Developing Skills in Interpretation

摘要

In the previous two columns, we explored the Clinical Judgment Model (Tanner, 2006; see Figure 1) and strategies that preceptors might use to assist beginning nurses to develop the skill of noticing. In this column, we will explore strategies for developing the skill of interpreting, the second component of the Clinical Judgment Model. Interpreting is the process of making sense of a clinical situation. What the nurse notices as relevant in the situation calls forth related knowledge and patterns of response that support interpretation and hint at appropriate courses of action. What the nurse notices as relevant in the situation calls forth related knowledge. Remember that noticing is based in an integration of background knowledge, contextual knowledge, and knowledge of the patient. Cognitive science has shown that knowledge, particularly expert level knowledge, is not held in the brain in discrete packages but is clumped together with related knowledge in relational webs (Bradsford, Brown, & Cocking, 2000). Knowledge seems to be organized into concepts fundamental to the discipline or area of practice. When one aspect of the web is triggered, other related knowledge is called forth and put into play almost automatically with little conscious effort on the part of the expert practitioner. Think about the different responses you receive when you ask an experienced compared with a beginner nurse a question.