A study of attention allocation mode in clinical decision-making in nurses with different professional titles: An eye-tracking experiment

Abstract

Background: Attention is an important cognitive process. Cognitive and thinking processes can be explored by examining how attention is allocated and the characteristics of visual behavior. Clinical decision-making skills are the focus of nurses’ knowledge and competency development, and the application of attention allocation modalities and visual behavioral traits in the study of clinical decision-making is lacking. Objective: The aim of this experiment was to investigate the way in which attention is allocated in the clinical decision-making process of nurses of different professional rank and titles and associated factors. Methods: Seventy-six subjects from emergency departments of three hospitals in Beijing were recruited in this experiment using the convenience sampling method, including 28 junior nurses, 24 senior nurses, and 24 supervisor nurses. Subjects were required to complete clinical decisions tasks, and datas on subjects’ visual behavior were recorded and analyzed using a Tobii Pro eye-tracker during the decision-making process. Results: Nurses with high professional titles had a higher correct response rate in the nursing diagnosis and ranking of nursing diagnoses part (P<0.05), and it was found that nurses with high professional titles would pay attention to pathophysiological mechanisms of illness earlier when making decisions (F=3.808, P=0.024).The heat maps showed differences in the attention allocation modes of nurses with different titles during the decision-making process. Conclusions: Lower-titled nurses focused more on the symptoms and signs section when making clinical decisions and paid less attention to the auxiliary examination results section, demonstrating a poorer level of active attention. Nurses with higher titles were relatively more comprehensive in their distribution of attention to patient disease information when making decisions and paid attention to the information in the patient’s auxiliary examination section earlier.