经验丰富和经验不足的护士的诊断推理：对培养学生批判性思维的启示
Experienced and less-experienced nurses' diagnostic reasoning: implications for fostering students' critical thinking.
作者信息
Ferrario Catherine G
机构信息
University of Saint Francis, St. Joseph College of Nursing, Joliet, IL, USA.
出版信息
Int J Nurs Terminol Classif. 2003 Apr-Jun;14(2):41-52. doi: 10.1111/j.1744-618x.2003.tb00059.x.
PURPOSE
To compare the use of mental representations (heuristics) in diagnostic reasoning of expert (> or = 5 years' experience) and novice (< 5 years' experience) emergency nurses.
METHODS
Clinical simulations were completed by a nationwide randomly selected sample of 173 experienced and 46 less-experienced emergency nurses (N = 219).
FINDINGS
Experienced nurses used the heuristic, Judging by Causal Systems (diagnostic inferences deduced from systems of causal factors) significantly more did than less-experienced nurses.
PRACTICE IMPLICATIONS
Standardized nursing diagnoses may cut short the time needed to develop representational thinking and spare cognitive reserves for reasoning needed for complex patients. Faculty need to promote student's cognitive development through strategies that promote active, reflective, and integrative learning.
目的
比较专家级（≥5年工作经验）和新手级（<5年工作经验）急诊护士在诊断推理中对心理表征（启发法）的运用。
方法
通过全国范围内随机抽取的173名经验丰富的急诊护士和46名经验不足的急诊护士（N = 219）完成临床模拟。
结果
经验丰富的护士比经验不足的护士更频繁地使用“因果系统判断”启发法（从因果因素系统推导出的诊断推理）。
实践意义
标准化护理诊断可能会缩短形成表象思维所需的时间，并为复杂患者所需的推理节省认知储备。教师需要通过促进主动、反思和综合学习的策略来促进学生的认知发展。
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