Clinical problem-solving in nursing: insights from the literature

This paper reviews the literature surrounding the research on how individuals solve problems. The purpose of the review is to heighten awareness amongst nurses in general, and nurse academics in particular about the theories developed, approaches taken and conclusions reached on how clinicians problem-solve. The nursing process, which is heavily used and frequently described as a problem-solving approach to nursing care, requires a deductive reasoning process which is not the problem-solving process in use during care-giving activities. More knowledge is required on what process is in place as we develop as a profession. The literature highlights the complexities involved in attempting to uncover thinking processes. The main research approaches to discovering problem-solving strategies in the past three decades have been from a cognitive perspective, with two main theories, decision-theory and information processing-theory, underpinning the majority of studies conducted. None of the research approaches used to date has resulted in the identification of a general model of problem-solving that is consistent across tasks or disciplines. However, early hypothesis activation with subsequent testing of the hypothesis seems to be consistent in clinicians across disciplines.