Accuracy of intuition in clinical decision‐making among novice clinicians

Price, Amanda L.; Zulkosky, Kristen D.; White, Krista A.; Pretz, Jean E.

doi:10.1111/jan.13202

Cited by 24 publications

(25 citation statements)

References 80 publications

(89 reference statements)

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“…This is congruent with findings about people in high-responsibility positions being more disposed to adopt experience-based, non-analytical ways of DM (Agor, 1986;Klein, 1999). Results along the same line in a medical context were obtained by Price, Zulkosky, White, and Pretz (2017).…”

Section: Job-specific Factors Of Intuitive Decision-makingsupporting

confidence: 87%

Person- and job-specific factors of intuitive decision-making in clinical practice: results of a sample survey among Hungarian physicians and nurses

Ruzsa

Szeverényi

Varga

2020

Health Psychology and Behavioral Medicine

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Objective: To assess the prevalence of intuitive decision-making (IDM) among health care practitioners (HCPs) and explore its person-and job-specific factors. Design and Outcome Measures: We used on-line survey data from a cross-sectional sample of Hungarian physicians and nurses (N = 460) to assess their reliance on IDM. In a second survey we asked physicians (N = 104) to rate medical specialties on dimensions of 'emergency' (necessity of making instantaneous decisions in unforeseeable situations) and 'complexity' (necessity of considering multiple perceptual and diagnostic aspects of patients' health condition along with diverse treatment options). Results: Altogether 40% of participants reported ever relying on IDM. Using logistic regression analysis, we found the estimated probability of IDM was 0.24 greater for physicians than for nurses, 0.10 greater for females than for males, and 0.11 greater for advanced level HCPs than for novices. Reaching expert level further increased (by 0.31) the probability of IDM for physicians, but not for nurses. Concerning physicians, practicing in a medical specialty of 'high likelihood of emergency' or 'high complexity' increased the probability of IDM by 0.25 and 0.23; the same effects for nurses were 0.20 and 0.07. We found some (inconclusive) evidence for education positively influencing HCPs' propensity for IDM. Additionally, we performed content analysis of participants' free-text answers to explore the psychological background of IDM instances. HCPs educated in the subject of IDM were found more disposed to perform or request further medical investigation, less prone to deviate from medical protocols, apter to reflect on their mental processes, and more inclined to rely on a large scope of information for their decisions. Conclusions: The associations between job-and person-specific factors and HCPs' propensity for IDM may have implications for their training and allocation in the health care system. Education has great potential for enhancing the quality of IDM in clinical practice.

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Section: Job-specific Factors Of Intuitive Decision-makingsupporting

confidence: 87%

Person- and job-specific factors of intuitive decision-making in clinical practice: results of a sample survey among Hungarian physicians and nurses

Ruzsa

Szeverényi

Varga

2020

Health Psychology and Behavioral Medicine

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“…Intuition provided a confidence in nursing skills and employs new nursing practice methods, as well as a feeling of connection with patients (Pretz & Folse, 2011). In contrast, inexperienced nurses employ an analytic approach when making decision (Price, Zulkosky, White, & Pretz, 2017). Research indicates that experienced nurses make better decisions, especially with more complicated patient care decisions, than inexperienced nurses (Corcoran, 1986).…”

Section: Nursing Decision-making Researchmentioning

confidence: 99%

Decision‐making in nursing practice: An integrative literature review

Nibbelink

Brewer

2018

Journal of Clinical Nursing

204

184

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“…Theories behind Simulation and Clinical Decision-making (CDM) Simulation offers a valuable means to students when practising processes involved in decision-making in a safe, controlled environment (Price et al, 2017). Eva, (Eva, 2005) proposes some of the challenges that teachers face when teaching clinical reasoning include, affording realistic scenarios, directed feedback and instruction to both analytical and intuitive processes as well as the possibility to observing expert behaviour.…”

Section: Theories Of Clinical Decision-makingmentioning

confidence: 99%

Learning by doing: To explore the influence of Simulation on Clinical Decision-Making Approaches on Final Year Medical Students at the University of Duisburg-Essen, Germany

Szalai¹,

Herbstreit²,

Novosadova³

et al. 2021

MedEdPublish

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Background: Final year medical students at the University Duisburg-Essen, Germany, are unsatisfied with their clinical judgement skills in common elective and emergency clinical situations. A competency based medical curriculum determines that clinical judgement is an essential tool in effective patient care, patient safety and limiting clinical error. Approaches to clinical judgement include either analytical, intuitive or a combination of both approaches. Novices show specific factors, which are typical in inexperienced clinicians. Simulation provides opportunities in a competency-based medical education curriculum. There is limited evidence showing that simulation can provide an effective environment for teaching and learning clinical decision-making skills. This project explores how final year medical students at the University of Duisburg-Essen approach the clinical decisionmaking process as well as how simulation influences this process. Methods: Ethics approval was obtained from the local ethics committee. After completing a 10-week simulation course,thirty-five students completed a clinical decision-making instrument to categorise their clinical decisionmaking approaches. The Novice Decision Making Model and the Cognitive Continuum Model were combined with learning theories in Simulation (Social Cognitive Theory) and used to explore and interpret data collected through questionnaires, interviews and observation. Results:The majority (60%) of students employed a predominantly analytic approach, some students showed intuitive tendencies in clinical situations. During interviews students displayed typical novice approaches to decision-

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Accuracy of intuition in clinical decision‐making among novice clinicians

Abstract: Novice clinicians should be supported by educators and nurse managers to note when their intuitions are likely to be valid. Our findings emphasize the integrated nature of intuition and analysis in clinical decision-making.

Cited by 24 publications

References 80 publications

Person- and job-specific factors of intuitive decision-making in clinical practice: results of a sample survey among Hungarian physicians and nurses

Person- and job-specific factors of intuitive decision-making in clinical practice: results of a sample survey among Hungarian physicians and nurses

Decision‐making in nursing practice: An integrative literature review

Learning by doing: To explore the influence of Simulation on Clinical Decision-Making Approaches on Final Year Medical Students at the University of Duisburg-Essen, Germany

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