Mental model for information processing and decision-making in emergency care.

Area of Science:

• Nursing
• Emergency Medicine
• Cognitive Psychology

Background:

• Emergency departments (EDs) present challenges to rational decision-making due to uncertainty and time pressure.
• A mental model for nurses' ED decision-making, especially for critical patients, is lacking.
• Understanding nurses' thought processes can improve ED practice and learning strategies.

Purpose of the Study:

• To explore how newly employed nurses process information and act during time-constrained, uncertain emergency situations.
• To identify cognitive strengths and weaknesses in nurses' emergency decision-making.

Main Methods:

• A simulated shock case scenario was used to assess nurses' decision-making under pressure.
• Participants had an 8-minute window to initiate actions.
• Retrospective think-aloud interviews were conducted post-simulation.

Main Results:

• Nurses were better at identifying shock categories than their underlying causes, affecting intervention accuracy.
• A five-step decision-making process was observed: Awareness, Beliefs (presumption), Controlling consequence (first-line action), Deliberate thinking, and Execution (second-line action).
• Cognitive weaknesses were most apparent during the first-line management actions (immediate life-saving activities).

Conclusions:

• Classifying decision-making steps in emergencies offers insight into cognitive strengths and weaknesses.
• Further research is needed to refine understanding and improve nursing practice in critical care settings.