A descriptive analysis of experienced nurses' clinical reasoning during a planning task.

A Think Aloud (TA) method was employed to collect verbal data from seven clinical nurses as they reviewed a written case study and formulated a plan of care. Protocol Analysis (PA) of the verbal data resulted in a visual representation of each subject's plan of care and provided information regarding the clinical data that subjects used to plan care. The results demonstrated that frequently problems and interventions were inextricably linked and considered in unison rather than during separate steps of a planning process. This finding has implications relative to the current practice within both nursing education and nursing service of focusing on problems and interventions separately when planning care.

[1]  B. Kuipers,et al.  Critical Decisions under Uncertainty: Representation and Structure , 1990, Cogn. Sci..

[2]  S. Corcoran,et al.  Task Complexity and Nursing Expertise as Factors In Decision Making , 1986, Nursing research.

[3]  C. Tanner,et al.  Diagnostic Reasoning Strategies Of Nurses and Nursing Students , 1987, Nursing research.

[4]  S. Corcoran,et al.  "Thinking aloud" as a strategy to improve clinical decision making. , 1988, Heart & lung : the journal of critical care.

[5]  C. Tanner,et al.  Activating clinical inferences: a component of diagnostic reasoning in nursing. , 1986, Research in nursing & health.

[6]  J. Kassirer,et al.  Generation of diagnostic hypotheses. , 1989, Hospital practice.

[7]  S A Corcoran Planning by expert and novice nurses in cases of varying complexity. , 1986, Research in nursing & health.

[8]  Arthur S. Elstein,et al.  Medical Problem Solving , 1990 .

[9]  G A Gorry,et al.  Toward a theory of clinical expertise. , 1982, The American journal of medicine.

[10]  P. Benner From novice to expert. , 2004, Nursing standard (Royal College of Nursing (Great Britain) : 1987).

[11]  L. Shulman,et al.  Medical Problem Solving: An Analysis of Clinical Reasoning , 1978 .

[12]  Benjamin Kuipers New Reasoning Methods for Artificial Intelligence in Medicine , 1987, Int. J. Man Mach. Stud..

[13]  K. A. Ericsson,et al.  Verbal reports as data. , 1980 .

[14]  P. Benner From novice to expert. , 1984, The American journal of nursing.

[15]  Benjamin Kuipers,et al.  Causal Reasoning in Medicine: Analysis of a Protocol , 1984 .

[16]  G. Gorry,et al.  Clinical problem solving: a behavioral analysis. , 1978, Annals of internal medicine.

[17]  L. Suchman Plans and situated actions , 1987 .