Learning from experience: differences in how novice vs. expert nurses diagnose why an infant is crying

Diagnosing client health problems is a well-recognized task for nurses. This study examined the effects of nursing education and experience on that problem-solving process by comparing the performance of four groups of nurses. Junior and senior nursing students, nursing students who were parents, and pediatric nurses solved two computer-presented problems. The task involved acquiring information in order to evaluate competing causal hypotheses. One problem concerned why an infant was crying and the other was a control problem. A number of group differences were identified. The experienced groups of pediatric nurses and parents differed from the student nurses by using less information and selecting different information units, such as information about the infant's age, earlier in the problems. Parents were the most accurate; they did not select any incorrect hypotheses. The dual roles of education and experience are discussed and it is proposed that computer-presented simulations can be an important tool for understanding problem-solving processes, as well as for promoting clinical skill development.