Clinical decision making


We all have to make decisions in life every day. Some are made quickly and intuitively, whilst others must be carefully thought out and backed up by evidence. This is particularly the case when it comes to patient care.

At one end of the decision-making spectrum, we use our intuition and experience to make our decisions. This is usually the case when decisions are easy and familiar. However, at the other end of the spectrum, our decisions are more complex with a high level of uncertainty. An analytical and evidence-based approach is therefore required to support the rules-based heuristics or experience we have gained over time in ‘similar’ situations. 

Clinical decision making is all about striking a balance between awareness, experience, knowledge, and information gathering, using appropriate assessment tools, colleague support and evidence-based practice in guiding you.

Clinical decision making: What are the core skills?

Effective, accurate clinical decision making involves a mix of experience and skills. These include:

  • Learning from situations that have happened before and recognising patterns
  • Critical thinking, which helps us remove emotion from our reasoning. It means we’re more ‘sceptical’, with the ability to clarify goals, are open-minded, can examine assumptions, recognise personal attitudes, and bias, and evaluate evidence.
  • Communication skills such as active listening that means we can hear what our patients are really saying to us. We also read the subtext in what they don’t say, thus enabling a patient-centred approach that embraces self-management.
  • Information provision, where we are able to provide information in a comprehensible way so that patients/clients, their carers and family can be involved in the decision-making process.
  • Evidence-based approaches that use available evidence and best practice guidelines as part of the decision-making process.
  • Teamwork that allows us to enlist help, support and advice from colleagues and the wider multi-disciplinary team. It’s important to liaise with colleagues, listen and be respectful, whilst also being persistent when you need support so that you can plan as a team when necessary.
  • Sharing your learning and obtaining feedback from colleagues about your clinical decisions.
  • Reflection, where we take in feedback from others as well as the outcomes of our decisions to reflect on how we can improve practice delivery in future. It’s also important to reflect on your decision-making strategies as a whole, to ensure that you hone your skills and learn from experience.

Better understanding clinical decision making in acute care

If you’re a primary healthcare professional such as a nurse, paramedic or other practitioner working in acute care, PDUK’s course Clinical decision making & the deteriorating adult in primary care is well worth considering. Offering a solid foundation in decision making processes, this is a hands-on, practical course that offers useful tools in effective diagnosis and treatment.

As the course is held online it’s ideal for those looking to fit learning around other work and family commitments. It’s run over 2 days and is worth 14 hours of CPD. However, spaces will be limited so it’s well worth booking up early.

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