• Advanced practice nurse;
  • coronary heart disease risk;
  • decision making;
  • education;
  • nurse practitioner

PURPOSE:  Understanding how nurse practitioners use clinical decision skills in practice has the potential to guide education programs to ensure safe, competent, and high quality advanced nursing practice. This study used the lens of social judgment theory to examine the clinical decision making of 60 nurse practitioners.

METHODS:  A three-group pretest–posttest comparison design was used to evaluate how much insight nurse practitioners had into their clinical decision-making process.

FINDINGS:  Nurse practitioners had modest insight into their clinical decision-making process.

CONCLUSION:  Self-insight has implications for enhancing nurses' decision making, improving education, and fostering agreement among advanced practice nurses.

IMPLICATIONS FOR NURSING PRACTICE:  Self-insight has implications for developing professional decision making and promoting appropriate educational opportunities for advanced practice nurses.