Defining characteristics of expertise in Japanese clinical nursing using the Delphi technique

Nojima, Y; Tomikawa, Takako; Makabe, Satsuki; Snyder, Mariah

doi:10.1046/j.1442-2018.2003.00129.x

Cited by 13 publications

(12 citation statements)

References 34 publications

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“…(); (7) McHugh and Lake (); (8) Morrison and Symes (); (9) Naumanen‐Tuomela (); (10) Nojima et al. (); (11) Cutcliffe (); (12) Johnston and Smith (); (13) Brykczynski (); (14) Bonner (); (15) Conway (); and (16) Bobay et al. ().…”

Section: Resultsmentioning

confidence: 99%

Nursing expertise: a course of ambiguity and evolution in a concept

Hutchinson

Higson²,

Cleary

et al. 2016

Nursing Inquiry

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In this article, we clarify and describe the nature of nursing expertise and provide a framework to guide its identification and further development. To have utility and rigour, concept-driven research and theories of practice require underlying concepts that are robust, valid and reliable. Advancing understanding of a concept requires careful attention to explicating its knowledge, metaphors and conceptual meaning. Examining the concepts and metaphors of nursing expertise, and how they have been interpreted into the nursing discourse, we aimed to synthesise definitions and similarities between concepts and elicit the defining characteristics and properties of nursing expertise. In clarifying the concept, we sought to move beyond the ambiguity that currently surrounds expertise in nursing and unravel it to make explicit the characteristics of nursing expertise from published peer-reviewed studies and structured literature synthesis. Findings indicate a lack of clarity surrounding the use of the term expertise. Traditional reliance upon intuition as a way of explaining expert performance is slowly evolving. Emerging from the analysis is a picture of expertise as the relationship between networks of contextual reasoning, understanding and practice. Striking absences in the discourse include limited explication of ethical reasoning and theorising a broader interpretation of expertise reflective of contemporary forms of nursing.

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Section: Resultsmentioning

confidence: 99%

Nursing expertise: a course of ambiguity and evolution in a concept

Hutchinson

Higson²,

Cleary

et al. 2016

Nursing Inquiry

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“…Although findings have not been consistent in all settings (Hoffman et al 2009), expert nurses were seen to collect and cluster fewer cues with high diagnostic accuracy and on a wider range of aspects of the patient's presenting symptoms focusing on these that are relevant to the hypothesis made (Aitken 2003). Novice nurses collected greater number of cues, concentrated only on the presenting symptoms of the patient and were less proactive in collecting relevant information and anticipating problems (Nojima et al 2003), because of their inability to discriminate between salient and non-salient cues. To understand better how nurses collect and use cues to make decisions, this study was designed to answer the following questions: 1 What cues do novice and expert critical care nurses cluster together to make a decision about the management of patients who wean off mechanical ventilation?…”

Section: Introductionmentioning

confidence: 94%

“…Novice nurses collected greater number of cues, concentrated only on the presenting symptoms of the patient and were less proactive in collecting relevant information and anticipating problems (Nojima et al . ), because of their inability to discriminate between salient and non‐salient cues. To understand better how nurses collect and use cues to make decisions, this study was designed to answer the following questions: What cues do novice and expert critical care nurses cluster together to make a decision about the management of patients who wean off mechanical ventilation? What strategies do novice and expert critical care nurses use to evaluate the cues presented by the patient when making decisions about the management of patients who wean off mechanical ventilation? Are there any differences between novice and expert critical care nurses in the use of cues when they make decisions about the management of patients who wean off mechanical ventilation? …”

Section: Introductionmentioning

confidence: 99%

Understanding nurses' decision‐making when managing weaning from mechanical ventilation: a study of novice and experienced critical care nurses in Scotland and Greece

Kydonaki

Huby

Tocher

et al. 2016

Journal of Clinical Nursing

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Aim and objectives To examine how nurses collect and use cues from respiratory assessment to inform their decisions as they wean patients from ventilatory support. Background Prompt and accurate identification of the patient's ability to sustain reduction of ventilatory support has the potential to increase the likelihood of successful weaning. Nurses' information processing during the weaning from mechanical ventilation has not been well‐described. Design A descriptive ethnographic study exploring critical care nurses' decision‐making processes when weaning mechanically ventilated patients from ventilatory support in the real setting. Methods Novice and expert Scottish and Greek nurses from two tertiary intensive care units were observed in real practice of weaning mechanical ventilation and were invited to participate in reflective interviews near the end of their shift. Data were analysed thematically using concept maps based on information processing theory. Ethics approval and informed consent were obtained. Results Scottish and Greek critical care nurses acquired patient‐centred objective physiological and subjective information from respiratory assessment and previous knowledge of the patient, which they clustered around seven concepts descriptive of the patient's ability to wean. Less experienced nurses required more encounters of cues to attain the concepts with certainty. Subjective criteria were intuitively derived from previous knowledge of patients' responses to changes of ventilatory support. All nurses used focusing decision‐making strategies to select and group cues in order to categorise information with certainty and reduce the mental strain of the decision task. Conclusions Nurses used patient‐centred information to make a judgment about the patients' ability to wean. Decision‐making strategies that involve categorisation of patient‐centred information can be taught in bespoke educational programmes for mechanical ventilation and weaning. Relevance to clinical practice Advanced clinical reasoning skills and accurate detection of cues in respiratory assessment by critical care nurses will ensure optimum patient management in weaning mechanical ventilation.

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“…Expert nurses were seen to collect information on a wide range of aspects in addition to the patients' presenting symptoms and illness when collecting cues for a particular problem, while novice nurses tended to concentrate on the presenting symptoms only (White, Nativio, Kobert and Engberg, 1992). In contrast, a study by Hanneman (1996) and a study by Nojima, Tomikawa, Makabe and Synder (2003) found that expert nurses' assessment was found to be more focused than that of novice nurses, concentrating on a smaller range of cues.…”

Section: Introductionmentioning

confidence: 95%