Related Experiment Videos
Diagnostic decision making: the last refuge for general practitioners?
1Department of Pharmacy & Pharmacology, University of Bath, Claverton, Bath GL6 6AD, UK. prsmw@bath.ac.uk
Social Science & Medicine (1982)
|July 9, 2011
Summary
Independent prescribers, including nurses and pharmacists, are responsible for patient assessment. This paper challenges the notion that diagnostic decision-making is inherently more difficult than prescribing, exploring expertise development for these healthcare professionals.
Area of Science:
- Healthcare Professions
- Clinical Decision-Making
- Medical Education
Background:
- Nurses and pharmacists in the UK became independent prescribers in 2007.
- Independent prescribers manage patient assessment for diagnosed and undiagnosed conditions.
- A prevailing view suggests diagnostic decision-making is a higher-level skill than prescribing.
Purpose of the Study:
- To critically examine the premise that diagnostic decision-making is inherently more difficult than prescribing.
- To explore the relationship between diagnostic and prescribing decision-making within clinical reasoning.
- To consider alternative models for developing diagnostic expertise in nurse and pharmacist independent prescribers.
Main Methods:
- The paper reviews public policy discourse and professional views on clinical decision-making.
- It analyzes the conceptual separation of diagnostic versus prescribing decisions.
- It discusses the development of diagnostic expertise, considering traditional medical models and alternative approaches like deliberate practice.
Main Results:
- Diagnostic decision-making is presented as part of broader clinical reasoning, not entirely separable from prescribing.
- The difficulty of clinical decisions is linked to complexity and uncertainty, not solely to diagnosis.
- The perception of diagnosis as more difficult may stem from professional power dynamics.
Conclusions:
- The inherent difficulty of diagnostic decision-making compared to prescribing is contested.
- Expertise in diagnosis for nurse and pharmacist prescribers can be developed through various methods beyond traditional medical training.
- Alternative educational strategies focusing on deliberate practice and feedback may enhance diagnostic capabilities in non-medical prescribers.
Related Concept Videos
01:10Documentation of Nursing Diagnosis
The nurse documents nursing diagnoses and enters them into the patient record. The identified patient's nursing diagnosis is either written out with a plan of care or entered into the electronic health record.
In some settings, data-driven computerized decision support systems are in place, allowing for more accurate nursing diagnoses. The database within one of these systems includes diagnostic labels defining characteristics, activities, and indicators for nursing. A nurse enters assessment...
In some settings, data-driven computerized decision support systems are in place, allowing for more accurate nursing diagnoses. The database within one of these systems includes diagnostic labels defining characteristics, activities, and indicators for nursing. A nurse enters assessment...
01:30Ethical Dilemmas II
Resolving an ethical dilemma in healthcare involves a systematic approach that considers every aspect of the issue, respecting both the patient's needs and values and the healthcare professional's ethical obligations. Here are potential steps to resolve an ethical dilemma:
01:21Methods of Documentation III: PIE
Problem-intervention-evaluation (PIE) is a systematic approach to documentation used in healthcare settings for clinical decision-making and patient care planning. It is a structured approach to organizing patient data based on problems, interventions, and evaluations. Here's a breakdown of its key features and considerations:
01:25Critical Thinking II
Critical thinking is a cognitive process with several attributes. The attributes of critical thinking include the following:
01:15Methods of Documentation VI: Case Management Model
The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic illness...
For example, a patient with a chronic illness...
01:14Decision Making: Traditional Method
The process of hypothesis testing based on the traditional method includes calculating the critical value, testing the value of the test statistic using the sample data, and interpreting these values.
First, a specific claim about the population parameter is decided based on the research question and is stated in a simple form. Further, an opposing statement to this claim is also stated. These statements can act as null and alternative hypotheses, out of which a null hypothesis would be a...
First, a specific claim about the population parameter is decided based on the research question and is stated in a simple form. Further, an opposing statement to this claim is also stated. These statements can act as null and alternative hypotheses, out of which a null hypothesis would be a...