The corridor of clinical uncertainty : using advanced clinical practice knowledge to make safe clinical decisions .
Abstract
' What '
' So what '
Article # 8
Title : The corridor of clinical uncertainty : using advanced clinical practice knowledge to make safe clinical decisions .
Author : David Jefferson
Keele University
DOI : https :// doi . org / 10.21252 / b2mb-af70
The corridor of clinical uncertainty : using advanced clinical practice knowledge to make safe clinical decisions .
Abstract
This paper offers a critical reflection about how undertaking an MSc Advanced Clinical Practice ( ACP ) programme , led to a greater understanding about how cognitive processes impact on making complex clinical judgements and decisions . Insights are offered about how using this understanding can ensure safe clinical decisions are made , especially if the clinician is stuck in the corridor of clinical uncertainty . Driscoll ’ s ( 2007 ) ‘ what ’, ‘ so what ’, ‘ now what ’ model is used to facilitate this reflection . To maintain confidentially , all names have been changed when discussing the case study .
' What '
Children and young people with attention deficit hyperactivity disorder ( ADHD ) present with symptoms of inattention , hyperactivity , and impulsivity , and are typically referred for assessment and diagnosis to Child and Adolescent Mental Health Services out-patient clinics . I worked as an independent non-medical prescriber in one such clinic . In 2019 , a young girl , Chloe , attended clinic with her mum , Sarah , to confirm a diagnosis of ADHD and to discuss the option of commencing medication , Methylphenidate Hydrochloride (‘ Mph ’) to treat her symptoms .
I am an experienced non-medical prescriber , possessing knowledge about the pharmacodynamics and pharmacokinetics of Mph , how it affects the body and how the body affects it . Chloe presented with all 3 symptoms of ADHD and pre-diagnostic testing also indicated ADHD . A clinical judgement of ADHD and clinical decision to prescribe MPH appeared a straightforward one .
' So what '
At the time I saw Chloe in clinic , I was undertaking a module about advanced clinical decision-making as part of my ACP programme . I learned that Dual Process Theory contends that two key processes are employed by clinicians when making decisions System