HESI CLINICAL DECISION MAKING
( LATEST ) ACTUAL QUESTIONS AND ANSWERS
100% CORRECT
• External Scientific Evidence:
Answer:
= the results of research that has been conducted in a specific area of treatment,
assessment, or service delivery
Clinical Decision:
1. Clinical Expertise
2. Best external scientific evidence
3. Patient preferences and values
*An alternative to the EBP triangle*
• External Scientific Evidence:
Answer:
Individual Studies: Individual Study Designs:
1. Experimental: variable(s) altered by investigator and a controlled comparison
between 2 or more groups
2. Quasi-Experimental: non-randomized, controlled comparison
3. Non-experimental or observational: no altered variables and no controlled comp
• Experimental RCT:
Answer:
Randomized Control Trial / Quasi Experimental Design: PARTICIPANTS ->
Random Assignment -> Condition 1 or Condition 2 -> Measurement of Change /
Outcome
• Observational:
Answer:
PARTICIPANTS -> Observational Measurement of Change / Outcome
,3. Synthesize Results
Meta-Analyses:
1. Identify Studies
2. Appraise Studies
3. Synthesize Results
4. Effect size and confidence interval
*ES = statistical measure of the size of the relationship
*CI = a range of values in which true value lies
• Statistical Significance & p-values:
Answer:
-NULL hypothesis = No difference between groups.
-P-values evaluate how well the sample data support the NULL.
-A p-value is the probability of finding the observed or more extreme results.
-A small p-value (typically d 0.05) indicates strong evidence of differences
between
group means (not likely due to error).
*REJECT NULL
-A large p-value (> 0.05) indicates weak / no evidence of differences between
group
means.
*ACCEPT NULL
-In most analyses, an alpha of 0.05 is used as the cutoff for significance.
*AGAIN -- If the p-value is less than 0.05, we reject the null hypothesis that
there's
no difference between group means and conclude that a significant difference does
exist
• What is Mindfulness:
Answer:
-Mindfulness is the basic human ability to be fully present, aware of where we are
and what we're doing, and not overly reactive or overwhelmed by what's going on
around us" or simply stated, "paying attention"
-Mindfulness can be developed.
-What does is mean to you?
• Clinical Education & Mindfulness:
Answer:
-Challenging patient experiences
-Assumptions about site, setting, practice, etc.
,-Qualities of clinical instructor
-Feedback
• Mindful Practice and Clinical Reasoning:
Answer:
-Mindfulness has been linked to increased critical thinking (CT).
-CT is an important higher-order cognitive process which involves the ability to
analyze and evaluate evidence and arguments.
-Being able to "think on your feet" requires the engagement of CT
• Conscious Competency Model:
Answer:
-Unconsciously Incompetent
*I don't know what I don't know
-Consciously Incompetent
*I know what I don't know
-Consciously Competent
*I know what I know
-Unconsciously Competent
*I don't think about what I know
• The Necessity of Relying on our Mind:
Answer:
-We Construct Our Decisions:
*Experts provide information and assertions
*But we must listen and evaluate
~We must construct our answer
-Responsibility of Decision Making:
*Must assert rational control of our beliefs and conclusions
*Answers must make sense to YOU
*Critical thinking is important tool
• Critical Thinking to the Rescue:
Answer:
-Awareness of a set of interrelated critical questions
-Ability to ask and answer critical questions in an appropriate manner
-Desire to actively use the critical questions
• Weak-Sense and Strong-Sense Critical Thinking:
, Answer:
Weak-Sense Critical Thinking:
1. Critical thinking as defending your beliefs
2. Not concerned with truth or virtue
3. Resist others' opinions and reasoning
4. Closed-minded
Strong-Sense Critical Thinking:
1. Applies critical thinking to all claims
2. Looks critically at own initial beliefs
3. Protects against self-deception and conformity
4. Open-minded
• The Sponge Thinking Style:
Answer:
-The more information you absorb, the more you can understand complexities
-Relatively passive; quick and easy
-Emphasizes knowledge acquisition
What's the problem?
• The Panning for Gold Thinking:
Answer:
-Question-asking attitude
-Must determine worth of what is seen and heard
-Emphasizes interactive involvement
BE THIS MODEL!!
• ASHA's Definition of EBP:
Answer:
-The goal of EBP is the integration of:
1. External scientific evidence
2. Client/patient/caregiver perspectives
3. Clinical expertise
-To provide high-quality services reflecting interests, values, needs, and choices of
the individuals we serve.
Dynamic integration of the three:
1. Client Perspectives
2. Clinical Experience
3. External Scientific Evidence
• Why Is EBP Important?:
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