Tuesday, 22 November 2016

Clinical decision-making: nurse practitoners versus doctors

Roger Watson, Editor-in-Chief

We have published many articles in JAN on how well doctors and nurses perform on tasks traditionally the domain of the doctor and we have featured several in JAN interactcive. This UK study by Thompson et al (2016) titled: 'A comparative study on the clinical decision-making processes of nurse practitioners vs. medical doctors using scenarios in a secondary care environment' and published in JAN demonstrates - again - that nurses perfom favourably when compared with doctors.

The aim of the study was to: 'investigate the decision-making skills of secondary care nurse practitioners compared with those of medical doctors.' As explained by the authors, to do this: 'The information processing theory and think aloud approach were used to understand the cognitive processes of 10 participants (5 doctors and 5 nurse practitioners). One nurse practitioner was paired with one doctor from the same speciality and they were compared using a structured scenario-based interview.' Data were processed over five months and the results showed that nurses took three minutes longer to complete the scenarios.  It was interesting to note that: 'NPs elicited more information when history taking.'

In conclusion the authors state: 'This research suggests that nurse practitioner consultations are comparable to those of medical doctors in a secondary care environment in terms of identifying the correct diagnosis and therapeutic treatment. The information processing theory highlighted that the decision-making processes of both types of professionals were similar.' One implication is that: '(n)urse practitioners should be allowed to assume a wider role in the assessment and treatment of patients in secondary care.'

You can listen to this as a podcast

Reference

THOMPSON S., MOORLEY C. & BARRATT J. (2016) . A comparative study on the clinical decision-making processes of nurse practitioners vs. medical doctors using scenarios in a secondary care environmenJournal of Advanced Nursing.  doi: 10.1111/jan.13206

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