The Science Journal of the American Association for Respiratory Care

2004 OPEN FORUM Abstracts

EARLY RECOGNITION AND CRITICAL THINKINGIN CLINICAL PRACTICE

Lynda T. Goodfellow, Ed.D. RRT and Ptlene Minick, Ph.D., RN Department of Cardiopulmonary Care Sciences and School of Nursing, Georgia State University, Atlanta, GA USA.

One would believe that the greater the healthcare provider knowledge and expertise, the more positive the patient outcomes, yet there are little data to support this premise. The purpose of this study was to develop a single instrument that would measure different aspects of clinical expertise in registered nurses (RNs) and respiratory therapists (RTs). In a pilot project, two previously tested instruments were combined to captures skill elements needed by both RNs and RTs in critical care areas. A descriptive correla-tional comparative research design was used. The sample consisted of RTs and RNs in critical care areas who provide direct patient care for at least 50% of their day-to-day assignment. All RNs enrolled in a graduate nursing course and all RTs on a respiratory therapy alumni list were invited to participate. IRB approval was obtained. The number of cases analyzed was 161. Reliability coefficients for early recognition and critical thinking behaviors are as follows:

Construct RN RRT
Early recognition (full scale) .85 .86
Knowing the patient .83 .87
Knowing the self .60 .61
Knowing the institution .67 .65
Critical thinking (full scale) .88 .95
Prioritizing .91 .91
Trouble shooting .82 .83
Reflecting .79 .79
Communicating .73 .83
Anticipating .78 .66
Negotiating .37 .87
Decision making .72 .77

The combined instrument appears to be a stable instrument. This initial pilot study provides the basis for further study of exploring the relationship between clinical expertise of the healthcare employee to better outcomes for the patient.

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