title: A "thinking-in-action" approach to teaching clinical judgment: a classroom innovation for acute care advanced practice nurses.
abstract: 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.
authors.affiliation: Department of Physiological Nursing, University of California, San Francisco, School of Nursing, USA.
authors.forename: P
authors.initials: P
authors.lastname: Benner
authors.forename: D
authors.initials: D
authors.lastname: Stannard
authors.forename: P L
authors.initials: PL
authors.lastname: Hooper
mesh_terms: D003657:Decision Making; D004511:Education, Nursing, Graduate / Q000379:methods*; D006801:Humans; D009720:Nurse Clinicians / Q000193:education*; D009722:Nurse Practitioners / Q000193:education*