knowlegde
• mismatch between what is expected and what happens
• multiple options are available

Question 15

Intuition

a pattern of reasoning

Answer 15

immediate apprehension of a clinical situation
- a function of experience with similar situations
- apprehension is often recognition of a pattern

Question 16

Narrative thinking

a pattern of reasoning

Answer 16

paradigmatic thinking and narrative thinking
- how human beings make sense of and explain
what they see

Question 17

paradigmatic thinking

narrative thinking (pattern of reasoning)

Answer 17

making sense of something by seeing it as an instance of a general type

Question 18

narrative thinking

narrative thinking (pattern of reasoning)

Answer 18

trying to understand
the particular case and is viewed as human beings’ primary way of making sense of experience
- creates deep background understanding of patient as a person
- important for reflection