The Outcome-Present State-Test (OPT) Model of Clinical Reasoning: A Framework for Advanced Practice Nursing

Abstract

The purpose of this article is to introduce the Outcome Present State Test (OPT) Model of Reflective Clinical Reasoning and discuss the value and importance of nursing knowledge work to support the clinical reasoning skill set of clinical nurse specialists. Knowledge representation and levels of practice data are critical to methods clinical nurse specialists use to filter, frame, and focus nursing care associated with individual, family, community, and health system care challenges. Nursing process is the foundation for patient problem management. The OPT model is an innovation in clinical reasoning that enhances clinical nurse specialist education, practice, competencies, and research efforts. In this chapter changes to the nursing process through time are described and discussed. The Outcome Present State Test (OPT) Model of Reflective Clinical Reasoning is explained. The cognitive and metacognitive thinking strategies that support use of the OPT model are identified and defined. Strategies to support the complexity of thinking involved in clinical reasoning are outlined. The process has evolved through time with attention to the ontology, epistemology, and evolving nature of professional nursing and developments in knowledge representation. These developments have influenced clinical reasoning perspectives and the critical, creative, systems, and complex thinking skills that support clinical reasoning (Nursology, n.d., Kuiper, Pesut, Arms, 2016).