The terms clinical reasoning, theory, practice and learning are widely used in our everyday lifestyle. Sometimes there is use of these words interchangeably without one realizing the difference between one and another. However, this sometimes does not matter to the common citizen as they just seek for the service and look forward to results. Nevertheless, for a medical practitioner or medical student these terms are quite important to take note of and fully understand. It is for this reason that this essay tries to go deeper into previous research work by various scholars to bring out a reasonable understanding of the relationship between these terms.
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Clinical reasoning is a process undertaken by clinicians in most cases it happens automatically. The rational process involves management and diagnosis of the problems that a patient presents when visiting a health facility (Linn, Khaw, Kildea & Tonkin, 2012). Clinical reasoning in this situation is viewed as a skill that one learns but not simply a concept to understand. The process involves observation by the learner from the teaching clinician followed by an explanation to the reasoning processes. Hypothesis testing, differential diagnosis and re-analysis are a part of this process as the student makes subsequent consultations from the trainer. Viewing from a different perspective Davies (2008) defines clinical reasoning as processes of thinking or decision making in clinical practice. He further elaborates the definition into a process that requires collaboration, reflection, and hypothesis oriented. With knowledge and organization, knowledge being important factors in the whole process.
Clinical practice
A good definition for clinical practice, it describes a spectrum of care subjected to a group of specific patients having a specified clinical condition. These practices are categorized into sub groups depending on the service the patients are receiving, it can be recommended, expected or optional (Banner Health, 2009). Many other research work and definitions of clinical practice are available in libraries and scholarly web materials, but they all have uniformity in explanation. They link the practice to nurses who that offer direct or indirect care to their patients. Direct care meaning there is “hands on†care while indirect care defined as the practice roles influencing nurses and patients in consultation, teaching, research, and management (Hooper, 2007).
Clinical theory
Clinical theory narrows down to those explanations that one can prove of the natural medical field basing on facts from observation of repeat events and experiments. These facts are not guesses but actual accounts of the real events and results relating to clinical practices (Brockopp & Eich 2008). They are known explanations from generalization of thinking being proven to work but not backed up by sufficient evidence to explain them.
Clinical learning
This type of learning occurs in a specific practice, basing on the nature that it is relating to a teaching practice. Findings from these practices are normally put in existing literature materials to create a framework on community practice and social learning. The process appears through available opportunities and commitment. Commitment in this case consists of four elements; relevance, recognition, emotion and respect. On the other hand opportunity consists of immediacy of patient encounters; availability; authenticity; opportunity to pick up from professional contemporaries and peers (Pearson, 2010). In general, clinical learning is the cornerstone of the education sort after in medical schools. However, some strong imperatives are there to improve the ways in which students are obtaining clinical knowledge. Advancement in instructional design and information technology provide a strengthening bond in opportunistic learning and educational activities in the clinical setting (Conn, Lake, McColl, Bilszta and Woodward-Kron, 2012).
Analysis
It is evident that from the above explanations and definitions all the terms relate to clinical education. In many situations or contextual framework excluding medical practitioners, it is more likely there is use of these terms interchangeably. However, as a nurse or generally as a medical practitioner it is important that one get to have the in-depth understanding of each term and their relationship. From a wider perspective in medical study, clinical learning, theory, and reasoning all these terms appear in medical schools or learning environments. Clinical practice on the other hand is the physical learning process by medical practitioners. In this situation, the students are required to learn from direct contact with the patients. Learning from experience is a near perfect solution that any medical student can deserves as it natures their understanding. Looking at the above explanations and after a critical analysis there are a few conclusions that emerge out as the relationship between these terms/practices.
The first relationship they have is that they are stages that a medical practitioner must understand and go through for him/her to be proficient. The other relationship they have is that each process directly links to the other. In clinical learning, it is necessary for one to employ clinical reasoning skills in order to understand certain phenomenon or processes in the medical field. While undergoing clinical learning one also needs to undergo through clinical practice and use clinical theory and reasoning in the process. Where he/she meets directly with patients and is necessary to use clinical reasoning combine with clinical theory to come up with a diagnosis for the patient.
Conclusion
To a nursing student, it is important for one to understand the clear meaning of each term. Second is to understand the relationship they have with each other such as clinical learning and reasoning or reasoning and theory or practice and learning. When nursing students are undergoing clinical learning placement they need to understand that while in practice they should use there learning experience to aid in clinical reasoning. They should also combine clinical learning acquired skills in combination with clinical theory and reasoning to diagnose patients. They should avoid the use of a single tool such as clinical theory or reasoning alone to diagnose their patients. Finally, it is also important for the students to apply their clinical leaning and reasoning to discuss freely with each other and brainstorm over the clinical theories they encounter during the practice.
Learning Plan
Learning Objective (Smart Goal)
What strategies will help me achieve the learning objective?
Who might help me achieve the learning objective
When will I achieve this learning objective?
How will I know that I have achieved the learning objective
Identify and recognize patient and family involvement so that I can plan their care appropriately while ensuring that I maintain the principles of patient/client privacy and confidentiality
Get to earn the patients trust by ensuring that he/she gets the care required. Also create a rapport with the patients family and ensure continuous communication with them on the patients progress
Academic staff at school, Patients family through collaboration, other senior staff/nurses in the clinical area
Should be able to achieve this objective between the first two weeks of placement at the clinic
When I finally create a good rapport with my patients and their family, See if they trust my competence through a series of questions and also through their behavior towards my services
Develop the required competency and confidence in the range of required skills available according to ANMC standards of proficiency
Follow guidelines and apply what I learned in class setting to the clinical setting. Be free with my colleagues, supervisor and senior nurses so that I can consult with them at any moment
Fellow students, senior nurses, patients through their positive feedback response and my clinical supervisor
this is a long term goal during the clinic practice, therefore by the end of the practice is when I intend to have fully achieved this objective
I will reflect on my experience and take notes to check how my confidence level improved as well as consult my fellow students. For competency this I will require the help of my supervisor as he will be able to give me a competency test
Whenever I get the opportunity, provide useful education, tips and motivation to others in order to encourage awareness, behavior and learning that gives way to healthy lifestyle.
Be free with other students on practice and create a good communication relationship with patients. ensure I have good communication skills, read extensively to ensure I do not give wrong information
Senior clinicians I will be working with and my clinical facilitator
I intend to achieve this by the third day of the clinical practice. which afterwards I will be able to freely communicate with my fellow students and patients
When I see that other students also want to share their ideas and tips, when they also confide in me for motivation. When my patients become free with me and trust in my competency through regular seeking of my advice and help
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