Critical Thinking and Clinical Judgment Model - Vocabulary Flashcards

Vocabulary-style flashcards covering critical thinking, clinical judgment, nursing process, assessment, data interpretation, planning, implementation, and evaluation topics.

Critical thinking

Ability to think in a systematic and logical manner, with openness to question and reflection on reasoning to inform clinical decisions.

Clinical Judgment

Outcome of critical thinking and decision making; conclusion about a patient’s needs or health problems that guides actions.

Nursing Process

Framework nurses use to apply critical thinking in practice to make clinical decisions; six steps: Assessment, Diagnosis (Problem), Outcome Identification, Plan, Implement, Evaluate.

Assessment

Collection of information about a patient to identify problems and determine health status.

Diagnosis (Problem)

Clinical judgment about a patient’s health problems or responses to health issues (nursing diagnosis, not a medical diagnosis).

Outcome Identification

Identifying measurable outcomes to address each patient problem.

Plan

Developing strategies and interventions to achieve identified outcomes.

Implement

Carrying out nursing actions and interventions to meet prioritized outcomes.

Evaluate

Determining whether patient outcomes were met and revising the plan as needed.

Critical Thinking Competencies

General: scientific method, problem solving, decision making; Specific: diagnostic reasoning, clinical decision making.

Diagnostic Reasoning

Understanding and thinking through clinical problems; analyze cues; determine when there is enough evidence to decide.

Clinical Decision Making

Choosing a course of action when facing a problem; involves inductive and deductive reasoning.

Inductive reasoning

Reasoning from specific cues to a general conclusion.

Deductive reasoning

Reasoning from general principles to specific conclusions.

Levels of Critical Thinking

Basic (task-oriented), Complex (begins to trust decisions), Commitment (accountability for decisions).

Competence

Ability to perform according to standards based on knowledge, experience, and skill.

Knowledge Base

Theoretical and practical information that supports clinical reasoning.

Experience

Practical involvement and prior practice that inform judgment.

Environment

Setting, time pressure, task complexity, and interruptions that affect thinking.

Attitudes

dispositions that influence thinking and decision making (e.g., independence, fairness, curiosity, integrity).

Standards

Intellectual standards used to evaluate thinking (e.g., clarity, accuracy, relevance, logic).

Intellectual Standard: Clarity

Information is understandable and easy to follow.

Intellectual Standard: Precision

Details are exact and specific to the problem.

Intellectual Standard: Specificity

Information directly addresses the issue without ambiguity.

Intellectual Standard: Accuracy

Information is true and free from error.

Intellectual Standard: Relevance

Information is essential to the issue at hand.

Intellectual Standard: Plausible

Reasonable or probable explanations are considered.

Intellectual Standard: Consistency

Beliefs and conclusions align with each other.

Intellectual Standard: Logical

Reasoning followed by valid conclusions from supported evidence.

Intellectual Standard: Deep

Engagement with complex, interrelated factors.

Intellectual Standard: Broad

Consideration of multiple viewpoints.

Intellectual Standard: Complete

Thorough thinking and evaluation of all aspects.

Intellectual Standard: Significant

Focus on what is important in a situation.

Intellectual Standard: Adequate

Quality or quantity is sufficient for the task.

Critical Thinking Attitudes

Examples include confidence, fair-mindedness, responsibility, risk taking, discipline, perseverance, creativity, curiosity, integrity, humility.

Maslow’s Hierarchy of Needs

A framework prioritizing needs from physiological up to self-actualization; guides priority setting.

Subjective data

Verbal descriptions from the patient about how they feel.

Objective data

Observable and measurable data obtained through observation, exams, or tests.

Cues

Signals or pieces of information collected that help identify patterns.

Data clustering

Grouping data into cues/patterns to identify problems.

Defining characteristics

Subjective and objective data that define a pattern or problem.

Patient Problems vs Medical Diagnoses

Problems are nursing judgments about patient responses; medical diagnoses label diseases.

PES format

Problem, Etiology, Symptoms used in problem/statements.

Goals vs Expected Outcomes

Goals are overarching; Expected Outcomes are specific, measurable results to achieve the goal.

SMART criteria

Specific, Measurable, Achievable, Relevant, Time-bound.

Interventions (Nursing)

Independent (nurse-initiated), Dependent (requires order), Interdependent (team-based).

Handoff Report

Critical time for collaboration and sharing information to ensure continuity of care.

SBAR

Communication framework used during consultation to discuss findings and recommendations.

Implementation

Phase where the plan of care is executed, including direct and indirect care within scope of practice.

Direct Care

Nursing actions involving direct patient contact (ADLs, teaching, etc.).

Indirect Care

Documentation, delegation, supervision, and communication about care.

Evaluation of Outcomes

Comparing observed outcomes to expected outcomes and revising the plan as needed.

NCSBN Clinical Judgment Model

Framework with layers: recognizing cues, analyzing cues, prioritizing hypotheses, generating solutions, taking actions, and evaluating outcomes.

Recognize Cues

Filter information from signs, symptoms, and history to identify what matters.

Analyze Cues

Link cues to the clinical presentation and establish probable needs or problems.

Prioritize Hypotheses

Rank hypotheses by urgency and importance based on data.

Generate Solutions

Identify expected outcomes and nursing interventions; collaborate with team and patient.

Take Actions

Implement prioritized nursing actions; consider patient preferences.

Evaluate Outcomes (Planning/Analysis)

Assess whether outcomes were achieved; modify plan as indicated.

Pneumonia (as example)

Infection causing inflammation of air sacs in lungs, with symptoms like cough, fever, and breathing difficulty.