Simmons Barbara, Lanuza Dorothy, Fonteyn Marsha, Hicks Frank, Holm Karyn
College of Nursing, Department of Medical-Surgical Nursing, University of Illlinois at Chicago, USA.
West J Nurs Res. 2003 Oct;25(6):701-19; discussion 720-4. doi: 10.1177/0193945903253092.
As an essential component of nursing practice, clinical reasoning is used to assimilate information, analyze data, and make decisions regarding patient care. Little is known about the reasoning strategies of experienced nurses who are not yet experts. This qualitative descriptive study explored the cognitive strategies used by experienced nurses as they considered assessment findings of assigned patients. To date, few studies of nurses' clinical reasoning have been conducted in a practice setting during actual patient care. A small group research design was employed using the think-aloud (TA) method with protocol analysis. A total of 15 experienced nurses were asked to "think aloud" about patient assessment findings. Data were audiotaped, transcribed, and analyzed using the three steps of protocol analysis. The results suggest that experienced nurses used a conceptual language to reason about assessment findings and used heuristics to reason more quickly and efficiently.
作为护理实践的重要组成部分，临床推理用于吸收信息、分析数据并就患者护理做出决策。对于尚未成为专家的经验丰富的护士的推理策略，人们了解甚少。这项定性描述性研究探讨了经验丰富的护士在考虑指定患者的评估结果时所使用的认知策略。迄今为止，很少有关于护士临床推理的研究是在实际患者护理的实践环境中进行的。采用了小组研究设计，运用出声思考（TA）方法并进行协议分析。总共15名经验丰富的护士被要求就患者评估结果“出声思考”。数据被录音、转录，并使用协议分析的三个步骤进行分析。结果表明，经验丰富的护士使用概念性语言对评估结果进行推理，并使用启发法进行更快、更有效的推理。
