Layer 0Layer 1Layer 2Layer 3SatisfiedEvaluationClinical JudgmentNot SatisfiedRefine HypothesesForm

Layer 0

Layer 1

Layer 2

Layer 3

Satisfied

Evaluation

Clinical Judgment

Not Satisfied

Refine HypothesesForm Hypotheses

Client
Needs

Clinical
Decisions

Recognize
Cues

Analyze
Cues

Prioritize
Hypotheses

Generate
Solutions

Take
Actions

Evaluate
Outcomes

The NCSBN Clinical Judgment Measurement Model

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Environmental Factor Examples Individual Factor Examples

Nursing
Process

Layer 4

Assessment Analysis Planning EvaluationImplementation

Environment Resources Medical
Records

Client
Observation

Consequences
& Risks

Task
Complexity

Time
Pressure

Cultural
Consideration

Prior
Experience

Candidate
Characteristics

Level of
Experience

SkillsKnowledge Specialty

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