REASONING PATTERNS USED IN DECISION MAKING BY COMMUNITY HEALTH NURSES WITH VARYING LEVELS OF PROFICIENCY, EDUCATION, AND EXPERIENCE (EXPERTISE).
Contributors: Columbia University. Teachers College.
Published: 1985
Number of pages: 175
Subjects: Health Sciences, Nursing.
Description: The purpose of this exploratory study was to identify and describe verbalized reasoning patterns used by community health nurses after they responded to a simulated decision making situation, and to examine whether these reasoning patterns were associated with clinical proficiency, educational level, years of experience in nursing practice, and cognitive development concerning causal reasoning on a non-nursing situation.

Fifty-five female practicing community health nurses volunteered for participation in this study. Subjects were tape recorded during a private interview as they responded to a simulated nursing situation about a home visit where the patient's husband is short of breath, and to a causal inference task about plants as developed by Kuhn, Pennington, and Leadbeater (1983). A written proficiency test concerning management of a patient with chronic obstructive pulmonary disease, and a background questionnaire were given following the interview.

Reasoning patterns from the nursing situation were analyzed in part from a cognitive developmental perspective, and in part, from reasoning units, linkages, and strategies empirically derived from this study and a study by Muzio. Nine reasoning pattern factors emerged by factor analysis, and they were as follows: (1) Complex Reasoning with Decision Focus; (2) Decision Making with Undifferentiated Strategy; (3) Information Seeking without Decision; (4) Experience Dictated; (5) Simple Focus-Causal Link to Decision; (6) Decision Timing--Initial versus Reflective Decision Making; (7) Reality or Given Bound; (8) Multiple Hypothesis Creation--Not Situation Bound; and (9) Multiple and Complex Reasoning.

Results showed: (1) negative association between non-nursing causal inference task and Reasoning Pattern Factor 8; (2) negative association between proficiency test and Reasoning Pattern Factor 4; (3) positive association with proficiency test and Reasoning Pattern Factor 8; (4) positive association between highest level of education and Reasoning Pattern Factor 6; and (5) positive association between years of practice in nursing and community health nursing with Reasoning Pattern Factor 1.

Conclusions centered on whether different test situations elicit different types of reasoning and whether these Reasoning Pattern Factors were unique to this greater metropolitan group of community health nurses, or nursing in general.
Notes: Source: Dissertation Abstracts International, Volume: 46-03, Section: B, page: 0797.

Thesis (ED.D.)--COLUMBIA UNIVERSITY TEACHERS COLLEGE, 1985.

School code: 0055.