Abstract
Background: Observation is an important skill for making appropriate nursing decisions and engaging in good practice. However, experts’ observation behavior and cognitive processes cannot be easily verbalized or documented in an objective and accurate manner. Quantitative analysis of the observation behavior of nurses with rich clinical experience will yield effective educational data for fostering and improving nursing students’ observation skills. Objectives: To improve nursing assessment education, the differences in the information gathering processes between clinical nurses and nursing students were analyzed by using a portable eye-tracker. Design: An experimental study. Settings: The experiment was performed at a university in Japan. Participants: The participants were 11 clinical nurses with at least 5 years of clinical experience for postoperative patients, and 10 fourth-year nursing students. Methods: In a mock hospital room, wherein we recreated a situation where a patient in postoperative day 1 was confined to a bed, participants wore an eye-tracking camera and engaged in nursing observation to make an early postoperative ambulation assessment of the patient. Participants’ gaze points and gaze fixation durations were extracted from the gaze measurement data and compared. Results: Clinical nurses had shorter observation times and gaze durations than did nursing students, and focused more on the patient chart, intravenous drip, and indwelling drain. Students gazed for longest at the measuring devices for vital signs. Conclusions: We quantitatively analyzed differences in nursing observation according to clinical experience. Although no significant difference was found in gaze points, nursing students had a greater tendency to focus on information that was numerically displayed. Nurses with clinical experience conducted observations by gazing at information that they needed to focus on the most according to the patients’ postoperative course.
Highlights
Observation is an important skill for making appropriate nursing decisions and engaging in good nursing practice
Since obvious measurement errors were found in the data of one clinical nurse and one nursing student, these two participants were excluded from further analysis
This study showed that clinical nurses spent at least half the time than did nursing students in performing observations to obtain an early postoperative ambulation assessment
Summary
Observation is an important skill for making appropriate nursing decisions and engaging in good nursing practice. From the late 1970s onward, research studies employing eye-tracking instruments have been conducted in the fields of cognitive psychology, pedagogy, and human engineering in order to elucidate the characteristics and decision-making processes involved in linguistic acquisition, ocular movement while driving, and visual searches of skilled technicians [2]-[5]. There appears to be no similar studies on nurse expertise This led us to the notion of quantitatively analyzing observational skills, which are fundamental to nursing practice, by tracking nurses’ gazes in a setting that involves making nursing judgments. Employing eye-tracking instruments would enable us to objectively identify the characteristics of observational skills and compare them among different levels of clinical experience This would involve measuring a series of nurse observation behaviors with an eye-tracking camera equipped while nurses act freely in an environment simulating a clinical setting. Nurses with clinical experience conducted observations by gazing at information that they needed to focus on the most according to the patients’ postoperative course
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