Clinical reasoning: concept analysis
- 1 April 2010
- journal article
- review article
- Published by Wiley in Journal of Advanced Nursing
- Vol. 66 (5), 1151-1158
- https://doi.org/10.1111/j.1365-2648.2010.05262.x
Abstract
This paper is a report of a concept analysis of clinical reasoning in nursing.Clinical reasoning is an ambiguous term that is often used synonymously with decision-making and clinical judgment. Clinical reasoning has not been clearly defined in the literature. Healthcare settings are increasingly filled with uncertainty, risk and complexity due to increased patient acuity, multiple comorbidities, and enhanced use of technology, all of which require clinical reasoning. Data sources. Literature for this concept analysis was retrieved from several databases, including CINAHL, PubMed, PsycINFO, ERIC and OvidMEDLINE, for the years 1980 to 2008.Rodgers's evolutionary method of concept analysis was used because of its applicability to concepts that are still evolving.Multiple terms have been used synonymously to describe the thinking skills that nurses use. Research in the past 20 years has elucidated differences among these terms and identified the cognitive processes that precede judgment and decision-making. Our concept analysis defines one of these terms, 'clinical reasoning,' as a complex process that uses cognition, metacognition, and discipline-specific knowledge to gather and analyse patient information, evaluate its significance, and weigh alternative actions.This concept analysis provides a middle-range descriptive theory of clinical reasoning in nursing that helps clarify meaning and gives direction for future research. Appropriate instruments to operationalize the concept need to be developed. Research is needed to identify additional variables that have an impact on clinical reasoning and what are the consequences of clinical reasoning in specific situations.Keywords
This publication has 39 references indexed in Scilit:
- Debriefing with the OPT Model of Clinical Reasoning during High Fidelity Patient SimulationInternational Journal of Nursing Education Scholarship, 2008
- Nurses’ reasoning process during care planning taking pressure ulcer prevention as an example. A think-aloud studyInternational Journal of Nursing Studies, 2007
- Using the Revised Bloomʼs Taxonomy in the Clinical LaboratoryNurse Educator, 2005
- Promoting Clinical Reasoning in Undergraduate Nursing Students: Application and Evaluation of the Outcome Present State Test (OPT) Model of Clinical ReasoningInternational Journal of Nursing Education Scholarship, 2005
- Modelling novice clinical reasoning for a computerized decision support systemJournal of Advanced Nursing, 2004
- Some surprising similarities in the clinical reasoning of‘expert’ and ‘novice’ orthopaedic nurses: report of a study using verbal protocols and protocol analysesJournal of Advanced Nursing, 1995
- Heuristics reasoning in diagnostic judgmentJournal of Professional Nursing, 1995
- Clinical reasoning in nursing*Journal of Advanced Nursing, 1988
- FROM NOVICE TO EXPERTThe American Journal of Nursing, 1984