Constance M Johnson1, James P Turley. 1. The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, #447 Houston, Texas 77030, USA. cmjohnson@mdanderson.org
Abstract
BACKGROUND: Although there are many reasons that widespread adoption of healthcare information systems has not transpired, one reason is a failure to take into account the cognitive needs of the users. AIM: To understand the cognitive needs of nurses and physicians and determine how these needs should influence the design of healthcare interfaces. DESIGN OF STUDY: A qualitative and quantitative study that compares how nurses and physicians comprehend patient information. SETTING: Twenty-four registered nurses and twenty-four physicians working in the specialties of gastrointestinal or internal medicine. METHODS: Each clinician reviewed two mock electronic medical records and summarized the cases using a think-aloud protocol. All verbalizations were coded for medical and conceptual information. RESULTS: The nurses included a larger mean proportion (p<0.001) of recalls than did the physicians. As compared to the nurses, the physicians included a statistically significant (p<0.001) larger mean proportion of inferences, conditional statements, and interventions. The nurses concentrated on functional problems, whereas the physicians focused on diagnosis, treatment, and management. CONCLUSION: The main cognitive differences between the physicians and the nurses are explained through the differences in their practice models. Therefore, healthcare IT must develop separate interfaces for each discipline to address their unique needs.
BACKGROUND: Although there are many reasons that widespread adoption of healthcare information systems has not transpired, one reason is a failure to take into account the cognitive needs of the users. AIM: To understand the cognitive needs of nurses and physicians and determine how these needs should influence the design of healthcare interfaces. DESIGN OF STUDY: A qualitative and quantitative study that compares how nurses and physicians comprehend patient information. SETTING: Twenty-four registered nurses and twenty-four physicians working in the specialties of gastrointestinal or internal medicine. METHODS: Each clinician reviewed two mock electronic medical records and summarized the cases using a think-aloud protocol. All verbalizations were coded for medical and conceptual information. RESULTS: The nurses included a larger mean proportion (p<0.001) of recalls than did the physicians. As compared to the nurses, the physicians included a statistically significant (p<0.001) larger mean proportion of inferences, conditional statements, and interventions. The nurses concentrated on functional problems, whereas the physicians focused on diagnosis, treatment, and management. CONCLUSION: The main cognitive differences between the physicians and the nurses are explained through the differences in their practice models. Therefore, healthcare IT must develop separate interfaces for each discipline to address their unique needs.
Authors: O Farri; A Rahman; K A Monsen; R Zhang; S V Pakhomov; D S Pieczkiewicz; S M Speedie; G B Melton Journal: Appl Clin Inform Date: 2012-10-31 Impact factor: 2.342
Authors: Thankam P Thyvalikakath; Michael P Dziabiak; Raymond Johnson; Miguel Humberto Torres-Urquidy; Amit Acharya; Jonathan Yabes; Titus K Schleyer Journal: Int J Med Inform Date: 2014-01-20 Impact factor: 4.046
Authors: Alvin D Jeffery; Laurie L Novak; Betsy Kennedy; Mary S Dietrich; Lorraine C Mion Journal: J Am Med Inform Assoc Date: 2017-11-01 Impact factor: 4.497