Health visitors' clinical decision making
Research type
Research Study
Full title
What is the contribution of conscious and unconscious thought to health visitors' clinical decisions?.
IRAS ID
202237
Contact name
Mary Malone
Contact email
Sponsor organisation
King's College London
Clinicaltrials.gov Identifier
NA, NA
Duration of Study in the UK
2 years, 8 months, 19 days
Research summary
This study explores the clinical decision-making activity of health visitors to identify the contribution of conscious and unconscious thought.
Clinical decision-making is a problem-solving activity which requires a choice to be made from two or more options. Health visitors must make decisions in order to safeguard the health and well-being of children during the first five years of life. As the only health professional universally available to all children at this time, health visitors must also make good decisions in situations that are characteristically complex, uncertain and have limited information. Research to date suggests that health visitors make decisions as part of their day-to-day activity; however, there is a dearth of research about how they do it. This makes it increasing difficult to prepare health visitors for their decision-making role.
The study uses ethnographic participant observation of real-life events to prospectively explore the steps health visitors take when making decisions during day-to-day practice. It draws on the descriptive, Social Judgement Theory, to explain how health visitors usually think or follow ‘rules of thumb’ when making decisions (heuristics). In line with decision-making research this study also uses dual-process theoretical models which illustrate the importance of combining conscious (analytical) and unconscious (intuitive) thought at different stages of the decision-making process. Vignette designed methods and the ‘think-aloud’ data collection method will be used to prospectively explore the actions and judgements that health visitor participants take during real-life decision-making activity.
The study will employ Toulmin’s deductive, ‘Uses of Argument’ Model to promote consideration of the counterargument in addition to belief, opinion and feelings. This approach to data analysis allows construction of the ‘insider’ perspective of the social world of the health visitor decision-maker. It also promotes a deeper understanding of how the individual (health visitor) interprets real-life events and experiences (during one-to-one consultations with clients) and the influence this has on their actions.
The findings of the study will be used to inform the content of future health visitor education programmes. The aim of which is to inform future curricula so that decision-making is made increasingly explicit and the content addresses the skills and knowledge required by health visitors to enable them to reason, draw conclusions and define actions.
REC name
London - Surrey Borders Research Ethics Committee
REC reference
18/HRA/1722
Date of REC Opinion
22 May 2018
REC opinion
Favourable Opinion