Nurses' Uncertainty in Decision‐Making: A Literature Review
Why this work is in the frame
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Bibliographic record
Abstract
AIM: This paper is a report of the results of a review of the literature conducted with the goal of determining how nurses' clinical uncertainty has been conceptualized in the nursing literature. BACKGROUND: Although existing research has advanced the body of knowledge regarding the concept of uncertainty in decision-making, this has been largely from physicians' viewpoints and from patients' perspectives (patients' uncertainty). Understanding how nurses' experience and act on uncertainty remains relatively unreported. METHOD: A search of Medline, CINAHL, and PubMed databases was conducted to retrieve literature published from 1990 to 2007. The question guiding the literature review was: How has nurses' clinical uncertainty been conceptualized in nursing literature? FINDINGS: Little exploration has been done of nurses' experience of uncertainty in practice. Many investigators have not theorized about the uncertainty in their studies, but have described nurses' uncertainty in the context of clinical decision-making. The findings from these studies indicated that unfamiliarity with the aspects of patient care is a source of uncertainty, and nurses tended to rely on heuristics or on the expertise of colleagues as sources of information for practice decisions. Expressing uncertainties as information needs might help guide information seeking and reduce uncertainty. However, studies indicated that nurses have difficulty recognizing or expressing uncertainties, and as a result, information needs are not recognized and information seeking is not initiated. CONCLUSIONS: A more comprehensive understanding of nurses' uncertainty could lead to the development and implementation of strategies to support nurses in their clinical decision-making and practice. Descriptions are needed about how nurses experience and respond to uncertainty in their practice, and the influence of uncertainty on their information needs and information seeking.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.117 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.002 |
| Bibliometrics | 0.001 | 0.004 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.000 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it