Thinking Like A Nurse: A Research-Based Model of Clinical Judgment in Nursing


An article by Tanner (2006) addresses the importance of clinical judgment and its impact on nursing practice. The author observed that in an examination of 200 studies, clinical judgment is directed by nurse knowledge, unit culture, patient responses and needs, and individual reasoning (Tanner, 2006). Therefore, models must develop that will capture the essence of this framework and the ability to use clinical judgment effectively under a wide variety of circumstances in nursing practice (Tanner, 2006). The article evaluates the use of clinical judgment and its ability to be effective in the diagnosis and treatment of patients in an effective manner (Tanner, 2006). The examination of studies was conducted primarily using the CINAHL database, along with a review of other articles written since 1998 (Tanner, 2006). Therefore, the article appears to be an evaluation of research between the years of 1998 and 2006 (Tanner, 2006).


The article by Tanner (2006) also considers the nursing process model upon which clinical judgment is achieved through the identification of problems and the development of diagnoses that are based upon effective assessment tools and nursing interventions to improve patient outcomes (Tanner, 2006). However, the article notes this type of model is not always effective in addressing clinical judgment as conveyed by nurses and therefore, leads to possible gaps in decision-making in some situations (Tanner, 2006). The article also considers the overall impact of clinical judgment and its relationship to clinical situations directly involving patients across a variety of settings (Tanner, 2006).

The article defines clinical judgment from a nursing-based perspective and provides further evidence patient assessments and evaluations in promoting sound and reasonable clinical judgment at all times (Tanner, 2006). At the same time, the article also considers the influence of family members on clinical judgment, particularly when there are specific issues and/or distractions which may deter the quality of patient care and treatment in some cases (Tanner, 2006). It is important to identify these weaknesses in clinical judgment and to take steps to facilitate clinical judgment in the desired manner (Tanner, 2006). The article represents the concept of clinical judgment effectively and addresses prior research that explores this topic in greater detail to emphasize the importance of clinical judgment in working through patient care diagnoses and problem-solving measures (Tanner, 2006).

The article also considers individual nursing experiences and their role in shaping sound clinical judgment in many patient care situations (Tanner, 2006). The familiarity of a given situation is likely to influence patients through experience and reason, while also considering textbook knowledge in conjunction with this practice (Tanner, 2006). Nurses also use their inherent beliefs regarding what is good and bad in assessing patients and developing clinical judgment in treating patients (Tanner, 2006). In addition, reasoning plays an important role in making decisions regarding patient care and treatment, accompanied by reflection on prior clinical experiences (Tanner, 2006). Each of these factors are addressed in detail in the article to provide an analytical and subjective approach to clinical judgment in patient care and treatment (Tanner, 2006).


The article by Tanner (2006) provides a number of unique examples of clinical judgment and its impact on patient care and wellbeing. In this context, the article summarizes the different areas upon which clinical judgment is based, thereby creating an environment that supports quality patient care and treatment in many different settings (Tanner, 2006). The article is based upon prior evidence regarding clinical judgment in existing articles, and since many of the same conclusions were drawn across different studies, the information appears to be reliable in nature.

Models reflective of clinical judgment represent a means of expanding learning and providing greater insight regarding this process and its impact on nursing practice through their implementation in direct patient care environments (Tanner, 2006). The ability to achieve sound and reasonable clinical judgment when evaluating and treating patients requires the ability to utilize past experiences, learning, and knowledge to facilitate successful outcomes.


Tanner, C.A. (2006). Thinking like a nurse: a research-based model of clinical judgment in                     nursing. Journal of Nursing Education, 45(6), 204-211.