Clinical intuition and its measurement in nursing research: An integrative review

Clinical intuition, a non-conscious, experience-based cognitive process, is widely recognized as a core component of nursing expertise and essential for competent patient care. However, varied perspectives on its defining characteristics have led to conceptual ambiguity. In addition, the extent to which existing measurement approaches align with the theoretical definition of the concept has not been systematically evaluated. This integrative review aims to (1) clarify the concept of clinical intuition by identifying key attributes from theoretical definitions found in nursing literature, and (2) evaluate the content alignment between these key attributes and intuition questionnaires used in nursing research.

An integrative review methodology was used. Four databases, PubMed, PsycINFO, EMBASE, and CINAHL, were systematically searched to identify theoretical definitions and associated questionnaires from studies focusing on clinical intuition in nursing. The theoretical definitions were analyzed using a three-step qualitative synthesis to identify key attributes and organize them into broader conceptual domains. The content of existing intuition questionnaires was then evaluated for alignment with the identified attributes.

The analysis included 31 theoretical definitions and seven published questionnaires of clinical intuition. The synthesis of the definitions revealed nine key attributes of clinical intuition, which were organized into four conceptual domains: (1) a rapid, non-conscious, and indescribable cognitive process, (2) experience- and risk-based knowledge structures not supported by clinical evidence, (3) affective experiences, and (4) patient-context dependency. Questionnaire analysis indicated a predominant reliance on retrospective, self-report methods, with limited content alignment to key attributes of clinical intuition.

Clinical intuition is a multidimensional construct involving cognitive processes, cognitive structures, and affective experiences. Current post hoc, self-report measurement is limited, given that the definition of clinical intuition includes a non-conscious, indescribable cognitive process. These findings highlight a need for more theory-aligned, objective methodologies to advance understanding of clinical intuition and its role in quality patient care.