2.50
Hdl Handle:
http://hdl.handle.net/10755/157559
Type:
Presentation
Title:
Measuring Thinking: One Act at a Time
Abstract:
Measuring Thinking: One Act at a Time
Conference Sponsor:Western Institute of Nursing
Conference Year:2009
Author:Molinari, Deana L., PhD, RN, CNE
P.I. Institution Name:Idaho State University, School of Nursing
Title:Associate Professor
Contact Address:921 South Eighth, Stop 8101, Pocatello, ID, 83209, USA
Contact Telephone:208-604-3152
Purpose: Describe the thinking of expert nurses. Rationale: As part of a four year model testing study, expert nurses were asked the same questions as 5 different classes of student nurses will be asked. The goal was to find out how experts think and to compare the results with nursing students in various stages of development. To see if the model could be used with both novices and experts. The study identifies the challenges in measuring thinking. Methods: A qualitative descriptive study using apriori concepts listed in the model were used to count frequencies and assess types of thinking acts. The way the categories were used was compared with other studies. Expert nurses were requested to answer 8 questions while analyzing five case studies. Nurses were asked to list all questions they would ask in each situation and identify information resources required to make decisions. Results: Nurse work experience ranged from 14 to 37 years and mean age was 47.9 while 66% possessed national certifications. Nurses demonstrated using a thinking framework. They approached each case similarly, manipulating their thinking framework to address questions. Nurses responded to questions according to their expertise. For example, case managers responded differently than pediatric nurse specialists to the same question, indicating there is more than one way of thinking about clinical issues. Participants addressed the case study as only one point in time rather than the focus of the question, whereas students addressed the questions as the only item of concern. RNs considered patient life and health history and anticipated future life and health issues like discharge planning, pain possibilities, and home care needs. They anticipated problems and tried to prevent them. Experts explored possible treatments. Experts utilized patient observation as thinking resource students did not. Experts did not list single thinking acts but summarized issues into categories. "Lab tests and medical imagining may need to be done." Ethical issues were addressed. "Care must be taken to be objective with an assessment." Participants questioned the authenticity of patient responses; for example, "although she rates her pain as a 3, she is obviously in pain." Demonstrated thinking about themselves within an interprofessional team while students referred to others as authorities. Expert nurses did not report self-assessment of perceptive, affective, or cognitive issues. Frequencies of thinking acts will be provided. Conclusions/Implications: Experts thought differently from students. They used continuums of time, acuity, professional involvement, and past/future needs. The lack of self-assessment requires further exploration. Why didn't the nurses report self-assessment thinking? Are experts so confident they did not self-assess skills or knowledge? Does the lack of self-assessment pose liability issues? Exploration of experts' clinical thinking frameworks may provide insight in how to teach students to think along continuums rather than focus on present contexts.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleMeasuring Thinking: One Act at a Timeen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157559-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Measuring Thinking: One Act at a Time</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Molinari, Deana L., PhD, RN, CNE</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Idaho State University, School of Nursing</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Associate Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">921 South Eighth, Stop 8101, Pocatello, ID, 83209, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">208-604-3152</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">molidean@isu.edu</td></tr><tr><td colspan="2" class="item-abstract">Purpose: Describe the thinking of expert nurses. Rationale: As part of a four year model testing study, expert nurses were asked the same questions as 5 different classes of student nurses will be asked. The goal was to find out how experts think and to compare the results with nursing students in various stages of development. To see if the model could be used with both novices and experts. The study identifies the challenges in measuring thinking. Methods: A qualitative descriptive study using apriori concepts listed in the model were used to count frequencies and assess types of thinking acts. The way the categories were used was compared with other studies. Expert nurses were requested to answer 8 questions while analyzing five case studies. Nurses were asked to list all questions they would ask in each situation and identify information resources required to make decisions. Results: Nurse work experience ranged from 14 to 37 years and mean age was 47.9 while 66% possessed national certifications. Nurses demonstrated using a thinking framework. They approached each case similarly, manipulating their thinking framework to address questions. Nurses responded to questions according to their expertise. For example, case managers responded differently than pediatric nurse specialists to the same question, indicating there is more than one way of thinking about clinical issues. Participants addressed the case study as only one point in time rather than the focus of the question, whereas students addressed the questions as the only item of concern. RNs considered patient life and health history and anticipated future life and health issues like discharge planning, pain possibilities, and home care needs. They anticipated problems and tried to prevent them. Experts explored possible treatments. Experts utilized patient observation as thinking resource students did not. Experts did not list single thinking acts but summarized issues into categories. &quot;Lab tests and medical imagining may need to be done.&quot; Ethical issues were addressed. &quot;Care must be taken to be objective with an assessment.&quot; Participants questioned the authenticity of patient responses; for example, &quot;although she rates her pain as a 3, she is obviously in pain.&quot; Demonstrated thinking about themselves within an interprofessional team while students referred to others as authorities. Expert nurses did not report self-assessment of perceptive, affective, or cognitive issues. Frequencies of thinking acts will be provided. Conclusions/Implications: Experts thought differently from students. They used continuums of time, acuity, professional involvement, and past/future needs. The lack of self-assessment requires further exploration. Why didn't the nurses report self-assessment thinking? Are experts so confident they did not self-assess skills or knowledge? Does the lack of self-assessment pose liability issues? Exploration of experts' clinical thinking frameworks may provide insight in how to teach students to think along continuums rather than focus on present contexts.</td></tr></table>en_GB
dc.date.available2011-10-26T19:59:06Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T19:59:06Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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