THE COGNITIVE STRUCTURE OF CLINICAL EXPERTISE (NURSE CLINICIANS).
Contributors: University of Rochester.
Published: 1992
Number of pages: 233
Subjects: Health Sciences, Nursing.; Psychology, Industrial.
Description: The purpose of this research was to explore the relationships among level of expertise, cognitive structure of clinical concepts, traditional measures of expertise, and valuation of caring activities for nurse clinicians. For this study 84 nurses were identified as either expert or nonexpert by their peers. In addition, 40 nurses with less than six months of clinical experience were identified as novices. All subjects (n = 124) rated 351 pairs of clinical concepts for their degree of dissimilarity. Cognitive maps were created from these data using multidimensional scaling and the Pathfinder network algorithm. Valuation of caring activities was measured using Larson's CARE-Q.

A relationship was demonstrated between the level of expertise and the cognitive structuring of clinical concepts. Experts organize their knowledge in a manner different from novices and nonexperts.

Two components of clinical nursing expertise were identified. The first is a professional factor consisting of items traditionally valued by the profession. These items include experience, undergraduate nursing education, professional certification, publications, and professional presentations. The second factor relates more closely to clinical performance. This performance factor includes measures of cognitive structure and peer perception of clinical expertise.

Valuation of caring activities did not vary across level of expertise. Nurses held a consistent perspective on caring activities important within their practice.

Graduate education was correlated with level of expertise. All master's prepared nurses in this sample were identified as expert. The small sample of master's prepared nurses precludes generalization, however.

Further investigation is required to validate the findings of this research. Replication of the results in other samples and using additional clinical concepts will strengthen the two factor conceptualization of clinical nursing expertise.
Notes: Source: Dissertation Abstracts International, Volume: 53-10, Section: B, page: 5145.

Thesis (PH.D.)--THE UNIVERSITY OF ROCHESTER, 1992.

School code: 0188.