References

A review of clinical decision making: models and current research. J Clin Nurs. 2006; 17:(2)187-95

Bajwa SU, Kitchlew N, Shahzad K, Rehman KU Brief communication: phronesis knowledge as enabler of intuitive decision making. Knowledge Organization. 2015; 42:(1)40-9

Barber K The complexity of decision-making in midwifery: A case study. British Journal of Midwifery. 2012; 20:(4)289-94 https://doi.org/10.12968/bjom.2012.20.4.289

Barnfather T Can intuitive knowledge be taught in midwifery practice?. British Journal of Midwifery. 2013; 21:(2)131-6 https://doi.org/10.12968/bjom.2013.21.2.131

Benner P From novice to expert. Am J Nurs. 1982; 82:(3)402-7

Benner PNew Jersey: Prentice Hall; 2000

Benner P, Tanner C Clinical judgment: how expert nurses use intuition. Am J Nurs. 1987; 87:(1)23-31

Blumenthal-Barby JS, Krieger H Cognitive biases and heuristics in medical decision making: a critical review using a systematic search strategy. Med Decis Making. 2015; 35:(4)539-57 https://doi.org/10.1177/0272989X14547740

Carper B Fundamental patterns of knowing in nursing. ANS Adv Nurs Sci. 1978; 1:(1)13-23

Cervone HF Systematic vs intuitive decision making and the Pareto principle: Effective decision-making for project teams. OCLC Systems & Services: International digital library perspectives. 2015; 31:(3)108-11 https://doi.org/10.1108/OCLC-05-2015-0005

Cook DA Much ado about differences: why expert-novice comparisons add little to the validity argument. Adv Health Sci Educ Theory Pract. 2015; 20:(3)829-34 https://doi.org/10.1007/s10459-014-9551-3

Cross RECheshire: Books for Midwives; 1996

Dale S Heuristics and biases: The science of decision-making. Business Information Review. 2015; 32:(2)93-9 https://doi.org/10.1177/0266382115592536

Draper ES, Kurinczuk JJ, Kenyon S(eds.). Leicester: MBRRACE-UK; 2015

Dreyfus SE, Dreyfus HLUniversity of California, Berkeley: Operations Research Centre; 1980

Elstein A, Shulman L, Sprafka SCambridge: Harvard University Press; 1978

Freeman LM, Griew K Enhancing the midwife–woman relationship through shared decision making and clinical guidelines. Women Birth. 2007; 20:(1)11-15 https://doi.org/10.1016/j.wombi.2006.10.003

Goodman B, Ley TLondon: SAGE Publications; 2012

Griffith R Understanding accountability in midwifery practice: Key concepts. British Journal of Midwifery. 2011; 19:(5)327-8 https://doi.org/10.12968/bjom.2011.19.5.327

Griffith R Accountability in midwifery practice: answerable to mother and baby. British Journal of Midwifery. 2012; 20:(8)601-2 https://doi.org/10.12968/bjom.2012.20.8.601

HM Government. The Nursing and Midwifery Order. 2001. http://tinyurl.com/np6cg46 (accessed 14 July 2016)

Jefford E, Fahy K, Sundin D Decision-Making Theories and their usefulness to the midwifery profession both in terms of midwifery practice and the education of midwives. Int J Nurs Pract. 2011; 17:(3)246-53 https://doi.org/10.1111/j.1440-172X.2010.01900.x

Jordan B Authoritative knowledge and its construction.(eds.). Berkeley: University of California Press; 1997

Kahneman DLondon: Penguin; 2011

Kennedy C, O’Reilly P, Fealy G, Casey M, Brady AM, McNamara M Comparative analysis of nursing and midwifery regulatory and professional bodies’ scope of practice and associated decision-making frameworks: a discussion paper. J Adv Nurs. 2015; 71:(8)1797-811 https://doi.org/10.1111/jan.12660

Klein G A naturalistic decision making perspective on studying intuitive decision making. Journal of Applied Research in Memory and Cognition. 2015; 4:(3)164-68 https://doi.org/10.1016/j.jarmac.2015.07.001

Klein G, Calderwood R, Clinton-Cirocco A Rapid Decision Making on the Fire Ground. Proc Hum Fact Ergon Soc Annu Meet. 1988; 30:(6)576-80

