title: A comparative study on the clinical decision-making processes of nurse practitioners vs. medical doctors using scenarios in a secondary care environment.
abstract: OBJECTIVE
  To investigate the decision-making skills of secondary care nurse practitioners compared with those of medical doctors.
  
  
  BACKGROUND
  A literature review was conducted, searching for articles published from 1990 - 2012. The review found that nurse practitioners are key to the modernization of the National Health Service. Studies have shown that compared with doctors, nurse practitioners can be efficient and cost-effective in consultations.
  
  
  METHODS
  Qualitative research design.
  
  
  METHODS
  The information processing theory and think aloud approach were used to understand the cognitive processes of 10 participants (5 doctors and 5 nurse practitioners). One nurse practitioner was paired with one doctor from the same speciality and they were compared using a structured scenario-based interview. To ensure that all critical and relevant cues were covered by the individual participating in the scenario, a reference model was used to measure the degree of successful diagnosis, management and treatment. This study was conducted from May 2012 - January 2013.
  
  
  RESULTS
  The data were processed for 5 months, from July to November 2012. The two groups of practitioners differed in the number of cue acquisitions obtained in the scenarios. In our study, nurse practitioners took 3 minutes longer to complete the scenarios.
  
  
  CONCLUSIONS
  This study suggests that nurse practitioner consultations are comparable to those of medical doctors in a secondary care environment in terms of correct diagnoses and therapeutic treatments. The information processing theory highlighted that both groups of professionals had similar models for decision-making processes.
authors.affiliation: School of Health & Social Care, London South Bank University, UK.
authors.forename: Stephen
authors.identifier: http://orcid.org/0000-0003-2531-2679
authors.initials: S
authors.lastname: Thompson
authors.affiliation: School of Health & Social Care, London South Bank University, UK.
authors.forename: Calvin
authors.identifier: http://orcid.org/0000-0002-5969-2465
authors.initials: C
authors.lastname: Moorley
authors.affiliation: Faculty of Education, Health and Wellbeing, University of Wolverhamptom, UK.
authors.forename: Julian
authors.initials: J
authors.lastname: Barratt
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D000066491:Clinical Decision-Making; D006801:Humans; D009722:Nurse Practitioners / Q000592:standards*; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D010820:Physicians / Q000592:standards*; D057184:Practice Patterns, Nurses' / Q000592:standards; D010818:Practice Patterns, Physicians' / Q000592:standards; D063127:Secondary Health Care
keywords: consultations; decision-making; medical doctors vs. nurse practitioners; nurse practitioners; scenario interviews