911: Card Sorts Help "Unpack" Clinician Perspectives on Patient Condition and Treatment Priorities
ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX
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Learning Objectives Patient care in the burn intensive care unit BICU is complex and understanding clinician decision making is a challenging. We developed a card sort to learn how clinicians perceive patient condition and how they prioritize care. Results will support development of cognitive aids to improve communication and decision making. Methods We developed the card sort through serial interviews with experts in burn critical care. The interviews discovered 10 categories of information that clinicians use to assess patient condition features and 9 categories of care elements treatment they use to manage patient care. This resulted in 97 total cards 67 features and 30 treatments. During the card sorts, clinicians were asked to identify a patient s severity of illness on a scale from could die today to could leave the ICU today. Clinicians then reviewed cards. They chose the cards they considered important to how they identified the patient s condition and what treatments should be given. The resulting arrangement of cards depicts a visual representation of the mental model they use to understand and care for patients. Results The research team completed 133 card sorts were performed on clinicians from three backgrounds nurse, physician, other caring for 70 patients. Clinician experience ranged from 0 42 years. Card sorts took on average 32 minutes to complete. Of the cards that were chosen, clinicians identified identical feature cards 48 23 of the time, and treatment cards 55 25 of the time. While most clinicians identified severity of illness similarly, there were notable differences with perceptions related to 7 patients 3 point variance. Clear patterns of clinician perspective emerged that can be used to develop cognitive aids. Conclusions Card sorting is a simple, effective method to help clinicians unpack their complex, intuitive understanding of patients and how they prioritize information and treatment.
- Medicine and Medical Research