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Clinical practice guideline-related knowledge representation models and comprehension-generated inferences of nurse practitioners and physicians at varying levels of expertise.

机译：临床实践指南相关的知识表示模型以及不同专业水平的护士和医生的理解推论。

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摘要

Clinical practice guidelines (CPGs) are intended to provide evidence-based knowledge for decision making for patient care. However, these guidelines have been poorly adopted by healthcare providers. One reason for this may be the static paper-based formats, isolated from the point of care. Biomedical informatics has provided a solution to this limitation through Computer Interpretable Guidelines (CIGs). An essential component of this process is CPG translation to a computer-interpretable model; comprehension of the CPG is a prerequisite to this process. Although physicians and Advanced Practice Nurses (APNs) are both CPG users, in the guideline modeling literature, the CPG translators are typically physicians, suggesting that the models reflect physician comprehension of CPGs. It is not known if APNs and physicians comprehend CPGs similarly and whether CPG comprehension varies by level of expertise. Therefore, this descriptive study utilized novice and expert APN and physician participants (n=12) using a CPG for screening for and treating tobacco use and dependence for a simulated patient task to determine if the comprehended CPG-related knowledge content and structure differed by discipline or by level of expertise (novice and expert). Methods. After gathering demographic data from each participant, Think Aloud technique was employed to obtain verbal protocols as data. This data set was derived as the participant was thinking aloud while using the study CPG to plan care for a simulated patient. After planning the simulated patient's care, each participant drew a representative model of the study CPG from recall. Methods of analysis for the verbal protocol data set included protocol, discourse, and content analyses. Structural and content analyses were employed for the examination of the recalled drawings. Results. The results of this study are derived from the examination of comprehension activity types, comprehension-generated inferences of knowledge content and structure made during the study task, and recall of the study CPG knowledge content and structure after completing the study task. The results indicate similarities and differences in the comprehension of the study CPG between the participants, grouped by discipline and level of expertise. The disciplines similarly employed types of comprehension activities during the study task. The disciplines differed in their comprehension-generated inferences of knowledge content; the physicians inferred more content during the study task. (Abstract shortened by UMI.)
机译：临床实践指南（CPG）旨在为患者护理决策提供循证知识。但是，这些准则并未被医疗保健提供者广泛采用。造成这种情况的原因之一可能是与护理无关的静态纸质格式。生物医学信息学已通过计算机可解释性指南（CIG）提供了针对此限制的解决方案。此过程的重要组成部分是将CPG转换为计算机可解释的模型；理解CPG是该过程的前提。尽管医师和高级执业护士（APN）都是CPG的使用者，但在指南建模文献中，CPG的翻译者通常是医师，这表明模型反映了医师对CPG的理解。尚不清楚APN和医师是否对CPG的理解类似，以及CPG的理解是否因专业水平而异。因此，这项描述性研究利用APG的新手和专家APN和医师参与者（n = 12），使用CPG筛选和治疗烟草使用情况以及对模拟患者任务的依赖性，以确定所理解的CPG相关知识内容和结构是否因学科而异或按专业知识水平（新手和专家）。方法。从每个参与者收集人口统计数据后，采用Think Aloud技术获取口头协议作为数据。该数据集是由于参与者在使用研究CPG计划模拟患者的护理时大声思考而得出的。在计划了模拟患者的护理计划之后，每个参与者从召回中得出了研究CPG的代表性模型。口头协议数据集的分析方法包括协议，话语和内容分析。使用结构和内容分析来检查召回的图纸。结果。这项研究的结果来自对理解活动类型的检查，在研究任务中对知识内容和结构的理解生成的推论以及完成研究任务后对研究CPG知识内容和结构的回忆。结果表明，参加者在研究CPG理解上的异同（按学科和专业水平分组）。这些学科在学习任务中同样采用了各种理解活动。这些学科在理解产生的知识内容推论上有所不同。医生在研究任务中推断出更多的内容。 （摘要由UMI缩短。）

著录项

  • 作者

    Roberts, William Daniel.;

  • 作者单位

    Columbia University.;

  • 授予单位 Columbia University.;
  • 学科 Health Sciences Nursing.; Psychology Cognitive.
  • 学位 D.N.Sc.
  • 年度 2006
  • 页码 195 p.
  • 总页数 195
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 预防医学、卫生学;心理学;
  • 关键词

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