Intuition and the development of expertise in surgical ward and intensive care nurses

King, Lindy; Clark, James G.

doi:10.1046/j.1365-2648.2002.02105.x

Cited by 98 publications

(127 citation statements)

References 22 publications

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“…King and Macleod Clark [28] support this, in their study that explored nurses' understanding and use of intuitive decision making in clinical practice in Australia. This means that critical care nurses usually make clinical decision based on their experience in similar situation and in accordance with cues they identify in the clinical situations they face.…”

Section: Discussionmentioning

confidence: 89%

Clinical Decision-Making among Critical Care Nurses: A Qualitative Study

Maharmeh¹,

Alasad²,

Salami³

et al. 2016

Health

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The purposes of this study were to describe the decision making process and decision activities of critical care nurses in natural clinical settings. An exploratory descriptive approach utilizing both interview and observation methods, was used for data collection. The study involved twenty four critical care nurses from three hospitals in Jordan. Participant observation was performed to understand the routine clinical decisions made by Intensive Care nurses. About 150 hours of observations were spent in the involved Intensive Care Units. Nurses were interviewed to elicit information about how they made decisions about patient's care. The study revealed that the most common model nurses tend to use was intuitive model in order to observe the cues relating to the patient's situation. Data revealed that the decision making process is continuous and that experience is one of the main factors that determine nurses' ability to take decisions. Five themes were generated from the data: on-going process, autonomy, experience/power, joint/ethical decisions, and advocacy. Critical care nurses were seen to be sensitive to the patient's verbal and non-verbal cues; they were able to respond to these evidences to ensure that the patient's condition did not deteriorate. Critical care nurses are likely to be more confident and effective when dealing with patient's changing situations with more experience.

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Section: Discussionmentioning

confidence: 89%

Clinical Decision-Making among Critical Care Nurses: A Qualitative Study

Maharmeh¹,

Alasad²,

Salami³

et al. 2016

Health

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show abstract

“…This derives from the original works of numerous authors, (Dewey 1958, Polanyi 1962and Carper 1978, as they describe the fundamental importance of intuition in ways of knowing in nursing. This is characteristically attributed to an "uneasy, gut feeling" about a patient as they expect the patient to "go off" (Benner& Tanner 1987, King & Appleton 1997, Effken 2001, Trueman 2003.…”

Section: Discussionmentioning

confidence: 99%

Factors that influence nurses' assessment of patient acuity and response to acute deterioration

et al. 2018

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Factors that influence nurses' assessment of patient acuity and response to acute deterioration.http://researchonline.ljmu.ac.uk/8425/ Article LJMU has developed LJMU Research Online for users to access the research output of the University more effectively. Copyright © and Moral Rights for the papers on this site are retained by the individual authors and/or other copyright owners. Users may download and/or print one copy of any article(s) in LJMU Research Online to facilitate their private study or for non-commercial research. You may not engage in further distribution of the material or use it for any profit-making activities or any commercial gain.The version presented here may differ from the published version or from the version of the record. Please see the repository URL above for details on accessing the published version and note that access may require a subscription. As they are responsible for the care they provide to their patients. A part of this care is the monitoring of the patient's vital signs such as blood pressure, pulse, respiratory rate, temperature, which are fundamental in the surveillance of health deterioration.

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“…Intuition is a component of the critical thinking process 44 and is considered to be knowledge that is not acquired through analytical reasoning, but rather through an immediate interaction of the clinician's wisdom, experience, and personality with surroundings, context, and patient response 16,45 . Clinicians appear to be increasingly capable of using intuition or a gut-feeling that can guide clinical decision-making as their clinical 45,46 . However, it is surprising that OMPT educators were undecided about this factor, as it may serve clinicians in the decision-making processes that are incorporated in OMPT examination and management of patients.…”

Section: Intrinsic and Extrinsic Factors Important To Manual Therapy mentioning

confidence: 99%

Intrinsic and Extrinsic Factors Important to Manual Therapy Competency Development: A Delphi Investigation

Sizer

Sawyer²,

Felstehausen³

et al. 2008

Journal of Manual & Manipulative Therapy

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A learner's development of orthopaedic manual physical therapy (OMPT) psychomotor skills may be influenced by selected intrinsic and extrinsic factors. The purposes of this study were to identify the factors that influence learners' development of manual physical therapy competencies and to define each factor as intrinsic or extrinsic. A 3-round Delphi method survey and a retrospective review of the data were used to develop composite scores and rankings. Eighty manual physical therapy educators participated in the 3 rounds. Thirty-six factor descriptor statements associated with manual physical therapy competency were established and further categorized as intrinsic (19 total), extrinsic (10 total), or conceptual outliers (7 total). Cognitive Processing ranked as the most important factor influencing manual physical therapy competency development. Adaptation ranked second, followed by Science Knowledge. This study is the first to establish manual physical therapy educational factors associated with attainment of competency. The majority of the factors distill into the theory of extrinsic and intrinsic factors identified by Schmidt and Lee. The outcomes of this study identify the factors to which OMPT educators should give particular attention when developing and executing the learning experiences for their learners. Keywords:Competency-Based Education, Curriculum, Delphi Technique, Factors, Motor Learning, Musculoskeletal Manipulations, Psychomotor Performance. S pecific manual and/or movement-based competencies are emphasized by physical therapy educators during learners' development of psychomotor skills. Psychomotor skill acquisition is a product of psychomotor learning, which is a set of processes associated with practice or experience leading to relatively permanent changes in the capability for responding to stimuli 1 . As a consequence of psychomotor learning, individuals gain greater movement efficiency, develop more complex movement control strategies, optimize movement behaviors, and develop movement expertise 2 . Schmidt and Lee identified five extrinsic and four intrinsic factors that influence psychomotor learning factors are 1) practice, 2) feedback, 3) task classification, 4) instruction format, and 5) movement context. Factors such as practice, which involves cognitive processing 3,4 , accentuate learned abilities through the processing of sensory information 5 . The use of quantitative feedback and concurrent feedback in manual physical therapy learning has provided both favorable [6][7][8] and unfavorable results 9 . Visual instructional formats incorporate observation to facilitate psychomotor skill acquisition 10 , while kinesthetic instruction uses the learner's sensory system by physically moving the learner through the task 11 . Finally, movement context appears to influence psychomotor skill acquisition 12 . The intrinsic factors include 1) attention, 2) memory, 3) motivation, and 4) psychomotor learning stage 13 . These factors are less tangible and more difficult to measure t...

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Intuition and the development of expertise in surgical ward and intensive care nurses

Cited by 98 publications

References 22 publications

Clinical Decision-Making among Critical Care Nurses: A Qualitative Study

Clinical Decision-Making among Critical Care Nurses: A Qualitative Study

Factors that influence nurses' assessment of patient acuity and response to acute deterioration

Intrinsic and Extrinsic Factors Important to Manual Therapy Competency Development: A Delphi Investigation

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