Asian Nursing Research
Volume 1, Issue 1 , Pages 68-82, June 2007

Thinking in Clinical Nursing Practice: A Study of Critical Care Nurses' Thinking Applying the Think-Aloud, Protocol Analysis Method

  • Kyung-Ja Han, RN, PhD

      Affiliations

    • Professor, College of Nursing, Seoul National University, Seoul, Korea
    • Corresponding Author InformationCorrespondence to: Kyung-Ja Han, RN, PhD, Professor, College of Nursing, Seoul National University, 28 Yongon-dong, Chongro-gu, Seoul, 110-799, Korea
    • ,
  • Hesook Suzie Kim, RN, PhD

      Affiliations

    • Professor, College of Nursing, University of Rhode Island, Kingston, RI, USA
    • ,
  • Mae-Ja Kim, RN, PhD

      Affiliations

    • Professor, College of Nursing, Seoul National University, Seoul, Korea
    • ,
  • Kyung-Ja Hong, RN, PhD

      Affiliations

    • Professor, College of Nursing, Seoul National University, Seoul, Korea
    • ,
  • Sungae Park, RN, PhD

      Affiliations

    • Professor, College of Nursing, Seoul National University, Seoul, Korea
    • ,
  • Soon-Nyoung Yun, RN, PhD, MPH

      Affiliations

    • Professor, College of Nursing, Seoul National University, Seoul, Korea
    • ,
  • Misoon Song, RN, PhD

      Affiliations

    • Professor, College of Nursing, Seoul National University, Seoul, Korea
    • ,
  • Yoenyi Jung, RN, PhD

      Affiliations

    • Department of Nursing, Samsung Medical Center, Seoul, Korea
    • ,
  • Haewon Kim, RN, PhD

      Affiliations

    • Professor, Department of Nursing, College of Medicine, Kwandong University, Gangreung, Gangwon do, Korea
    • ,
  • Dong-Oak Debbie Kim, RN, PhD

      Affiliations

    • Associate Professor, Department of Nursing, College of Oriental Medicine, Daejeon University, Daejeon, Korea
    • ,
  • Heejung Choi, RN, PhD

      Affiliations

    • Associate Professor, Department of Nursing, College of Medicine, Konkuk University, Chungju, Chungbuk, Korea
    • ,
  • Kyungae Kim, RN, PhD

      Affiliations

    • Professor, College of Nursing, Seoul National University, Seoul, Korea

Article Outline

Purpose

The purpose of the paper is to discover the patterns and processes of decision-making in clinical nursing practice.

Methods

A set of think-aloud data from five critical care nurses during 40 to 50 minutes of caregiving in intensive care units were obtained and analyzed by applying the procedures recommended by Ericsson and Simon for protocol analysis.

Results

Four thinking processes before acting were identified to constitute various sorts of thoughts in which the nurses were engaged during patient care: reviewing, validation, consideration, rationalization, and action. In addition, three patterns of sequential streaming of thinking (short, intermediate, long) were identified to reveal various ways the nurses dealt with clinical situations involving nursing tasks and responsibilities.

Conclusion

This study specifies the initial categories of thoughts for each of the processes and various patterns with which these processes are sequentially combined, providing insights into the ways nurses think about problems and address their concerns. The findings suggest that the thinking in clinical practice involves more than focused decision-making and reasoning, and needs to be examined from a broader perspective.

Key Words:  clinical practice nursing research , critical care , nurses , thinking

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PII: S1976-1317(08)60010-9

doi:10.1016/S1976-1317(08)60010-9

Asian Nursing Research
Volume 1, Issue 1 , Pages 68-82, June 2007

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