Experienced and less-experienced nurses' diagnostic reasoning: implications for fostering students' critical thinking.
OBJECTIVE
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).


RESULTS
Experienced nurses used the heuristic, Judging by Causal Systems (diagnostic inferences deduced from systems of causal factors) significantly more did than less-experienced nurses.


CONCLUSIONS
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.
Ferrario
Catherine G
CG
University of Saint Francis, St. Joseph College of Nursing, Joliet, IL, USA. kayferr@ameritech.net
D000328:Adult; D001291:Attitude of Health Personnel; D015984:Causality; D002983:Clinical Competence / Q000592:standards*; D003071:Cognition; D003657:Decision Making; D016529:Emergency Nursing / Q000193:education / Q000379:methods*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008128:Logic; D008297:Male; D016294:Models, Nursing; D020380:Needs Assessment; D009733:Nursing Diagnosis; D015402:Nursing Education Research; D009740:Nursing Staff / Q000193:education / Q000523:psychology*; D011340:Problem Solving; D013850:Thinking; D013997:Time Factors