The significance of cognitive modeling in building healthcare interfaces.
BACKGROUND
Although there are many reasons that widespread adoption of healthcare information systems has not transpired, one reason is a failure to take into account the cognitive needs of the users.


OBJECTIVE
To understand the cognitive needs of nurses and physicians and determine how these needs should influence the design of healthcare interfaces.


METHODS
A qualitative and quantitative study that compares how nurses and physicians comprehend patient information.


METHODS
Twenty-four registered nurses and twenty-four physicians working in the specialties of gastrointestinal or internal medicine.


METHODS
Each clinician reviewed two mock electronic medical records and summarized the cases using a think-aloud protocol. All verbalizations were coded for medical and conceptual information.


RESULTS
The nurses included a larger mean proportion (p<0.001) of recalls than did the physicians. As compared to the nurses, the physicians included a statistically significant (p<0.001) larger mean proportion of inferences, conditional statements, and interventions. The nurses concentrated on functional problems, whereas the physicians focused on diagnosis, treatment, and management.


CONCLUSIONS
The main cognitive differences between the physicians and the nurses are explained through the differences in their practice models. Therefore, healthcare IT must develop separate interfaces for each discipline to address their unique needs.
Johnson
Constance M
CM
The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, #447 Houston, Texas 77030, USA. cmjohnson@mdanderson.org
Turley
James P
JP
D000328:Adult; D003198:Computer Simulation; D003695:Delivery of Health Care; D005260:Female; D006801:Humans; D008297:Male; D008490:Medical Informatics; D008499:Medical Records; D008875:Middle Aged; D009740:Nursing Staff / Q000523:psychology; D005791:Patient Care; D010820:Physicians / Q000523:psychology; D013850:Thinking; D014481:United States; D014584:User-Computer Interface