Novice nurse information needs in paper and hybrid electronic-paper environments: a qualitative analysis

A within group, laboratory, experimental study of nurse information seeking was conducted. As a part of the study, 35 novice nurses assessed and planned the care of two patients in two simulation environments: a paper (PR) environment and a hybrid (HY) environment [i.e., part of the environment was made available in electronic form via an electronic patient record (EPR) and part of it was paper-based]. Subjects were asked to "think aloud" in each environment and participated in a cued recall session following participation in the simulations. Subjects' verbalizations and actions were audio and video recorded and then transcribed. In the first phase of the study audio and video data were qualitatively coded using Model Based Coding with concepts from Newcomer Information Seeking Theory (NIST). This paper presents the qualitative results of this study with a focus upon the types of information used by novice nurses during the assessment and planning of patient care. Qualitative findings revealed novice nurses used referent, relational and appraisal information (as predicted by NIST theory and research) including information composed of more than one type of information (e.g., referent-relational). Two new types of information emerged from the qualitative data - situational task and situational organization information.