The significance of cognitive modeling in building healthcare interfaces

Summary 

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.

Aim

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

Design of study

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

Setting

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.

Conclusion

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.

Keywords: Nursing informatics, Medical informatics, Cognitive modeling, Healthcare systems, Human–computer interaction