Using clinical decision making and reflection strategies to support practice
Abstract
Clinical decision making and reflection are essential skills for any health care professional to possess in that they underpin and enhance practice by providing a robust framework for structuring one's thinking and subsequent actions.
This article highlights the need for the study of clinical decision making which forms a vital part of the paramedic's practice. It provides a background to clinical decision making before presenting an example case study.
Clinical decision making has been studied in medicine over the last few decades (Norman, 2005). Jensen et al (2009) noted that very little evaluation has been conducted in the paramedic population. This article highlights the need for the study of clinical decision making which forms a vital part of the paramedic's practice.
According to Parsons and O'Brien (2011), clinical decision making can be considered as a process of applying knowledge and skills to a clinical situation. The dichotomy between the clinical and non-clinical environment creates challenges. In the non-clinical environment, this process is a vital part of paramedical life that often takes place in settings which are unpredictable (Shaban, 2005). Lord (2003) suggested that clinical environments, e.g. emergency departments, increase the likelihood that clinicians will have access to expert opinion, medical records and advanced diagnostic tests. The assessment and management of patients in the non-clinical setting, however, is usually characterised by independent and time critical factors and where access to similar support systems and medical technology is potentially unavailable (Lord, 2003). In this situation, the role of a paramedic is a complex one, as they have to gather, assess, evaluate and synthesise information that relates to a patient's presentation before deciding on appropriate treatment (Saunders, 2005; Caroline, 2008). Throughout this decision-making process, paramedics must continuously evaluate and decide on the extent to which they are making the correct decisions about a particular patient.
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