Clinical Reasoning Process of Novice and Expert using Consensual Qualitative Research in Observational Situations of Postpartum mothers and Newborns

Abstract

Purpose: The purpose of this study is to describe the process of clinical reasoning in novice level nursing students and expert level midwives using the Dreyfus model in the setting of an observational situations of subjects (postpartum mothers and newborns) as nursing practice.Methods: Consensual Qualitative Research used for qualitative research. The study used the Vignettes Method to compare the behaviors of novices and experts in the same situation, setting up an observation scene of a postpartum woman on the third day and a newborn on the third day after birth. The novices in the study were two fourth-year nursing students at the A university, and the experts were two midwives with more than10 years of experience.Results: Eighteen core ideas were identified as clinical reasoning processes in the two domains of ‘pre-information gathering’ and ‘participants’ observation situations’ for novices and experts.Conclusions: Novices functioned mainly on analytic reasoning only and were likely to make errors in definitive diagnosis, while the experts used empirical knowledge intuitively and combined narrative reasoning to ensure the accuracy of their clinical reasoning.