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2010/1 Module Catalogue
 Module Code: NURM055 Module Title: CLINICAL DECISION MAKING
Module Provider: Health & Social Care Short Name: CLINDECMAKING
Level: M Module Co-ordinator: MOORE CR Mrs (HSC)
Number of credits: 15 Number of ECTS credits: 7.5
Module Availability
Semester 1
Assessment Pattern
Academic assignment discussing comparative theories in clinical reasoning and their application to practice.
3,000 words (100%)

Module Overview
First degree or ability to work at Level M.
Module Aims
The development of professional knowledge in the sphere of clinical reasoning and decision-making skills within the health and social care context. The module aims to facilitate a wider understanding of the theories of reasoning in the clinical domain including the development of expertise, memory and knowledge, and reasoning strategies employed by practitioners
Learning Outcomes
On completion of the module, the student should be able to:

Subject knowledge and understanding
• show depth of knowledge of reasoning skills within the health and social care setting
• demonstrate a comprehensive understanding of the strategies applied in clinical reasoning and of underpinning theoretical concepts.

Cognitive skills
• critically analyse complementary theories within the reasoning domain
• synthesise information and utilise knowledge from various sources in the decision-making pathway
• exhibit a conceptual understanding, which allows critical appraisal of research and alternative approaches within the reasoning domain.

Practical skills
• utilise a comprehensive problem-solving approach in decision making relevant to practice, operating with complex issues.

Key / transferable skills
• exhibit competent management of information with reflective evaluation, using the full range of learning resources.
Module Content
Problem setting:
Problem identification, critical thinking, structuring the problem, pattern recognition / categorisation processes, prototypes.

Decision making:
Process in practice, alternative actions, information processing, diagnostic and narrative reasoning, using evidence and best practice, forward and backwards reasoning, illness script theory

Factors affecting decision-making:
Intrinsic and extrinsic, legal and ethical issues, the development of expertise, health and social care policies

Decision analysis approach:
Evaluation of effectiveness of decision making, peer review and feedback, clinical supervision.
Methods of Teaching/Learning
The module will be delivered over five full days utilising lectures, discussion and evaluation, small group work, focused clinical enquiry-based learning and tutorials as teaching methods. Lectures and decision theory content will be delivered by specific expert teachers, and supported by pathway specialists.

Taught: 36 hours
Self-directed learning: 114 hours
Selected Texts/Journals


Benner P 1984 From Novice to Expert. Excellence and Power in Clinical Nursing Practice Addison Wesley, London

Dowie J, Elstein A 1999 Professional Judgement. A reader in clinical decision-making. University Press Cambridge

Elstein A 2000 Clinical problem solving and decision psychology Academic Medicine 75 S134 - 136

Greenhalgh T, Hurwitz B 2004 Narrative Based Medicine BMJ Books London

Hammond K R 1996 How convergence of research paradigms can improve research on diagnostic judgement Med Dec Making 16(3) 281 - 87

Higgs J, Jones M, Loftus S, Christensen N 2008 Clinical reasoning in the Health Professions. 3rd Edition Elsevier Butterworth Heinemann London

Knottnerus J 2002 The Evidence base of Clinical Diagnosis BMJ books London.

Llewelyn H Hopkins A (Eds) 1993 Analysing how we Reach Clinical Decisions Royal College of Physicians London

Norman S 2005 Research in clinical reasoning: past history and current trends Med Education 39 418 - 427

Schwartz A Bergus G 2008 Medical Decision Making : A Physicians Guide Cambridge University Press Cambridge

Thompson C, Dowding D 2002 Clinical Decision-Making & Judgement in Nursing Churchill Livingstone


Alfaro-LeFevre R 2009 Critical Thinking and Clinical Judgement 4nd edn Saunders Elsevier, London

Brechin A, Brown H, Eby M A 2000 Critical Practice in Health and Social Care OU Press, London

Cox C L 2001 Clinical Effectiveness in Practice Palgrave, Basingstoke

Davies C, Finlay L, Bullman A 2000 Changing Practice in Health & Social Care Sage, London

Johns C, Freshwater D (eds) 1998 Transforming Nursing Through Reflective Practice. Blackwell Scientific Publications, Oxford

McCormack B, Manley K, Garbett R 2004 Practice development in nursing, Blackwell Publishing, Oxford

Specialist tutors will advise students on the specific reading required for their area of practice.
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