Conservatism in Clinical Decision-Making: A Concept Analysis Using Walker and Avant’s Method

Background Conservatism is a multidimensional construct applied across disciplines; however, its meaning and role in clinical decision‑making remain insufficiently delineated, particularly in relation to defensive medicine. Such conceptual ambiguity may contribute to inappropriate clinical judgments and unnecessary interventions, including in nursing practice. Objective To analyse and clarify the concept of conservatism in clinical decision‑making using Walker and Avant’s method of concept analysis. Methods A structured search of PubMed/MEDLINE, Scopus, Web of Science, and CINAHL was conducted without time restrictions to identify literature addressing conservatism in clinical decision‑making. Of 2,401 records screened, 19 sources met the eligibility criteria and contributed conceptual data to the analysis. Data were extracted and synthesized to identify defining attributes, antecedents, related concepts, and consequences. Results Conservatism in clinical decision-making comprised four core attributes: watchful waiting and monitoring, risk–benefit balance, shared decision-making, and reliance on scientific evidence and clinical experience. Identified antecedents included the presence of a decision-making situation and adherence to professional values and norms, with consequences observed at both patient and healthcare system levels. Conclusions Conservatism in clinical decision-making is an evidence-informed approach used under uncertainty when multiple clinically reasonable options are available. It involves structured monitoring, explicit assessment of benefits and harms, shared decision-making, and integration of evidence with clinical judgment. Conceptual clarification may help distinguish this approach from passive delay and defensive practice and inform future research and professional education.