A comparison of novice and expert nurses' cue collection during clinical decision-making: Verbal protocol analysis

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Title A comparison of novice and expert nurses' cue collection during clinical decision-making: Verbal protocol analysis
Author Hoffman, Kerry A.; Aitken, Leanne Maree; Duffield, Christine
Journal Name International Journal of Nursing Studies
Year Published 2009
Place of publication Netherlands
Publisher Elsevier
Abstract Background The type of cues used during clinical decision-making contexts is not well understood. Further, there are conflicting findings in relation to how novice and expert nurses use cues. Objective The aim of this study was to determine if there were differences between novice and expert nurses in the range and type of cues selected as well as how cues were clustered together when making clinical decisions while caring for post-operative patients in an Intensive Care Unit. Method The sample consisted of four novice and four expert nurses caring for patients post Abdominal Aortic Aneurysm surgery in an Intensive Care Unit. Data were collected using a think aloud (TA) process while participants cared for patients, followed by retrospective interviewing, to generate verbal protocols. The verbal protocols were analysed using content analysis to examine various aspects of decision-making, including number and type of cues used and cue clustering. The decision tasks attended in the real world of practice were described in detail to illuminate the use of cues in context. Results Expert nurses collected a wider range of cues than novice nurses, almost twice as many different cues. The expert nurses also clustered more cues together to identify patient status when making decisions. Expert nurses were more proactive in collecting relevant cues and anticipating problems that may help identify patient problems. Conclusions In the real world of practice expert nurses collect a broader range of cues to assess patient status than novice nurses. This differs to expert nurses cue collection in simulations where expert nurses may select only those cues that are necessary for the identified problem. This difference, if identified in other studies, may have important implications for nursing research and education.
Peer Reviewed Yes
Published Yes
Alternative URI http://dx.doi.org/10.1016/j.ijnurstu.2009.04.001
Copyright Statement Copyright 2009 Elsevier. This is the author-manuscript version of this paper. Reproduced in accordance with the copyright policy of the publisher. Please refer to the journal's website for access to the definitive, published version.
Volume 46
Issue Number 10
Page from 1335
Page to 1344
ISSN 0020-7489
Date Accessioned 2010-02-16
Language en_AU
Research Centre Griffith Health Institute; Centre for Health Practice Innovation
Faculty Griffith Health Faculty
Subject Clinical Nursing: Secondary (Acute Care)
URI http://hdl.handle.net/10072/30917
Publication Type Journal Articles (Refereed Article)
Publication Type Code c1

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