The Structure of Clinical Judgment Making Based on Nurse's Visual Observation

To elucidate the structure of nurses’ clinical decisions based on visual observation; we established objectives targeting nurses with varying levels of experience. Subjects: Thirty-three nurses. As simulated patient information, written information on an 85-year old inpatient with pneumonia was provided to subjects. Four images of a simulated patient room with the simulated patient in the bed, each image was displayed on the monitor for five seconds. After observation, while confirming the path of line of sight during observing simulated patient room images, which was measured with Talk Eye II, subjects reviewed their thought processes and made an oral report. No significant differences were observed in indices of eye movement based on years of clinical experiences. But, this indicated that potential awareness and peripheral vision might be used to prioritize the order of areas to observe. There were 58 types of observation items, and then divided into the seven categories. From the relationship of included in the thought process, four types of thoughts were extracted. Overall, the proportion of visual observation being reflected in verbal data was 50.4–68.9%. Among nurses with 10 or more years of clinical experience, their visual observation was reflected in verbal data slightly less than among nurses with less clinical experiences. The results of analyses showed the eye movement of nurses, potential awareness and peripheral vision were used to determine the priority of areas for observation. In addition, during the observation of a simulated patient room, and years of clinical experience affected thought type.