Using Metacognitive Skills: The Quality Audit Tool

The authors describe a strategy used to teach clinical reasoning skills to novice diagnosticians. The strategy proposed is the Quality Audit Tool, an instrument designed to help novices use metacognitive skills to critique diagnostic statements and care plans. The Quality Audit Tool has eight frames (Diagnostic Statement, Diagnostic Cues, Functional Relationship, Outcome, Etiology, Nursing Orders, Evaluation, and Clinical Judgment); each frame has a content and process focus. Conducting a Quality Audit enables the novice diagnostician to understand relationships among the parts of a nursing diagnosis, recognize the metacognitive skills used in clinical reasoning, and evaluate knowledge and clinical reasoning against a set of standards.