The impact of mobile technologies on new graduate nurses’ perceived self-efficacy and clinical decision making: A report from a longitudinal study in Western Canada

Abstract

Healthcare environments require practitioners to competently and independently collect pertinent data, select appropriate key resources, prioritize information, solve problems, and make sound clinical decisions. The steady increase of health-related information implies a need for useful, practical Information and Communication Technology (ICT) tools that easily provide nurses' access to accurate evidence-based information. The purpose of this study was to explore the impact of using mobile technologies at the point of care on new graduates' perceived clinical decision making ability and associated level of self-efficacy over time. A longitudinal quasi-experimental pre-test/post-test design was used. A trend in the findings of this small study suggests that over time, using mobile technologies at the point of care did not enhance the participants' perceived clinical decision making ability or self-efficacy in clinical decision making. Notwithstanding, the use of mobile technologies in the practice setting is wide spread. It, however, may be that the transition from student to graduate nurse is a significant enough event that seriously limits the useful influence of mobile devices and their associated applications on clinical decision making ability and self-efficacy.

Handheld Computer Devices to Support Clinical Decision-making in Acute Nursing Practice: Systematic Scoping Review

“…The characteristics and outcomes of the 12 studies that investigated HCDs as clinical decision-making supports are summarized in Table 3 . The studies in this group investigated the extent to which HCDs could improve the quality of clinical assessment and management decisions or processes (10/12, 83%) [ 28 , 31 - 33 , 35 , 36 , 40 , 42 , 51 , 52 ] and enhance nurses’ capacity for clinical decision-making (2/12, 17%) [ 37 , 38 ]. HCD interventions targeted processes of nurse clinical decision-making using a range of modalities, which varied according to the predominance of clinician versus algorithmic judgment.…”

“…HCD interventions targeted processes of nurse clinical decision-making using a range of modalities, which varied according to the predominance of clinician versus algorithmic judgment. These were as follows: (1) clinical reference guides to support unstructured clinical judgments (2/12, 17%) [ 37 , 38 ]; (2) aide-mémoire to structure clinical judgment (3/12, 25%) [ 28 , 31 , 35 ]; and (3) fully computerized algorithmic assessments [ 32 , 52 ], drug dosing [ 40 ], and clinical pathways [ 33 , 36 , 42 , 51 ], with varying levels of clinician override (7/12, 58%). In total, 8% (1/12) of studies investigating the impact of HCD use on clinical decision-making used PDAs [ 35 ], whereas the remaining 92% (11/12) of studies used modern HCD technology.…”

“…In total, 8% (1/12) of studies investigating the impact of HCD use on clinical decision-making used PDAs [ 35 ], whereas the remaining 92% (11/12) of studies used modern HCD technology. Studies within this theme were undertaken in emergency departments (4/12, 33%) [ 31 , 36 , 42 , 51 ], in various health and hospital settings (3/12, 25%) [ 28 , 37 , 38 ], in inpatient wards (3/12, 25%) [ 35 , 40 , 53 ], in an infectious pediatric ward (1/12, 8%) [ 52 ], and in the context of a laboratory-based simulation (1/12, 8%) [ 32 ].…”

“…Research (2/28, 7%) examining the degree to which handheld technology may enhance nurses’ self-rated decision-making capacity reported no significant impact from HCDs. Specifically, Sedgwick et al [ 37 ] found that the use of a nursing smartphone app (“PEPID”) over the course of 1 month failed to significantly improve nurses’ ratings of self-efficacy and the ability of new graduate nurses to make clinical decisions in a rural hospital setting. A later publication by the same authors [ 38 ] reported that the intervention was not associated with nurses’ perceptions of improvements in their clinical decision-making processes.…”