Decision-making in primary care: outcomes from a study using patient scenarios

Area of Science:

• Healthcare Delivery and Policy
• Nursing Practice and Health Services Research

Background:

• Modernizing health services and improving public health necessitate new professional roles and innovative working methods.
• Nurse practitioners are identified as pivotal in the advancement and modernization of healthcare delivery.

Purpose of the Study:

• To investigate and compare the decision-making processes of nurse practitioners and general practitioners.
• To identify differences or similarities in diagnosis and treatment planning when presented with identical patient scenarios.

Main Methods:

• Employed Information Processing Theory and a 'think aloud' protocol to analyze cognitive processes.
• 22 participants (11 general practitioners, 11 nurse practitioners) engaged with six clinical scenarios, including medical photographs.
• Data analysis was conducted using NUD*IST computer software.

Main Results:

• The study revealed more similarities than differences in the decision-making approaches of both groups.
• Hypothesis evaluation emerged as a critical element in the diagnostic and treatment decision-making process.
• Post-procedure justifications confirmed the validity of diagnoses and management plans for both nurse practitioners and general practitioners.

Conclusions:

• Findings support the flexible utilization of nurse practitioners and service-based healthcare delivery models.
• The research validates the application of Information Processing Theory, demonstrating shared cognitive processes between nurse practitioners and general practitioners.
• This study contributes evidence for aligning healthcare provider roles with government policies for enhanced health service delivery.