critical thinking
A combination of:
-reasoned thinking
-openness to alternatives
-ability to reflect
-a desire to seek truth
Clinical decision making
-Critical thinking process for choosing best actions to meet a desired goal.
Steps:
-identify problem
-list possible alternatives
-compare, evaluate pros & cons of each
-select best one
-put into action
-evaluate success
intellect
-ability to learn and understand knowledge
-capacity for thinking and reasoning intelligently
creativity
-outlet for imagination
-take what can be seen in mind, make tangible
-finding unique solutions to unique problems
-requires knowledge of problems
inquiry
-search for knowledge or facts
-gain clarification
-find solutions to problems
-different than query: merely asking ?'s or requesting info
reasoning
Deductive:
-top down approach
-start with conclusion
Inductive:
-bottoms up approach
-start w/ significant cues
Clinical:
-ability to reflect on previous situations and decisions
intuition
-gut reaction
-use of nursing knowledge, experience, expertise for understanding without conscious use of reasoning
-process of continual analyzing (clustering patterns, similarities)
- not for novice nurses, students
Clinical types of decisions
-value
-time management
-scheduling
-priority
full spectrum nursing model
-unique blend of thinking, doing, caring for the purpose of affecting good outcomes from a pt. Situation
Salient cues
-Indicate a change in pt. Health status
-varies from norms in pt. Population
-indicates developmental delay
Clinical judgment
Standards based perspective:
-involves algorithms, decision trees, guidelines
-ex. Bls, acls, stroke protocols
Interpretivist perspective:
-life experiences are culturally bound
-interpret experiences on basis of encounters within a given culture
Attributes of clinical judgment
-involves holistic view of pt. Situation
-circular process
-requires reasoning and data interpretation
Clinical reasoning + critical thinking =
Clinical judgment
Concepts in full spectrum nursing
Thinking:
-theoretical knowledge
-Critical thinking
Doing:
-practical knowledge
-nursing process
Caring:
-self knowledge
-ethical knowledge
Patient situation:
-pt. Data
-pt. Preferences
-context
Tanners clinical judgement model
Thinking like a nurse includes:
-different types of knowledge
-length of experience, values, morals
-intuition, knowing the client
-culture of work environment
-reflecting on experiences
Banners skill acquisition model
-differences in judgment between senior nursing students, novice nurses, experienced nurses
-five levels of clinical competence
four progressive changes in levels of competence:
-each builds on previous one
-Critical thinking skills mastered, confidence b