Benner P, Stannard D, Hooper P L
Department of Physiological Nursing, University of California, San Francisco, School of Nursing, USA.
Adv Pract Nurs Q. 1996 Spring;1(4):70-7.
The complexity of the evolving advanced practice nurse (APN) role demands new teaching strategies. Based on the challenges that clinicians face daily, we have developed a teaching-learning strategy that addresses five central issues: (a) learning to perceive or identify relevant clinical problems; (b) learning to address the limits of formalism by situating clinical problem solving according to the most relevant goals and intents; (c) learning to reason in transition about the particular clinical situation; (d) learning the ethical skill of problem engagement and interpersonal involvement; and (e) learning to take a stand as a responsible agent by making clinical judgments, acting on them, and advocating for the patient/family. Although these five central issues are typically excluded from classic academic approaches, they are addressed in the "Thinking-in-Action" approach. This teaching-learning strategy offers a different way of teaching clinical judgment that closely resembles the way in which expert nurses actually think and reason in patient situations as they unfold.
不断演变的高级执业护士（APN）角色的复杂性需要新的教学策略。基于临床医生日常面临的挑战，我们开发了一种教学策略，该策略解决五个核心问题：（a）学会感知或识别相关临床问题；（b）学会通过根据最相关的目标和意图来定位临床问题解决过程，以应对形式主义的局限性；（c）学会在特定临床情况的转变中进行推理；（d）学习问题处理和人际参与的伦理技能；（e）学会通过做出临床判断、据此采取行动并为患者/家庭进行倡导，以成为负责任的行动者。尽管这五个核心问题通常被经典学术方法所排除，但它们在“行动中的思考”方法中得到了解决。这种教学策略提供了一种不同的临床判断教学方式，与专家护士在实际患者情况中随着情况展开而进行思考和推理的方式非常相似。
