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Cited by 119Clinical Reasoning and Diagnostic SkillsDecision-Making and Behavioral EconomicsHealth Sciences Research and Education

Clinical decision‐making by midwives: managing case Complexity

Cioffi, Jane, Markham, Roslyn·1997·Journal of Advanced Nursing
DOI 10.1046/j.1365-2648.1997.1997025265.x
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Abstract

In making clinical judgements, it is argued that midwives use 'shortcuts' or heuristics based on estimated probabilities to simplify the decision-making task. Midwives (n = 30) were given simulated patient assessment situations of high and low complexity and were required to think aloud. Analysis of verbal protocols showed that subjective probability judgements (heuristics) were used more frequently in the high than low complexity case and predominated in the last quarter of the assessment period for the high complexity case. 'Representativeness' was identified more frequently in the high than in the low case, but was the dominant heuristic in both. Reports completed after each simulation suggest that heuristics based on memory for particular conditions affect decisions. It is concluded that midwives use heuristics, derived mainly from their clinical experiences, in an attempt to save cognitive effort and to facilitate reasonably accurate decisions in the decision-making process.

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  • No studies relating to expertise have been undertaken, in Australia or elsewhere, which focus on nephrology nursing.

    “While studies relating to expertise have been undertaken in a range of nursing contexts and specialties (see for example Benner et al 1992, Greenwood & King 1995, Cioffi & Markham 1997, King & Macleod Clark 2002, Reischman & Yarandi 2002) to date none have been undertaken, in Australia or elsewhere, which focus on nephrology nursing.”

    From The acquisition and exercise of nephrology nursing expertise: a grounded theory study (2006) · cites this paper as Cioffi & Markham 1997

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Authors
Cioffi, J., & Markham, R.
Affiliations
  • Western Sydney University (AU)
  • The University of Sydney (AU)
ORCID
Cioffi, Jane
Venue
Journal of Advanced Nursing
Publisher
Wiley
Published
1997-02
Volume
25
Issue
2
Pages
265-272
ISSN
  • 0309-2402 (ISSN-L)
  • 1365-2648
DOI
10.1046/j.1365-2648.1997.1997025265.x
OpenAlex
W2020323129
Cited by
119
References
32
Citations by year
2026: 2 · 2025: 1 · 2022: 3 · 2019: 4 · 2018: 5 · 2017: 3 · 2016: 3 · 2015: 1 · 2014: 6 · 2013: 5 · 2012: 7
FWCI
5.16
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 4165 d)
Locations
  • Journal of Advanced Nursing (publishedVersion)
  • PubMed (publishedVersion)
Funders
Tehran University of Medical Sciences and Health Services
Topics
  • Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
  • Social Sciences › Decision Sciences › General Decision Sciences › Decision-Making and Behavioral Economics
  • Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
Keywords
midwives, clinical decision-making, heuristics, representativeness heuristic, case complexity, patient assessment, think-aloud, verbal protocols, clinical judgment, memory-based decision making, cognitive effort
MeSH terms
Decision Making, Female, Humans, Interviews as Topic, Nurse Midwives, Nursing Assessment, Students, Nursing, Tape Recording, Case Management

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