Decision‐making in primary care: outcomes from a study using patient scenarios

Offredy, Maxine

doi:10.1046/j.1365-2648.2002.02410.x

Cited by 51 publications

(38 citation statements)

References 19 publications

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“…To this point, scholars have carried out most nursing studies using the think-aloud technique or protocol analysis with simulations or patient scenarios (see Cioffi & Markham, 1997;Daly, 2001;Offredy, 2002) and have conducted only a small number of studies in acute clinical settings (see Aitken & Mardegan, 2000 [protocol analysis was not used]; Greenwood and King, 1995;Greenwood, Sullivan, Spence, & McDonald, 2000;Simmons et al, 2003). One reason for this is that researchers can easily control interfering variables existing in real-life situations during simulations.…”

Section: Performing a Study With The Think-aloud Techniquementioning

confidence: 99%

Think-Aloud Technique and Protocol Analysis in Clinical Decision-Making Research

2009

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In this article, we aim to describe the practical aspects of research actions that should be taken into account when two methods--the think-aloud technique for data collection and protocol analysis as an analysis technique--are combined with research of decision making in acute clinical settings. These methods are rarely used together or written about in health care research. In addition, careful consideration of the pros and cons of study sampling, data collection, data management, and analysis techniques or approaches is still lacking when these methods are used in health care research. We discuss the background of the think-aloud technique and protocol analysis and review previous studies that have used these methods. The examples in the article are based on our study, in which we investigated the decision making of critical care experts. We find that the combination of the think-aloud technique and protocol analysis is applicable when investigating complex and overlapping decision-making processes and rapid, ad hoc decisions made by critical care experts.

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Section: Performing a Study With The Think-aloud Techniquementioning

confidence: 99%

Think-Aloud Technique and Protocol Analysis in Clinical Decision-Making Research

2009

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“…Having a clear and agreed decision-making process promotes transparency and allows for consensual checking of knowledge and reasoning. Likewise a consensual decision can be made and justified against the data (12,(17)(18)(19)(38)(39)(40). The emphasis on rationality and empirical data is a strength but it is a limitation if rationality and objectivity are used to rule out any data that is emotional or contextual (41)(42).…”

Section: Discussionmentioning

confidence: 99%

Decision‐Making Theories and their usefulness to the midwifery profession both in terms of midwifery practice and the education of midwives

Jefford

Fahy

Sundin

2011

Int J of Nursing Practice

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Jefford E, Fahy K, Sundin D. International Journal of Nursing Practice 2011; 17: 246–253 Decision‐Making Theories and their usefulness to the midwifery profession both in terms of midwifery practice and the education of midwives What are the strengths and limitations of existing Decision‐Making Theories as a basis for guiding best practice clinical decision‐making within a framework of midwifery philosophy? Each theory is compared in relation with how well they provide a teachable framework for midwifery clinical reasoning that is consistent with midwifery philosophy. Hypothetico‐Deductive Theory, from which medical clinical reasoning is based; intuitive decision‐making; Dual Processing Theory; The International Confederation of Midwives Clinical Decision‐Making Framework; Australian Nursing and Midwifery Council Midwifery Practice Decisions Flowchart and Midwifery Practice. Best practice midwifery clinical Decision‐Making Theory needs to give guidance about: (i) effective use of cognitive reasoning processes; (ii) how to include contextual and emotional factors; (iii) how to include the interests of the baby as an integral part of the woman; (iv) decision‐making in partnership with woman; and (v) how to recognize/respond to clinical situations outside the midwife's legal/personal scope of practice. No existing Decision‐Making Theory meets the needs of midwifery. Medical clinical reasoning has a good contribution to make in terms of cognitive reasoning processes. Two limitations of medical clinical reasoning are its reductionistic focus and privileging of reason to the exclusion of emotional and contextual factors. Hypothetico‐deductive clinical reasoning is a necessary but insufficient condition for best practice clinical decision‐making in midwifery.

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“…In a study of UK primary care nurse practitioners and general practitioners, Offredy (2002) attributed the differences between the diagnostic accuracy of the two groups to general practitioners having more knowledge and experience than nurse practitioners. This was related to nurse practitioners' lack of familiarity with the case presentations due to the restrictions general practitioners placed on the type of consultations they performed.…”

Section: Nurse Practitioner and Physician Patient Outcomesmentioning

confidence: 99%

Nurse practitioners versus doctors diagnostic reasoning in a complex case presentation to an acute tertiary hospital: A comparative study

Pirret

Neville

Grow

2015

International Journal of Nursing Studies

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Decision‐making in primary care: outcomes from a study using patient scenarios

Cited by 51 publications

References 19 publications

Think-Aloud Technique and Protocol Analysis in Clinical Decision-Making Research

Think-Aloud Technique and Protocol Analysis in Clinical Decision-Making Research

Decision‐Making Theories and their usefulness to the midwifery profession both in terms of midwifery practice and the education of midwives

Nurse practitioners versus doctors diagnostic reasoning in a complex case presentation to an acute tertiary hospital: A comparative study

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