Nurses’ Professional Judgement of Emergency Cases. A Pilot Randomised Controlled Trial to Enhance the Unterstanding of Decision-Making

Master's Thesis , 2023 , 74 Pages , Grade: A

Business economics - Business Management, Corporate Governance

This study serves as a pilot project utilizing simulation-based research tools to enhance understanding of decision-making processes and judgments in critical, clinical contexts. The aim is to conduct a 'noise audit' simulation to capture decision outcomes and analyze variances resulting from judgmental errors, particularly from a 'non-practitioner' standpoint. A blinded, randomized controlled trial employing Simulation-Based Research (SBR) methods was conducted with control and experimental groups. Participants used a custom web-application to self-report mood, score triage judgments on fictitious emergency cases, provide justifications, and share personality traits. Sessions were held at hospital administration buildings and university campuses, with no interaction with academic personnel on setup.

The study explores the concept of smoke detectors in managerial decision-making, recognizing errors and judgments as inherent to decision processes faced by organizational leaders and decision-makers. Bias and noise, identified as contributors to errors, are examined, with bias referring to systematic distortion and noise to variability or randomness in decision information. Empirical studies have demonstrated their impact, particularly in medical decision-making. Strategies such as bias recognition training and noise reduction through multiple information sources can mitigate human error. The study aims to deepen understanding of decision-making in critical contexts through simulation-based research tools.

Inhaltsverzeichnis (Table of Contents)

• 1. Introduction
  • 1.2 Goals
  • 1.3 Rationale
  • 1.4 Description
  • 1.5 Summary
• 2. Review of the Literature
  • 2.1 The Concept of Bounded Rationality
  • 2.2 Total Error and Unwanted Variability in Judgement
  • 2.3 Kahneman's view of Total Error: identifying 'Noise' in the real world
  • 2.4 The Role of Mood, Personality and Emotions in Decision-making
  • 2.5 Decisions under critical Conditions: The Case for Emergency Medicine
  • 2.6 Research Questions and Hypotheses
• 3. Method
  • 3.1 Study Design
  • 3.2 Sampling
  • 3.3 Drafting and development of hypothetical vignettes
  • 3.5 Measuring the Effect of Mood and Personality
  • 3.6 Procedure
• 4. Results
  • 4.1 Population description
  • 4.2 Professional nurses' differences in their judgement of emergency case scenarios
  • 4.3 Qualitative Data Analysis
  • 4.4 Consistency in Justifying Judgements
  • 4.5 Observations outside the main research scope
  • 4.6 Summary
• 5. Discussion
  • 5.1. Interpretation of Key Findings
  • 5.2 Opportunities and Implications for Future Research
  • 5.3 Contribution to Knowledge, Theory and Practice

Zielsetzung und Themenschwerpunkte (Objectives and Key Themes)

The study aimed to investigate the occurrence of judgemental error in emergency healthcare situations. It utilized an experimental, blinded, randomized controlled trial with simulation-based research methods to analyze decision outcomes in a controlled environment. The research sought to identify the factors contributing to variability in nurses' judgments of emergency cases and explore the impact of mood, personality, and time pressure on their decision-making.

• Bounded rationality and its influence on decision-making
• Judgemental error and the concept of noise in professional judgments
• The role of mood, personality, and emotions in emergency medical decision-making
• The effectiveness of simulation-based research in studying professional judgments
• The implications for improving emergency healthcare management and reducing cognitive biases

Zusammenfassung der Kapitel (Chapter Summaries)

The Introduction provides an overview of the research project, outlining its purpose, rationale, and methodology. Chapter 2 reviews existing literature on bounded rationality, judgemental error, noise, and the role of mood, personality, and emotions in decision-making. It also discusses the specific challenges of making decisions in emergency medicine. Chapter 3 details the research methodology, including the study design, sampling strategy, vignette development, and data collection procedures. Chapter 4 presents the findings of the study, focusing on the differences in nurses' judgments of emergency case scenarios and the impact of mood, personality, and time pressure on their decision-making. This chapter also explores the consistency of nurses' justifications for their judgments and examines observations beyond the main research scope.

Schlüsselwörter (Keywords)

The study explores key concepts such as bounded rationality, judgemental error, variance analysis, system noise, and healthcare management. It focuses on emergency medicine, specifically on triage decisions and the application of simulation-based research. The research examines the influence of mood, personality, and emotions on decision-making in critical situations.

• College: University of Malta (Ecnonomics, Management, Accountancy)
• Course: Management
• Grade: A
• Author: Anonym (Author)
• Publication Year: 2023
• Pages: 74
• Catalog Number: V1446195
• ISBN (PDF): 9783963553318
• ISBN (Book): 9783963553325
• Language: English
• Tags: Noise, evidence-based, management, cognitive behavioural psychology, system noise, error,, occupational psychology, i/o psychology, judgemental error, variance analysis, healthcare, triage, simulation-based research