Reflection On Clinical Reasoning

To enhance my clinical knowledge I take time to understand why I am doing a task a particular way

It is widely known that early recognition of a deteriorating patient can contribute largely to a successful outcome, through recognising and taking action on the deteriorating health status of the patient (National Consensus Statement, 2010). This report will explore the ways in which deteriorating patients and clinical reasoning are used in the public health care system in New South Wales (NSW).

In this assignment I will be reflecting on a clinical skills formative assessment, to do this I will be using the driscoll’s model of reflection (2007) This model will be used in the essay to show that I have thought critically, relating the theory to practical session I will also be using this model because this is a recognized framework that will assist me in demonstrating how able I am to think and reflect critically on my assessment.

Alfaro-LeFevre, R. (2013). Critical thinking, clinical reasoning, and clinical judgment : A practical approach (Fifth ed.).

Nursing practice requires both critical thinking and clinical reasoning. Critical thinking is the process of deliberate higher level thinking to define a patient’s problem, examine the evidence-based practice in caring for the patient’s, and make options in the delivery of optimal care. Critical thinking involves the demarcation of statements of fact, judgment, and opinion. The progression of critical thinking requires the nurse to think imaginatively, use reflection, and engage in logical thinking (Alfaro-LeFevre, 2013). Critical thinking is a vital skill needed for the recognition of patient’s

Reflection is an important tool for all health care practitioners. It can improve our skills and help us understand the choices we make while in practice. Williams (2001) states that “Reflective learning involves assessment and re-assessment of assumptions and critical reflection occurs whenever

In addition, teaching is a significant part of any doctor’s life. As physicians, we are constantly educating not only our patients and their families, but also other physicians, residents and medical students. A physician may know all the medical information in the world, but the care of a patient is primarily predicated on that physician’s ability to successfully

In order to review this clinical incident, the use of a clinical model is highly useful. School of Nursing and Midwifery Faculty of Health (2009) explains that clinical reasoning is a nursing process to collect cues, analyse information, identify patient problems, plan and implement nursing care, evaluate outcomes, and reflect and learn new strategies. This model is to be used through this story. School of Nursing

My clinical professor can facilitate my learning by continuing to allow us to watch new and educative illness/procedure on other patients that are assigned to another team member in addition to discussing medications our patient are taking.

Clinical Expertise: Clinical expertise revolves around the ideas of skills, critical thinking, and reasoning required in a clinical setting. As the differing of patients and patient needs changes so to does the clinical process. Due to this a strong sense of clinical skill, critical thinking and clinical reasoning needs to be used to alter the clinical process and personalise it for patient needs. For example if a chiropractor did not use his clinical expertise to personalise the treatment of patients they may end up with little results to show for their work or even negative results.

In order to develop clinical reasoning, in the occupational therapy (OT) studies program, self-reflection is an essential part of getting students to connect principle and practice. The efforts of my school’s director and/or advisor emphasizing self-reflection was often encountered with resistance on my part.

Critical thinking and clinical judgment are important skills that professional nurses use in every day clinical setting. In 2012, a mix method qualitative study by Dr. Jeanne Mann was done to evaluate the effectiveness of educational strategy to develop clinical judgment skills in nursing students. In this study, the population was identified as volunteered Level II baccalaureate nursing students from a Midwest nursing program. The variables identified in this article are the relation between critical thinking and clinical judgment. The title of the article clearly indicated the focus of the study and created an interest in reading the research due to nurses utilize their ability to critical think and

Clinical reasoning can be defined as, ‘the process by which nurses (and other clinicians) collect cues, process the information, come to an understanding of a patient’s problem or situation, plan and implement interventions, evaluate outcomes and reflect on and learn from the process’ (Levett-Jones & Hoffman 2013, p.4). It requires health professionals to be able to think critically and ensures better engagement and results for the patient (Tanner 2006, p.209). The Quality in Australian Healthcare Study (Wilson 1995, p.460) discovered that ‘cognitive failure’ resulted in approximately 57% of unfavourable clinical events involving the failure to produce and act correctly on clinical information. It also recognises that often nurse’s preconceptions and assumptions can greatly affect patient care and by going through such a process, one can take into account the holistic nature of the patient and provide the best, most appropriate care.

Johnny Obrien aged 79 years, presented to the Emergency Department after a fall at the RSL, resulting in a laceration on his left elbow which required 3 stitches. He lives by himself with no family close by, and has a history of hypertension and alcohol addiction. Clinical reasoning is a cyclic process, where cues are collected and their data processed to come to a conclusion of the patient situation so that appropriate interventions can be implemented and evaluated through reflective practices which allows for further learning (Levett-Jones 2013). Applying these clinical reasoning skills in practice is important as it has a positive impact on patient outcomes, resulting in less adverse effects due to the detection of patient deterioration throughout this process to ensure safe and effective care (Levett-Jones 2010).Subjective data is information from the patient’s point of view, including their feelings, perceptions and concerns, whereas objective data is information that is observable or measurable (Delmar Cengage Learning 2015).

While critical thinking and clinical reasoning are similar in many ways, they are not the same thing. Critical thinking includes reasoning inside and outside of the clinical setting. Critical thinking involves cognitive processing, challenging assumptions, and thinking beyond a specific knowledge base. Clinical reasoning consists of reasoning about patient care issues. The nursing process is applied to determine the patient’s problem,