An Analysis of Expert Nurse Practitioners’ Diagnostic Reasoning

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PurposeTo examine whether the Information Processing Model or the Hermeneutical Model or a combination ofthe two models best describes expert nurse practitioners (NPs) diagnostic reasoning.Data SourcesContent analysis of “think-aloud” verbaliza-tions elicited while diagnosing a patient were used todescribe diagnostic reasoning behaviors. Post-session interviews were also used to identify diagnostic reasoning behaviors in NPs’ practice.ConclusionResults indicate that NPs use the information processing Model 55% of the time and the Hermeneutical Model 45% of the time. Reasoning behaviors do not strictly exemplify individual components of either model.Implications for PracticeEducators may need to devise additional methods to develop novice NPs’ clinical reasoning. This may require changes in the NP curriculum. Students need to identify significant clinical data, determine the meaning of data, and reason about patient problems in ways aligned to those of expert practitioners.

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