NUR2868 Assignment: Concepts for Clinical Judgment
NUR2868 Assignment: Concepts for Clinical Judgment
NUR2868 Assignment: Concepts for Clinical Judgment
Read the article “Thinking Like a Nurse: A Research-Based Model of Clinical Judgment in Nursing” by Christine Tanner, which is linked below:
Link to article
In at least three pages, answer the following questions:
What do you feel are the greatest influences on clinical judgment? Is it experience, knowledge, or a combination of those things?
In your opinion, what part does intuition play in clinical judgment? How do you think you’ll be able to develop nursing intuition?
Additional sources are not required but if they are used, please cite them in APA format.
In this study, researchers classified the factors influencing nursing students’ clinical judgment into five main themes including thoughtful behaviour, professional ethics, use of evidence based care, context of learning environment and individual and professional characteristics of clinical teachers.
The findings highlighted that patient assessment is a thoughtful behaviour and prerequisite for clinical judgment. It starts with systematic assessment in order to determine patients’ physical, mental, emotional needs followed by continuous assessment for diagnosis of their degree of harm and examining the effect of clinical interventions on judgment. Wallace S showed that comprehensive assessment is defined as finding objective and subjective data in six physiological, psychological, sociological, developmental, spiritual and cultural dimensions [16].
Participants pointed to factors such as follow up inquiries, clinical discussion and analysis, enhancing the inquiring and problem solving spirit in students. Another study found a significant relationship between intellectual analysis skills, critical thinking and students’ clinical performance [17].
Teachers believed that although intuition is shaped through experiences and mostly in skilled nurses, such way of thinking can also be seen in students at some level. Seidi J et al., also defined intuition as an immediate knowledge and experience based reaction in nurses, thus students have stronger intuition in the final years than the first years [11].
The teachers pointed to recognition of the relationship between parts and whole, understanding the reasons for changes in patient’s status. Our results correspond to the study by Levett-Jones J et al., where clinical reasoning was defined as nurse’s ability to identify key components and connections between elements for reasoning [18].
According to the findings, moral judgment competence in nursing students may significantly influence the quality of clinical judgment and deficiency of clinical standards negatively affects their performance on professional ethics. Researchers believed that deficiencies in clinical settings, such as lack of efficient organization and excessive work are important factors that reduce the quality of ethical issues and care [19].
This study showed evidence based care including application of knowledge, experience and evidence as significant fundamental factors for clinical judgment. These findings are consistent with the study by Brooke J et al., in which nursing students applied evidence based practice to enhance their knowledge, empowerment and develop accountability and professional promotion [20].
Participants believed that skilled and committed teachers can strengthen students’ thoughtful behaviours by supporting and respecting them in a safe environment. In the present study, “individual and professional features of clinical teachers” was introduced as a new category. Aghamolaei J et al., argued that experienced teachers support students by creating an atmosphere with no tension, establishing good communication and respecting students. These are some of the teaching roles of an effective teacher [21].
In the present study, the environmental barriers of clinical judgment were found to be; no consecutive days of internship, environmental stresses, lack of clinical opportunities, discrimination between medical and nursing students, patients and their families’ mistrust in students, disinterest of students in nursing profession. These results correspond with a study done in Iran in which students pointed to factors such as duties imposed by nurses, lack of learning opportunities and large number of students as obstacles to their decision making [22].