A comparative study focusing on the clinical decision making processes of nurse practitioners versus medical doctors using scenarios within a secondary care environment

Journal article


Thompson, T, Barratt, J and Moorley, CR (2016). A comparative study focusing on the clinical decision making processes of nurse practitioners versus medical doctors using scenarios within a secondary care environment. Journal of Advanced Nursing. 73 (5), pp. 1097-1110. https://doi.org/10.1111/jan.13206
AuthorsThompson, T, Barratt, J and Moorley, CR
Abstract

Subjects This study was conducted from May 2012 to January 2013. Aim To investigate the decision-making skills of secondary care nurse practitioners compared to those of medical doctors. Background A literature review was conducted, searching for articles published from 1990 to 2012. The review found that nurse practitioners are key to the modernisation of the National Health Service. Studies have shown that compared to doctors, nurse practitioners can be efficient and cost-effective in consultations. Design Qualitative research design. Methods 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. To ensure that all critical and relevant cues were covered by the individual participating in the scenario, a reference model was used to measure the degree of successful diagnosis, management and treatment. Results The data were processed for 5 months, from July to November 2012. The two groups of practitioners differed in the number of cue acquisitions obtained in the scenarios. In our study, nurse practitioners took three minutes longer to complete the scenarios. Conclusion This study suggests that nurse practitioner consultations are comparable to those of medical doctors within a secondary care environment in terms of correct diagnoses and therapeutic treatments. The information processing theory highlighted that both groups of professionals had similar models for decision-making processes. SUMMARY STATEMENT Why is this research or review needed? • The purpose of this research was to highlight the similarities in decision-making skills between nurse practitioners and doctors during consultations. • To highlight to other multi-disciplinary teams that nurse practitioners are equally as capable as doctors in making diagnoses and prescribing further studies or treatment. • To help provide clarity on the role of the nurse practitioner. What are the key findings? • Nurse practitioners and medical doctors used similar cognitive decision-making skills. However, medical doctors were able to chunk more information and used less cue acquisition (history taking) to reach a diagnosis and thus finished their consultations quicker than nurse practitioners. • The more experienced (> 2 years) nurse practitioners were comparable to medical doctors in their consultations. • The two professions showed different consultation styles; nurse practitioners were more holistic, whilst medical doctors were more paternalistic. How should the findings be used to influence policy/practice/research/education? • This study may influence government policy, as it provides more clarity regarding the nurse practitioner’s role and responsibilities. • This study may affect caring practices, as multi-disciplinary teams may acknowledge the nurse practitioner’s abilities, assign them a variety of patients and organize opportunities for further training. • This study contributes to the number of studies that have confirmed that consultations performed by nurse practitioners are comparable to medical doctors’ consultations.

KeywordsNurse practitioners, decision making, medical doctors vs nurse practitioners, consultations, scenario interviews
Year2016
JournalJournal of Advanced Nursing
Journal citation73 (5), pp. 1097-1110
PublisherWiley
ISSN1365-2648
Digital Object Identifier (DOI)https://doi.org/10.1111/jan.13206
Publication dates
Print30 Nov 2016
Publication process dates
Deposited11 Oct 2016
Accepted10 Oct 2016
Accepted author manuscript
License
File Access Level
Open
Additional information

This is the peer reviewed version of the forthcoming article, which will be published in final form at Journal of Advanced Nursing This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.

