How did the readings influence your perception of your own clinical decision-making? How do we reconcile the value of nursing experience with known heuristics and biases used in human decision making?
Until I completed the readings for this module, I fancied myself to be the kind of nurse who is up to date on the latest evidence based guidelines and could easily incorporate them into my clinical decision making. Now I see that I relied upon my own clinical experience, or the clinical experience of others, to shape the majority of my decisions. It appears that I am not that different from most nurses in that I "rely heavily on experience to meet the information needs associated with decision choices under conditions of uncertainty" (Thompson, 2003). The benefits to incorporating evidence based decision support systems (DSS) into my nursing practice are pretty clear. I just need to get over my technophobic ways and embrace some of the DSS that are currently in use and think about ways that I could contribute to the development of a nursing specific DSS.
Reconciling the value of nursing experience with known heuristics and biases used in human decision making looks to be quite an undertaking. Thompson offers the following suggestions for reconciling the effects that heuristics and bias can have on human decision making: avoid making predictions in unfamilliar domains; adjust your own personal confidence estimates downwards; look for objective sources of feedback on your decisions; don't get stuck in the past, explore alternative possible outcomes that could have occured; and learn how to use base rates appropriatley in your decision making (Thompson, 2003).
Reference:
Thompson, C.(2003). Clinical experience as evidence in evidence-based practice. Journal of Advanced Nursing, 43(3), 230-7.
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