Knight M, Tuffnell D, Kenyon S, Shakespeare J, Gray R, Kurinczuk JJ(eds.). Oxford: National Perinatal Epidemiology Unit; 2015

Ménage D Part 1: A model for evidence-based decision-making in midwifery care. British Journal of Midwifery. 2016a; 24:(1)44-9 https://doi.org/10.12968/bjom.2016.24.1.44

Ménage D Part 2: A model for evidence-based decision-making in midwifery care. British Journal of Midwifery. 2016b; 24:(2)137-43 https://doi.org/10.12968/bjom.2016.24.2.137

McFall JP Rational, normative, descriptive, prescriptive, or choice behavior? The search for integrative metatheory of decision making. Behavioral Development Bulletin. 2015; 20:(1)45-59 https://doi.org/10.1037/h0101039

Mok H, Stevens PA Models of decision making.(eds.). Philadelphia: Elsevier; 2005

Muoni T Decision-making, intuition, and the midwife: Understanding heuristics. British Journal of Midwifery. 2012; 20:(1)52-6 https://doi.org/10.12968/bjom.2012.20.1.52

National Institute for Health and Care Excellence. Intrapartum care for healthy women and babies CG190. 2014. http://www.nice.org.uk/guidance/cg190 (accessed 14 July 2016)

London: NMC; 2012

London: NMC; 2015

Okoli JO, Weller G, Watt J Information processing and intuitive decision-making on the fireground: towards a model of expert intuition. Cognition Technology and Work. 2016; 18:(1)89-103 https://doi.org/10.1007/s10111-015-0348-9

Payne LK Toward a theory of intuitive decision-making in nursing. Nurs Sci Q. 2015; 28:(3)223-8 https://doi.org/10.1177/0894318415585618

Raynor M, Marshall J, Sullivan A(eds.). Philadelphia: Elsevier; 2005

Rew L Acknowledging intuition in clinical decision making. J Holist Nurs. 2000; 18:(2)94-108 https://doi.org/10.1177/089801010001800202

Standing MMaidenhead: Open University Press; 2010

Thompson C, Dowding D Decision making and judgement in nursing – an introduction.(eds.). London: Churchill Livingstone; 2002

Decision-making in midwifery: A tripartite clinical decision

02 August 2016

Professional

02 August 2016

Volume 24 · Issue 8

ISSN (print): 0969-4900

ISSN (online): 2052-4307

Abstract

Decision-making within midwifery practice is complex and challenging, and is directly linked to the standard of care provided. In the literature around decision-making there are alternative approaches mentioned, which are founded on the notion that decision-making is either: logical, such as Elstein et al's (1978) four-stage model; intuitive, such as the intuitive-humanistic model; or an amalgamation of the two. The extent to which these existing models can be applied to midwifery decision-making is discussed, and an adapted decision-making model is presented. This modified model attempts to address the complexity of decision-making in midwifery practice, with reference to a clinical case study to illustrate its function.

This paper aims to consider clinical decision-making within midwifery and critically analyse three decision-making approaches—the hypothetico-deductive approach, the intuitive-humanistic approach and the dual process theory—in relation to a chosen case. Using a modified decision-making tool, a tripartite decision (Box 1) will be discussed and the key elements involved in decision-making within midwifery explored. Pseudonyms have been used when discussing the tripartite decision in order to maintain confidentiality (Nursing and Midwifery Council (NMC), 2015).

Laura*, a woman at term, was visited at home for an early labour assessment. On arrival she appeared to be experiencing one uterine contraction every 7 minutes. Contractions were moderate to palpate, but did not seem to be causing her too much discomfort. The rationale for a vaginal examination to assess her cervical effacement and dilatation was discussed and the woman requested this procedure. Upon examination, it was found that the cervix was mid-anterior, soft and stretchy, 0.5 cm long and 4 cm dilated, which could be stretched to 6 cm. Although 4 cm dilated, the woman's uterine contractions were incoordinate, and too lacking in strength and frequency to diagnose active labour.

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

Limited access to our clinical or professional articles
New content and clinical newsletter updates each month

Or continue by

Signing in with your registered email address

Decision-making

Midwifery

Intuition

Emotional intelligence