The treatment of pressure sores: a comparison of novice and expert nurses' knowledge, information use and decision accuracy

The knowledge experts have and the way it is organized is thought to affect their decision accuracy and the information they use to make decisions. This exploratory study examines the information used by experts, the way they organize their knowledge and their decision accuracy when considering treatments for pressure sores. A convenience sample of 14 subjects (seven experts and seven novices) were given a card sorting task and a decision task. The cards for the sort contained photographs of pressure sores and various dressings, which the subjects had to place into meaningful categories. In the decision task they were given a photograph of a pressure sore, together with various items of information which could be used to make a decision about the appropriate treatment for the pressure sore. The accuracy of the subjects' decisions were compared to a 'gold standard' decision formulated by an expert panel. Results indicated that experts were more accurate in their choice of treatments in the decision task, and also focused on specific items of information to make their decisions. The accuracy of their decisions was not linked to the categorization strategy used in the card sorts. The findings from this study indicate that more research into the way in which such treatment decisions are undertaken needs to be carried out. Specifically, the way in which education into wound care treatments affects decision accuracy needs to be identified, and ways of aiding individuals to focus on relevant information explored.