Advancing the Science of Research in Nursing Education: Contributions of the Critical Decision Method

Author(s):  
Angela M. McNelis ◽  
Pamela M. Ironside ◽  
Sarah E. Zvonar ◽  
Patricia R. Ebright
Author(s):  
Laura G. Militello ◽  
Christen Sushereba ◽  
Simon Fernandez ◽  
David Bahner ◽  
Emily S. Patterson

Strategies for assessing macrocognitive skill must be tailored to work domains and specific tasks. This paper describes one approach for leveraging the critical decision method, a structured interview technique, to develop an assessment method for new technologies. The approach uses garden path scenarios, where initial cues suggest a different (false prime) diagnosis than later cues and thus requires changing the leading diagnosis over time, to assess sensemaking and re-planning skills in the context of tactical combat casualty care. Critical decision method interviews with emergency medicine physicians revealed critical cues specific to particular injuries and common across different injuries, and also provided cases that were used as the foundation for garden path scenarios. Evaluations using this approach with garden path scenarios enables having an objective measure to compare performance with and without a new technology on a continuous variable of the time until landmark events, such as recognition of a critical cue, committing to a likely diagnosis, or ruling out an inaccurate diagnosis. Additional measures include whether or not particular cues are noticed based upon gaze tracking data and think aloud statements, and exams that assess knowledge of anatomy and treatment priorities. Re-planning measures will focus on comparing performance to an expert model such as for tourniquet application, whether or not tasks on a checklist are conducted in the expected order including for prioritizing where to look for patient assessment, action priorities, and the trainee’s ability to link diagnosis to appropriate treatment.


1989 ◽  
Vol 19 (3) ◽  
pp. 462-472 ◽  
Author(s):  
G.A. Klein ◽  
R. Calderwood ◽  
D. MacGregor

2016 ◽  
Vol 10 (1) ◽  
pp. 36-56 ◽  
Author(s):  
Mary D. Patterson ◽  
Laura G. Militello ◽  
Amy Bunger ◽  
Regina G. Taylor ◽  
Derek S. Wheeler ◽  
...  

Author(s):  
Giovanni Dolif ◽  
Andre Engelbrecht ◽  
Alessandro Jatobá ◽  
Antônio Dias ◽  
José Orlando Gomes ◽  
...  

2016 ◽  
Vol 11 (1) ◽  
pp. 42-62 ◽  
Author(s):  
Hana Harenčárová

The objective of this article is to improve the understanding of uncertainty in paramedics’ work and the strategies they employ to manage uncertainty, and to provide a resource for training novices. Managing uncertainty is an important part of paramedic decision making and may have a direct impact on patient’s health. Yet, uncertainty has not been sufficiently examined in the naturalistic decision-making paradigm. Therefore, in this study I looked at the uncertainty paramedics have to deal with in nonroutine situations and the strategies they use to manage it. I conducted critical decision method interviews with nine paramedics from paramedic-only ambulance crews. To study uncertainty and coping strategies, I used the RAWFS (reduction, assumption-based reasoning, weighing pros and cons, forestalling, and suppression) heuristic framework. As hypothesized, types of uncertainty were predicted by incident phase, and the coping strategies were predicted by both incident phase and type of uncertainty. The most prevalent type of uncertainty was inadequate understanding of the situation, and the strategy most used to manage uncertainty was reduction. I describe specific examples of cases of uncertainty and the strategies used by paramedics, with the aim of providing materials for training the novices.


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