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Clinical Reasoning

Cassity Clay

Brigham Young University-Idaho


Sister Hawkins

January 19th, 2017


Clinical Reasoning

Nurses often have multiple patients at once who demand a great deal of care. Nurses have

to be able to assess their patients needs thoroughly and provide treatment in a timely matter.

This process is known as clinical reasoning.

Definition of Clinical Reasoning

According to Simmons (2009), clinical reasoning is a complex ever-changing cognitive

process by which nurses think abstractly to assess their patients situations in order to provide

pertinent interventions. This thinking process is a cutting-edge assessment tool that focuses on

different forms of data and clinical decision-making (Forsberg, 2014). Clinical reasoning is often

confused with the term critical thinking, which is an information-based practice that does not

take the specific patients situation into account. In contrast, clinical reasoning is a combined

process that uses critical thinking skills in addition to specific patient symptoms (Lee, Joo Lee,

Bae, Seo, 2016).

Clinical Reasoning in Nursing Practice

Clinical reasoning is vital to the field of nursing as it can potentially save lives, if used

correctly and efficiently. Nurses with effective clinical reasoning skills have a positive impact

on patient outcomes. Conversely, those with poor clinical reasoning skills often fail to detect

impending patient deterioration resulting in a failure-to-rescue (University of Newcastle,

2009). Besides potentially saving a life by using clinical reasoning, nurses may be able to detect

other changes in patients that arent life threatening such as emotional stability, spiritual distress,

and flatted affect. According to Tuttle, Bialocerkowsk, and Laakso (2016), one of the most

effective ways to develop clinical reasoning is by patient centered simulations or clinical


experience. Another effective learning tool used in developing clinical reasoning is a concept

map. Concept maps are a visual aid that allow nurses to write down patient symptoms, vital

signs, medications, laboratory values, and other diagnostic findings. By doing this, the nurse will

be able to find relationships between the different findings.

Clinical Reasoning Importance to Students

Clinical reasoning is important not only to the nursing profession, but also nursing

students. A better understanding of clinical reasoning will enhance nursing student practice,

professional practice, and guide further research (Simmons, 2009). Additionally, when students

are not prepared to enter the work field, they may make irrational choices that lead to hazardous

consequences. A study done by New South Wales Health Patient Safety and Clinical Quality

Programme concluded that while graduated nursing students had adequate content knowledge

and procedural skills, they lacked in the ability to assess and respond to critical situations

(University of Newcastle, 2009).


In summary, clinical reasoning is pertinent to the field of nursing to provide the best level

of healthcare possible. Although this skill is not innate, it can be learned over time through

productive teaching, simulations, and experience in the nursing field.



E. F. (2014). Clinical reasoning in nursing, a think-aloud study using virtual patients A base for

an innovative assessment. Nurse Education Today, 34(4), 538-542.

Lee, J., Bae, U., Lee, Y., & Seo, M. (2016). Registered nurses' clinical reasoning skills and

reasoning process: A think-aloud study. Nurse education today, 46, 75-80.

Newcastle, U. O. (2009). Clinical reasoning. Retrieved January 19, 2017, from


Simmons, B. (2009). Clinical reasoning: concept analysis. Journal of Advanced Nursing, 66(5),

1151-1158. doi: 10.1111/j.1365-2648.2010.05262

Tuttle , N., Bialocerkowsk, A., & Laakso, E. (2016). Combining patient centred simulation with

an online adaptive learning platform to assist students in developing clinical and

reasoning skills to transition from classroom to clinical practice. Manual Therapy, 46, 55-