Ritter Barbara J
J Am Acad Nurse Pract. 2003 Mar;15(3):137-41. doi: 10.1111/j.1745-7599.2003.tb00270.x.
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.
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.
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.
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.
探讨信息加工模型、诠释学模型或这两种模型的组合是否最能描述专家执业护士（NP）的诊断推理过程。
通过对诊断患者时“出声思考”的言语进行内容分析来描述诊断推理行为。会后访谈也用于识别NP在实践中的诊断推理行为。
结果表明，NP在55%的时间里使用信息加工模型，在45%的时间里使用诠释学模型。推理行为并不严格体现任何一种模型的各个组成部分。
教育工作者可能需要设计额外的方法来培养新手NP的临床推理能力。这可能需要对NP课程进行调整。学生需要识别重要的临床数据，确定数据的意义，并以与专家从业者一致的方式对患者问题进行推理。
