Module 4 - Question #2

Nurses are human, and it’s not humanly possible to collect, organize, store, and readily recall all the data that could be used to best serve our patients….not to mention also keeping up with all the latest evidence developments! Thompson (2003) described that many nursing clinical decisions are made from the ‘evidence’ of their experiential knowledge. And, Kahneman & Tversky (1974) mention how more frequent/common occurrences are easier & quicker to recall than less common ones. These situations (plus lack of time) can lead to errors in judgment. Clinical errors have lead to many of the regulations we face in healthcare today.

A clinical decision support system (CDSS) has an advantage over the human brain in that it has the capability to hold a tremendous amount of organized/categorized data. The application of this tool can provide reminders and assist with decision-making, but it can only provide data based on its programming and may lack the necessary variables to handle a complex patient. The data from a CDSS may have the potential to save nursing time in a one-stop search, but would still need to be used in combination with nursing experience and judgment.

Module 4 - Question #1

The readings were interesting and really got me reflecting about my past clinical decision making and how I’m now having to adapt for my advance practice position. I’ve been a nurse for 26 years, so over the years I’ve acquired experiential knowledge that I’ve used to make various clinical decisions. I think the combination of past experience with evidence based guidelines points toward best patient outcomes today.

I’m now aware of the overconfidence and hindsight heuristics & biases that I have applied in my past. I actually didn’t recognize that I used hindsight until I read about it. However, starting an advanced role where I get to more fully participate in problem-identification and management gives me a whole new outlook…including much more responsibility. It requires an expanded experiential knowledge base, so I currently don’t feel ‘overconfident’ about my abilities at all. I’m excited to learn about the availability of a CDSS and feel it will greatly benefit my practice. I can see that heuristics awareness and use of a decision support system will help me as I develop in my new role.

Module 3 - MIT

My Multiple Intelligences Test scored the following as my top three intelligence types: Logical-Mathematical, Spatial-Visual, and Intrapersonal. One technology that I have found helpful to my learning is an on-line webcast. These are presented in a logical/sequential format with audio & visual capabilities. They are much like attending a conference or workshop but in the comfort of sitting in front of your own computer! Computer-Based Training (CBT) would be a second choice, as long as it was well-planned and organized. Another technology that really helps me to learn is simply searching the internet. In my searches, I’m able to build upon my discoveries in a way that is logical to me.
I think an important benefit of completing these tests are to be more understanding of the variety of learning needs of those we teach – whether it’s a patient, staff member, or student in the academic environment. By understanding the different types of teaching methods that benefit the different learning styles (intelligence types), I can be a more effective teacher in my Clinical Nurse Specialist role.