Permalink -

https://openresearch.lsbu.ac.uk/item/87150

  • 264
    total views
  • 684
    total downloads
  • 7
    views this month
  • 12
    downloads this month

Export as

Related outputs

Young adults with kidney failure lived experiences of kidney replacement therapy decision‐making
Ofori‐Ansah, S., Evans, M., Baillie, L. and Moorley, C. (2024). Young adults with kidney failure lived experiences of kidney replacement therapy decision‐making. Journal of Renal Care. https://doi.org/10.1111/jorc.12508
Person-centred oral hydration care for older people with dementia admitted to acute hospital wards: Empirical research qualitative.
Higgins, S., Baillie, L., Moorley, C. and Nolan, F. (2023). Person-centred oral hydration care for older people with dementia admitted to acute hospital wards: Empirical research qualitative. Journal of Clinical Nursing. 32 (19-20), pp. 7467-7482. https://doi.org/10.1111/jocn.16807
Diffusion of social media in nursing education: A scoping review.
Cathala, X. and Moorley, C. (2023). Diffusion of social media in nursing education: A scoping review. Nurse Education Today. 127, p. 105846. https://doi.org/10.1016/j.nedt.2023.105846
Social justice in nursing education: A review of the literature
Abu, V. and Moorley, C. (2023). Social justice in nursing education: A review of the literature. Nurse Education Today. 126, p. 105825. https://doi.org/10.1016/j.nedt.2023.105825
Reflecting on the experiential journey: Creating, developing and understanding leadership in Equality, Diversity and Inclusion within a Faculty
Premkumar, P., Leadley-Meade, Z., Moorley, C., Rye, S., Clegg, D. and Alasia, S. (2023). Reflecting on the experiential journey: Creating, developing and understanding leadership in Equality, Diversity and Inclusion within a Faculty. Equality, Diversity and Inclusion Conference 2023: The Shoulders of Giants: Listening, Learning and Improving our Practice.
An exploration of social participation in Caribbean student nurses' use of social media in their learning journey
Cathala, X., Ocho, O., Mcintosh, N., Watts, P. and Moorley, C. (2022). An exploration of social participation in Caribbean student nurses' use of social media in their learning journey. Journal of Advanced Nursing. https://doi.org/10.1111/jan.15499
Inclusivity in nurse education.
Moorley, C. and West, R. (2022). Inclusivity in nurse education. Evidence-Based Nursing. 25, pp. 75-76. https://doi.org/10.1136/ebnurs-2022-103570
healthcareCOVID: a national cross-sectional observational study identifying risk factors for developing suspected or confirmed COVID-19 in UK healthcare workers.
Kua, J., Patel, R., Nurmi, E., Tian, S., Gill, H., Wong, D., Moorley, C., Nepogodiev, D., Ahmad, I. and El-Boghdadly, K. (2021). healthcareCOVID: a national cross-sectional observational study identifying risk factors for developing suspected or confirmed COVID-19 in UK healthcare workers. PeerJ. 9, p. e10891. https://doi.org/10.7717/peerj.10891
Senior nurses’ perceptions of junior nurses incident reporting: A qualitative study
Atwal, Anita, Phillip, Miriam and Moorley, Calvin (2020). Senior nurses’ perceptions of junior nurses incident reporting: A qualitative study. Journal of Nursing Management. https://doi.org/10.1111/jonm.13063
Performing an A-G patient assessment: a step-by-step guide
Cathala, X and Moorley, C (2020). Performing an A-G patient assessment: a step-by-step guide. Nursing Times. 115 (11), pp. 53-55.
Gender and health literacy: men’s health beliefs and behavior in Trinidad
Wills, J., Sykes, S., Hardy, S., Joshua, K., Moorley, C. and Ocho, O (2019). Gender and health literacy: men’s health beliefs and behavior in Trinidad. Health Promotion International. https://doi.org/10.1093/heapro/daz076
How to appraise qualitative research
Moorley, C and Cathala, X (2019). How to appraise qualitative research. Evidence-Based Nursing. 22 (1), pp. 10-13. https://doi.org/10.1136/ebnurs-2018-103044
A narrative synthesis on healthcare students use and understanding of social media: Implications for practice
Ramage, C and Moorley, C (2019). A narrative synthesis on healthcare students use and understanding of social media: Implications for practice. Nurse Education Today. 77, pp. 40-52. https://doi.org/10.1016/j.nedt.2019.03.010
