IMPACT OF TIME CONSTRAINTS ON CLINICAL DIAGNOSTIC REASONING POLICIES AND PERFORMANCE: AN ADAPTATION OF REASONING TO TIME PRESSURE

Purpose: ,

Time constraint is a significant factor that influences clinical judgement and decision making. This study aims to evaluate nurses’ diagnostic reasoning policies and performance under time constraint in a simulated acute care setting.

Method(s): ,

Ninety-seven nurses were exposed to 25 clinical scenarios under time constraint and no time constraint conditions in a simulated acute care setting.  In 12 of the scenarios only 20 seconds per judgement was allowed, in the other 13 scenarios no time constraint existed. The proportion of correct judgments in both situations was calculated. The logistic regression modelling was used to assess the relationship between their judgments and information cues utilised.  Relative weights were calculated to capture the degree of attention paid to particular information cues.

Result(s):

There was no significant difference in the proportion of correct judgments between the time constraint and no time constraint conditions. However, time constraint significantly impacted on the reasoning policies used. Results showed that nurses used fewer cues to reach their clinical judgements under time constraint, with the relative weight of heart rate being much smaller in the time constraint model. 

Conclusion(s):

Time constraint had a significant impact on nurses’ diagnostic reasoning policies but not outcomes. Nurses tended to use less information cues to reach their judgements under time pressure without the expense of reasoning performance. Nurses showed adaptive reasoning when making clinical judgements under time constraints.