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Rethinking clinical judgment

C A Tanner

    NLN Publications
    |April 1, 1993
    PubMed
    Summary
    This summary is machine-generated.

    This study challenges traditional rational cognitive models in nursing, revealing aspects of clinical judgment that these models fail to explain. It suggests new educational approaches for registered nurse (RN) training.

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    Area of Science:

    • Nursing
    • Cognitive Science
    • Medical Education

    Background:

    • Traditional cognitive models, based on rational thought, heavily influence nursing research and education.
    • These models focus on "cognitive processes" in clinical judgment.
    • Existing educational practices in nursing are largely shaped by these rationalist perspectives.

    Purpose of the Study:

    • To explicate the dominance of rational cognitive models in nursing clinical judgment.
    • To identify aspects of clinical judgment not explained by current cognitive models.
    • To propose alternative educational strategies for registered nurse (RN) education.

    Main Methods:

    • Analysis of cognitive models in nursing.
    • Examination of exemplars from a study on clinical expertise in nursing.

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  • Critique of assumptions in current nursing educational practices.

    • Main Results:

    • Several facets of clinical judgment in nursing are not adequately explained by rational cognitive models.
    • Current educational assumptions are challenged by a deeper understanding of clinical judgment.
    • Alternative teaching approaches for RNs can be developed.

    Conclusions:

    • Rational cognitive models offer an incomplete framework for understanding nursing clinical judgment.
    • A revised understanding of clinical judgment necessitates a re-evaluation of nursing education.
    • New pedagogical strategies are needed to better prepare RNs for complex clinical decision-making.