An analysis of expert nurse practitioners' diagnostic reasoning.

PURPOSE

To examine whether the Information Processing Model or the Hermeneutical Model or a combination of the two models best describes expert nurse practitioners (NPs) diagnostic reasoning.

DATA SOURCES

Content analysis of "think-aloud" verbalizations elicited while diagnosing a patient were used to describe diagnostic reasoning behaviors. Post-session interviews were also used to identify diagnostic reasoning behaviors in NPs' practice.

CONCLUSIONS

Results indicate that NPs use the Information Processing Model 55% of the time and the Hermeneutical Model 45% of the time. Reasoning behaviors do not strictly exemplify individual components of either model.

IMPLICATIONS FOR PRACTICE

Educators may need to devise additional methods to develop novice NPs' clinical reasoning. This may require changes in the NP curriculum. Students need to identify significant clinical data, determine the meaning of data, and reason about patient problems in ways aligned to those of expert practitioners.