Clinical Judgements

Please use this information to formulate the essay

Learning outcomes – these must be addressed
1. Demonstrate detailed knowledge and critical understanding of theories and
frameworks of clinical decision-making that will support clinical judgement in
practice

2. Demonstrate advanced knowledge and skills in the management of uncertainty
and the application of reasoning in the assessment and management of care.

3. Critically examine and synthesise the legal, professional and ethical dimensions
of applying clinical judgement and decision making in practice

4. Critically evaluate ways in which evidenced based practice will support clinical
judgment and clinical decision-making.

5. Critically appraise the use of problem solving strategies in the use of clinical
judgement and decision-making in practice

Assignment – details of how I would like the essay formed
You are required to submit a 3500 word essay which should highlight your
achievement of all of the learning outcomes 1 to 5 of this module. This will be in the
form of a case study. The essay can be split into sections using the 5 learning
outcomes as subheadings if you wish, within each section you should demonstrate
knowledge and understanding of the theories relating to the learning outcome.
You will need to critically analyze the theories and relate them to your practice,
referring to the case study as you discuss each aspect.
If you wish, you may choose to include some of the more descriptive aspects of the
case study as an appendix to the essay, preserving the word count in your main body
for discussion and analysis of the case and making reference to them throughout the
assignment discussion.

Suggested Format
Introduction
The essay should commence with an introduction, which explains to the reader the
purpose of the essay and the topics to be covered. Outline to the reader in a concise
way how you will address the outcomes – The essay should be written in the third
person, so begin with This essay will……
Introduce your case study to the reader, ensuring that confidentiality is maintained
through including a reference to consent and confidentiality.

Main body
After writing your introduction, you need to critically discuss and analyse the theories
and frameworks which are within each learning outcome to demonstrate your
knowledge and understanding of these. This is where you will be awarded most of
your marks and you should use the majority of your word count. Remember that each
learning outcome is of equal weighting in the marking of the work.
You also need to link your own clinical practice to the theory you have learned, so you
will need to make reference to your case study throughout the assignment to
demonstrate using the theories in your practice. .
Consider in your discussion that each of the following learning outcomes must be
addressed:
1. Develop knowledge and critical understanding of theories and
frameworks of clinical decision-making that will support clinical judgment in
practice
To meet this LO you need to define clinical judgment and clinical decision making and
critically analyze the theories and what are relevant to you. Your case study should
incorporate and demonstrate clinical decisions you have made and how the theories
relate.

2. Enhance your knowledge and skills in the management of uncertainty and
the application of reasoning in the assessment and management of care.
Discuss assessment theories and tools, what uncertainties existed in this case? How
do you manage uncertainty? What tools did you utilize to justify your decisions and
ensure your patient was safe? For example safety netting, appropriate referral on
using SBAR tool

3. Critically examine the legal, professional and ethical dimensions of
applying clinical judgment and decision making in practice.
What are the legal, professional and ethical issues that support or hinder your
practice? Refer to the law and your code of practice. You may wish to consider
whether you were able to manage this case within your own scope of practice or when might recognise when a case is outside your scope? Issues

such as competence
and accountability need to be considered.

4. Critically evaluate ways in which evidenced based practice will support
clinical judgment and clinical decision-making.
Define and discuss evidence based practice, what resources did you utilize to support
your practice and therefore your decisions and judgments.
Did you refer to any specific evidence guidelines when managing this patient?

5. Critically reflect on the use of problem solving strategies in the use of
clinical judgment and decision-making in practice
Define and discuss problem solving models. You could compare and contrast a
couple. How did they support your practice? Within the case study demonstrate their
application.

Conclusion and action plan
The conclusion should incorporate some elements of learning outcome 5 as you
critically reflect on your case study and the strategies you used and an evaluation of
their effectiveness. Your conclusion should be more than just a summary of the essay.
It should be a good end to your piece of writing, emphasizing or reinforcing your main
ideas, but restating them in a new way and avoiding using the same language as in
your essay.

Reading List
Ankner, G (2007) Clinical Decision Making: case studies in medical-surgical nursing Thomson Delmar New York

Benner, P (1984) From Novice to Expert Addison Welsey California

Buckingham, C & Adams, A (2000) “Classifying clinical decision making: a unifying approach” Journal of
Advanced Nursing 32 (4) pp.981-989

Buckingham, C & Adams, A (2000) “Classifying clinical decision making: interpreting nursing intuition, heuristics
and medical diagnosis” Journal of Advanced Nursing 32 (4) pp.990-998

Calder, R, Campbell, S & Watson, D (2005) “Cognitive continuum theory in nursing decision making” Journal of
Advanced Nursing 49 (4) pp.397-405

Douglas G, Nicol F, Robertson C. (2009), McLeods Clinical Examination Book. (12th Ed) Churchill Livingstone.
London.

Gillespie, M & Paterson, B (2009) “Helping novice nurses make effective clinical decisions: the situated clinical
decision making framework” Nursing Education Perspectives 30 (3) pp. 164-170

Gillespie, B, Chaboyer, W, Winsome, S, Morley, S & Nieuwenhoven, P (2015) “Health professionals ‘decision

making in wound management: a grounded theory” Journal of Advanced Nursing 71 (6) pp.1238-1248
Greenhalgh, T. (2014) How to Read a Paper: The Basics of Evidence-based Medicine (5th ed) Blackwell Wiley.
London

Kumar P, Clarke M. (2012). Clinical Medicine. (8th Ed)Saunders Ltd. London.

Lissauer, T and Clayden, G. (2011) Illustrated Textbook of Paediatrics: with STUDENTCONSULT Online Access.
(4th ed). Mosby

Llewelyn, H. Aun Ang, H., Lewis, K. and Al-Abdullah (2014) Oxford Handbook of Clinical Diagnosis (Oxford
Medical Handbooks. Oxford Universtiy Press

Odell, J (2015)” Clinical Decision Making in Minor Illness” Practice Nursing 26 (10) pp.505-509
Porth, C. (2010) Essentials of Pathophysiology: Concepts of Altered Health States [3rd Ed] London : Lippincott

Robinson, S (2002) Clinical Decision making: a case study approach Lippincott, Philadelphia

Sahib El- Radhi, A. (2011) Paediatric Symptom Sorter. Radcliffe Publishing Oxford

Tower, M, Chaboyer, W, Green, Q, Dyer, K & Wallis, M (2012) “Registered nurses’ decision making regarding
documentation in patient’s progress notes “ Journal of Clinical Nursing 21 pp.2917-2929

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