Module Components

• Learning Activities

Topics

• Decisions Making Overview
• Research
• Patient Preferences
• Clinician Expertise and Context

NRSG 790-Methods for Research and Evidence-Based Practice

Module 12: Practice Decision Making

Clinician Expertise and Context

Evidence based practice decisions are influenced by the research, patient preferences as well as the providers experience and skills. Expertise is developed from observations over time by clinicians based on patient reactions to interventions. Clinical expertise is the mechanism that provides for the integration of research and patient preference into the decision making. Examples of utilizing provider expertise includes:

• Deciding whether or not the best available research evidence actually supports a new practice
• Interpreting the patient’s input and their stated preferences.
• Evaluating the outcomes of previous practice changes in the context of each clinical encounter

Decisions happen with in the context of an organization. Context refers to the conditions in which a particular event or situation occurs. Common contextual elements of a system include the type of services provided, a particular patient population or geographic location, leadership style and structure, care delivery models, and technology. Understanding context requires understanding of elements as well as interrelatedness of elements.

As context refers to the conditions in which something occurs, culture refers to the pattern of perceptions within the system. This relates to values and beliefs, an understanding of norms, and customs and tradition as to how things are done. Organizational culture is a powerful force that determines both individual as well as collective behavior.