Nurse practitioner consultations in primary health care: An observational interaction analysis of social interactions and consultation outcomes - ERRATUM
Barratt, J and Thomas, N (2018). Nurse practitioner consultations in primary health care: An observational interaction analysis of social interactions and consultation outcomes - ERRATUM. Primary Health Care Research and Development. 20. https://doi.org/10.1017/S1463423618000634
Nurse practitioner consultations in primary health care: patient, carer, and nurse practitioner qualitative interpretations of communication processes
Barratt, J and Thomas, NM (2018). Nurse practitioner consultations in primary health care: patient, carer, and nurse practitioner qualitative interpretations of communication processes. Primary Health Care Research and Development. 20 (e37). https://doi.org/10.1017/S1463423618000427
Nurse practitioner consultations in primary health care: an observational interaction analysis of social interactions and consultation outcomes
Barratt, J and Thomas, NM (2018). Nurse practitioner consultations in primary health care: an observational interaction analysis of social interactions and consultation outcomes. Primary Health Care Research and Development. 20 (e37). https://doi.org/10.1017/S1463423618000427
Nurse practitioner consultations in primary health care: a case study-based survey of patients’ pre-consultation expectations, and post-consultation satisfaction and enablement
Barratt, J and Thomas, NM (2018). Nurse practitioner consultations in primary health care: a case study-based survey of patients’ pre-consultation expectations, and post-consultation satisfaction and enablement. Primary Health Care Research and Development. 20. https://doi.org/10.1017/S1463423618000415
Fathers’ presence in the birth room – implications for professional practice in the Caribbean
Ocho, O, Lootawan, K A and Moorley, CR (2018). Fathers’ presence in the birth room – implications for professional practice in the Caribbean. Contemporary Nurse. 54 (6), pp. 617-629. https://doi.org/10.1080/10376178.2018.1552524
A case study of the nurse practitioner consultation in primary care: communication processes and social interactions
Barratt, J (2016). A case study of the nurse practitioner consultation in primary care: communication processes and social interactions. PhD Thesis London South Bank University School of Health and Social Care https://doi.org/10.18744/PUB.000476
Stroke among African-Caribbean women: lay beliefs of risks and causes.
Moorley, CR, Cahill, S and Corcoran, N (2016). Stroke among African-Caribbean women: lay beliefs of risks and causes. Journal of Clinical Nursing. 25 (3-4), pp. 403 - 411. https://doi.org/10.1111/jocn.13061
First year nursing students’ experiences of social media during the transition to university: a focus group study
Moorley, CR (2016). First year nursing students’ experiences of social media during the transition to university: a focus group study. Contemporary Nurse. https://doi.org/10.1080/10376178.2016.1205458
The condom imperative in anal sex – one size may not fit all: A qualitative descriptive study of men who have sex with men (MSM).
Nevillie, S, Adams, J, Moorley, CR and Jackson, D (2016). The condom imperative in anal sex – one size may not fit all: A qualitative descriptive study of men who have sex with men (MSM). Journal of Clinical Nursing. 25 (23-24), pp. 3589-3596. https://doi.org/10.1111/jocn.13507
Being Responsive: Promoting LGBTI Health and Well-being.
Moorley, CR, Nevillie, S and Johnson, J (2016). Being Responsive: Promoting LGBTI Health and Well-being. Journal of Clinical Nursing. 25 (23-24), pp. 3413-3414. https://doi.org/10.1111/jocn.13596
Improving the physical health assessment of people with serious mental illness
Bardi, J and Moorley, CR (2016). Improving the physical health assessment of people with serious mental illness. Primary Health Care. 26 (10), pp. 28-33. https://doi.org/10.7748/phc.2016.e1149
Editorial: Defining, profiling and locating older people: an inner city Afro-Caribbean experience
Moorley, CR and Corcoran, N (2014). Editorial: Defining, profiling and locating older people: an inner city Afro-Caribbean experience. Journal of Clinical Nursing. 23 (15-16), pp. 2083 - 2085. https://doi.org/10.1111/jocn.12487