title: Using the Situated Clinical Decision-Making framework to guide analysis of nurses' clinical decision-making.
abstract: Nurses' clinical decision-making is a complex process that holds potential to influence the quality of care provided and patient outcomes. The evolution of nurses' decision-making that occurs with experience has been well documented. In addition, literature includes numerous strategies and approaches purported to support development of nurses' clinical decision-making. There has been, however, significantly less attention given to the process of assessing nurses' clinical decision-making and novice clinical educators are often challenged with knowing how to best support nurses and nursing students in developing their clinical decision-making capacity. The Situated Clinical Decision-Making framework is presented for use by clinical educators: it provides a structured approach to analyzing nursing students' and novice nurses' decision-making in clinical nursing practice, assists educators in identifying specific issues within nurses' clinical decision-making, and guides selection of relevant strategies to support development of clinical decision-making. A series of questions is offered as a guide for clinical educators when assessing nurses' clinical decision-making. The discussion presents key considerations related to analysis of various decision-making components, including common sources of challenge and errors that may occur within nurses' clinical decision-making. An exemplar illustrates use of the framework and guiding questions. Implications of this approach for selection of strategies that support development of clinical decision-making are highlighted.
authors.affiliation: British Columbia Institute of Technology, Speciality Nursing, 3700 Willingdon Ave, Burnaby, BC, Canada V5G 3H2. mary_gillespie@shaw.ca
authors.forename: Mary
authors.initials: M
authors.lastname: Gillespie
mesh_terms: D002983:Clinical Competence; D004506:Education, Nursing; D006801:Humans; D007600:Judgment; D024802:Nurse's Role / Q000523:psychology; D009736:Nursing Process