Clinical Judgment among Relatively Inexperienced Nurses : Toward the Development of Educational Methods to Teach Critical Thinking

－The Ability of Relatively to Apply Clinical Judgment while Taking a Health History－

Abstract

This study aimed to clarify processes for making clinical judgments by inexperienced nurses (RINs). The process of clinical judgment includes : determining what is relevant for the patient, collecting specific data, and incorporating data to design a plan of care for the new patient. I interviewed 12 RINs. We used non-participant observation of history taking situations and semi-structured interviews. RINs tended to either act "according to the manual" or "evaluated the patient by using their existing skills and current level of knowledge". The nurses who acted "according to the manual" tended to "only take patient data", "perceive only part of the situation "and "ask sporadic questions". Nurses who "evaluated patients by using their existing skills and current level of knowledge" tended to focus on "establishing the initial bond with the patient or the family". They carefully listened to the patients' stories, and were able to "sense" the meaning and determine the "irrelevancies".